Senate Bill 444
By: Senators Kirkpatrick of the 32nd, Watson of the 1st, Hodges of the 3rd, Harbison of the
15th and Walker III of the 20th
AS PASSED
A BILL TO BE ENTITLED
AN ACT
To amend Chapter 46 of Title 33 of the Official Code of Georgia Annotated, relating to
certification of private review agents, so as to provide that certain decisions with regard to
the provision of insurance coverage for healthcare services shall not be based solely on
artificial intelligence systems, artificial intelligence, or other software tools; to provide for
definitions; to provide for related matters; to provide for an effective date; to repeal
conflicting laws; and for other purposes.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION 1.
Chapter 46 of Title 33 of the Official Code of Georgia Annotated, relating to certification of
private review agents, is amended by adding a new Code section to read as follows:
<ins>"33-46-7.1.
(a) As used in this Code section, the term:
(1) 'Artificial intelligence' means a machine based system that can, for a given set of
human defined objectives, make predictions, recommendations, or decisions influencing
real or virtual environments.
</ins>
<ins>(2) 'Artificial intelligence system' means an engineered or machine based system that
emulates the capability of a person to receive audio, visual, text, or any other form of
information and use such information to emulate a human cognitive process, including,
but not limited to, learning, generalizing, reasoning, planning, predicting, acting, or
communicating; provided, however, that artificial intelligence systems may vary in the
forms of information they can receive and in the human cognitive processes they can
emulate.
(b) Private review agents and utilization review entities may use artificial intelligence
systems, artificial intelligence, or other software tools, provided that such systems or tools
are a part of a utilization review plan that is in accordance with the standards set forth in
this chapter and the rules and regulations adopted by the Commissioner.
(c) Artificial intelligence systems, artificial intelligence, and other software tools may be
used to automate tasks, reduce administrative burdens, participate in decision-making
processes, and perform other lawful functions; provided, however, that such systems shall
not issue an adverse determination to a patient until a natural person qualifying as a private
review agent or a utilization review entity conducts a utilization review in which a clinical
peer participates. In no event shall artificial intelligence systems, artificial intelligence, or
other software tools supersede the judgment of such clinical peer."
</ins> SECTION 2.
This Act shall become effective on January 1, 2027.
SECTION 3.
All laws and parts of laws in conflict with this Act are repealed.