SB 444: 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

Georgia insurance companies use private review agents and utilization review entities to decide whether to approve or deny coverage for medical treatments. This bill adds a new section to Georgia's insurance law (O.C.G.A. Chapter 46 of Title 33) addressing how artificial intelligence can be used in that process. The bill allows insurers to use artificial intelligence systems, artificial intelligence, or other software tools to automate tasks and help with decision-making, as long as those tools are part of an approved utilization review plan. However, it prohibits AI from issuing a final denial of coverage (called an adverse determination) to a patient on its own. A human private review agent or utilization review entity, including a clinical peer, must be involved before a denial is finalized, and AI cannot override that person's judgment. The law would take effect January 1, 2027.

• Adds a new Code section (33-46-7.1) letting insurers use AI systems for utilization review, but only within an approved review plan.
• Bars AI systems from issuing an adverse determination (a coverage denial) to a patient without a human private review agent or utilization review entity involved.
• Requires a clinical peer, a medical professional with relevant expertise, to participate before a denial is finalized.
• States that AI tools cannot override or supersede the judgment of the clinical peer reviewing the case.
• Defines 'artificial intelligence' and 'artificial intelligence system' for purposes of this insurance law.
• Sets the law to take effect January 1, 2027.

Health insurance companies and their private review agents and utilization review entities in Georgia, the clinical peers (licensed medical professionals) who review coverage decisions, and patients whose insurance claims go through utilization review for healthcare services.

Patients seeking insurance approval for medical care would be guaranteed that a human medical reviewer, not just an automated algorithm, has a role in any decision to deny coverage. This could affect how quickly and how coverage denials are issued by Georgia insurers.

• Section 1 adds Code Section 33-46-7.1 defining 'artificial intelligence' and 'artificial intelligence system' for insurance review purposes.
• Subsection (b) permits private review agents and utilization review entities to use AI tools if they are part of a compliant utilization review plan approved under existing standards and Commissioner rules.
• Subsection (c) allows AI to automate tasks and assist decision-making but bars it from issuing an adverse determination without a human private review agent or utilization review entity and a participating clinical peer.
• Subsection (c) also states AI tools cannot 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 (Senado)
4. 2026-04-10Senate Sent to Governor (Senado)
5. 2026-03-25Senate Agreed House Amend or Sub (Senado)
6. 2026-03-19House Passed/Adopted By Substitute (Cámara de Representantes)
7. 2026-03-19House Third Readers (Cámara de Representantes)
8. 2026-03-18House Committee Favorably Reported By Substitute (Cámara de Representantes)

• Kay Kirkpatrick (R, SD-032)Patrocinador principal
• 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. AprobadaVotación: Senado11 de febrero de 2026

   49 a favor, 0 en contra (0 sin votar, 5 ausentes)

   Passage: Senate Vote #540

2. AprobadaVotación: Cámara de Representantes19 de marzo de 2026

   166 a favor, 0 en contra (3 sin votar, 7 ausentes)

   Passage: House Vote #729

3. AprobadaVotación: Senado25 de marzo de 2026

   47 a favor, 0 en contra (2 sin votar, 5 ausentes)

   Agree To House Substitute: Senate Vote #821

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