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

26 LC 46 1522S 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 to1 certification of private review agents, so as to provide that certain decisions with regard to2 the provision of insurance coverage for healthcare services sha ll not be based solely on3 artificial intelligence systems, artificial intelligence, or other software tools; to provide for4 definitions; to provide for related matters; to provide for an effective date; to repeal5 conflicting laws; and for other purposes.6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:7 SECTION 1.8 Chapter 46 of Title 33 of the Official Code of Georgia Annotated, relating to certification of9 private review agents, is amended by adding a new Code section to read as follows:10 "33-46-7.1.11 (a) As used in this Code section, the term:12 (1) 'Artificial intelligence' means a machine based system tha t can, for a given set of13 human defined objectives, make predictions, recommendations, or decisions influencing14 real or virtual environments.15 S. B. 444 - 1 - 26 LC 46 1522S (2) 'Artificial intelligence system' means an engineered or ma chine based system that16 emulates the capability of a person to receive audio, visual, t ext, or any other form of17 information and use such information to emulate a human cognitive process, including,18 but not limited to, learning, generalizing, reasoning, planning , predicting, acting, or19 communicating; provided, however, that artificial intelligence systems may vary in the20 forms of information they can receive and in the human cognitiv e processes they can21 emulate.22 (b) Private review agents and utilization review entities may use artificial intelligence23 systems, artificial intelligence, or other software tools, provided that such systems or tools24 are a part of a utilization review plan that is in accordance with the standards set forth in25 this chapter and the rules and regulations adopted by the Commissioner.26 (c) Artificial intelligence systems, artificial intelligence, and other software tools may be27 used to automate tasks, reduce administrative burdens, particip ate in decision-making28 processes, and perform other lawful functions; provided, however, that such systems shall29 not issue an adverse determination to a patient until a natural person qualifying as a private30 review agent or a utilization review entity conducts a utilization review in which a clinical31 peer participates. In no event shall artificial intelligence systems, artificial intelligence, or32 other software tools supersede the judgment of such clinical peer."33 SECTION 2.34 This Act shall become effective on January 1, 2027.35 SECTION 3.36 All laws and parts of laws in conflict with this Act are repealed.37 S. B. 444 - 2 -