SB444: SB444 Private Review Agents; certain decisions with regard to the provision of insurance coverage for healthcare services shall not be based solely on artificial intelligence systems; provide

Under current Georgia law, private review agents and utilization review entities (the companies and staff that decide whether an insurer will cover a medical treatment) are not explicitly barred from letting artificial intelligence make coverage decisions on its own. This bill adds a new section to Georgia's private review agent law (O.C.G.A. Chapter 46 of Title 33) addressing that gap. The bill defines 'artificial intelligence' and 'artificial intelligence system' and allows insurers to keep using such tools to automate tasks and support decision-making, as long as they follow the state's utilization review standards. But it requires that before a patient can be denied coverage (an 'adverse determination'), a human private review agent or utilization review entity must conduct the review with a clinical peer involved, and AI cannot override that person's judgment. The law would take effect January 1, 2027.

• Adds a new Code section (O.C.G.A. § 33-46-7.1) to Georgia's private review agent law setting rules for AI use in health insurance coverage decisions.
• Defines 'artificial intelligence' and 'artificial intelligence system' for purposes of this law.
• Allows private review agents and utilization review entities to keep using AI or software tools for tasks like automation and administrative work, if done under an approved utilization review plan.
• Requires a human private review agent or utilization review entity, working with a clinical peer, to review any case before a coverage denial (adverse determination) is issued to a patient.
• Prohibits AI systems or other software tools from overriding the judgment of the human clinical peer.
• Sets the effective date as January 1, 2027.

Health insurance companies and the private review agents and utilization review entities they use to decide whether to cover medical treatments; clinical peers (medical professionals) who participate in those reviews; and patients in Georgia whose insurance claims are reviewed for coverage decisions.

If a Georgia patient's insurer considers denying coverage for a treatment, this bill would require a real clinical reviewer, not just an algorithm, to make that call. Insurers could still use AI to speed up paperwork and support decisions, but AI alone could not issue a denial.

• Section 1 adds new Code section 33-46-7.1 to Chapter 46 of Title 33, defining 'artificial intelligence' and 'artificial intelligence system' in subsection (a).
• Subsection (b) permits private review agents and utilization review entities to use AI systems or software tools if they operate within an approved utilization review plan under state standards and Commissioner regulations.
• Subsection (c) allows AI to automate tasks, reduce administrative work, and participate in decision-making, but bars AI from issuing an adverse determination (coverage denial) without a human private review agent and clinical peer conducting the review first.
• Subsection (c) also states that AI systems or software tools may never supersede the judgment of the clinical peer involved in the review.
• Section 2 sets the effective date as January 1, 2027.
• Section 3 repeals conflicting laws.

1. 2026-05-05Effective Date 2027-01-01
2. 2026-05-05Act 411
3. 2026-05-05Senate Date Signed by Governor (Senate)
4. 2026-04-10Senate Sent to Governor (Senate)
5. 2026-03-25Senate Agreed House Amend or Sub (Senate)
6. 2026-03-19House Passed/Adopted By Substitute (House)
7. 2026-03-19House Third Readers (House)
8. 2026-03-18House Committee Favorably Reported By Substitute (House)

• Kay Kirkpatrick (R, SD-032)Primary sponsor
• Ben Watson (R, SD-001)
• Mike Hodges (R, SD-003)
• Ed Harbison (D, SD-015)
• Larry Walker (R, SD-020)
• Lee Hawkins (R, HD-027)

1. PassedSenate voteFebruary 11, 2026

   49 yea, 0 nay (0 not voting, 5 absent)

   Passage: Senate Vote #540

2. PassedHouse voteMarch 19, 2026

   166 yea, 0 nay (3 not voting, 7 absent)

   Passage: House Vote #729

3. PassedSenate voteMarch 25, 2026

   47 yea, 0 nay (2 not voting, 5 absent)

   Agree To House Substitute: Senate Vote #821

• health insurance
• artificial intelligence regulation
• utilization review
• insurance coverage denials
• healthcare policy