Regulon — MN-SF-1856 · MN SF 1856 (AI Prohibition in Utilization Review)

2025-02-24 introduced Introduction and first reading

2025-02-24 committee referral Referred to Commerce and Consumer Protection

2025-02-27 Authors added Boldon; Mann; Mohamed Authors added Boldon; Mann; Mohamed

2025-03-10 Author added Mitchell Author added Mitchell

2026-02-26 committee referral Withdrawn and re-referred to Judiciary and Public Safety

2026-03-04 Author stricken Mitchell Author stricken Mitchell

2026-03-18 committee referral Comm report: Amended, No recommendation, re-referred to Commerce and Consumer Protection

Summary

Prohibits the use of artificial intelligence in any part of the utilization review process conducted by utilization review organizations in Minnesota, including review, evaluation, determination, and appeals. Requires the physician making an adverse determination to attest in writing that AI was not used. Any adverse determination made in violation is null and void. The attorney general is authorized to enforce the prohibition under section 8.31. The bill amends Minnesota's existing utilization review statute (Chapter 62M) and does not define specific covered entities beyond utilization review organizations already governed by that chapter.

Enforcement & Penalties

Enforcement Authority

The attorney general may enforce the prohibition under Minnesota Statutes section 8.31, which grants the attorney general broad authority to investigate and bring enforcement actions for violations of laws within its scope. Enforcement is agency-initiated. No private right of action is expressly created by this bill. Additionally, any adverse determination made in violation of the AI prohibition is null and void as a matter of law.

Penalties

The bill does not specify monetary penalties or damages. Remedies available are those under Minnesota Statutes section 8.31, which generally authorizes the attorney general to seek injunctive relief, restitution, and civil penalties for violations. Any adverse determination made using AI in utilization review is declared null and void.

Who Is Covered

Compliance Obligations 3 obligations · click obligation ID to open requirement page

HC-01 Healthcare AI Decision Restrictions · HC-01.1 · Deployer · Healthcare

Minn. Stat. § 62M.20(a)-(b)

Plain Language

Utilization review organizations are categorically prohibited from using artificial intelligence in any part of their utilization review operations — including initial review, clinical evaluation, adverse determinations, and appeals. This goes beyond HC-01.1's requirement that AI not serve as the sole or primary basis for adverse determinations; it is an outright ban on AI use at any stage. Any adverse determination made using AI is automatically null and void, regardless of whether the determination would otherwise have been correct. This is the broadest possible restriction: not merely a human-in-the-loop requirement, but a complete prohibition on AI involvement.

Statutory Text

(a) The use of artificial intelligence is prohibited in utilization review. Without limiting the generality of the foregoing, a utilization review organization is prohibited from using artificial intelligence in any part of its review, evaluation, determination, or appeals processes. (b) Notwithstanding section 62M.14, any adverse determination made in violation of this section is null and void.

HC-01 Healthcare AI Decision Restrictions · HC-01.2 · Professional · Healthcare

Minn. Stat. § 62M.09, subd. 3(a)-(b), (f)

Plain Language

The physician who reviews and makes an adverse clinical determination must hold an unrestricted Minnesota medical license and practice in the same or similar specialty as the treating provider. The bill adds a new requirement that this physician must also attest in writing that artificial intelligence was not used in the utilization review process. This attestation is a compliance artifact — it must be produced for every adverse determination. Any adverse determination made in violation of this attestation requirement is automatically null and void. The existing requirement that a qualified clinical peer make the adverse determination was already in law; the new obligation is the written AI-non-use attestation.

Statutory Text

(a) A physician must review and make the adverse determination under section 62M.05 in all cases in which the utilization review organization has concluded that an adverse determination for clinical reasons is appropriate. (b) The physician conducting the review and making the adverse determination must: (1) hold a current, unrestricted license to practice medicine in this state; and (2) have the same or similar medical specialty as a provider that typically treats or manages the condition for which the health care service has been requested. (f) The physician must attest in writing that artificial intelligence was not used in the utilization review process. Notwithstanding section 62M.14, any adverse determination made in violation of this paragraph is null and void.

Other · Healthcare

Minn. Stat. § 62M.20(c)

Plain Language

This provision authorizes the Minnesota Attorney General to enforce the AI prohibition in utilization review using the powers granted under Minnesota Statutes section 8.31, which provides broad investigative and enforcement authority. It creates no new compliance obligation of its own — it merely designates the enforcement mechanism for the substantive prohibition in section 62M.20(a).

Statutory Text