This bill would impose requirements on health care service plans and specialized health care service plans in New York that use AI, algorithms, or other software tools for utilization review or utilization management functions. Core obligations include requiring that AI tools base determinations on individualized enrollee clinical data, not supplant provider decision-making, not discriminate on protected characteristics, be open to inspection, be periodically reviewed for accuracy, and limit patient data use to stated purposes. Adverse determinations based on medical necessity must be made by a licensed physician or competent health care provider considering individualized clinical circumstances. The bill would be enforced by the Department of Financial Services through existing Insurance Law authority. No private right of action is created.