SF1856 (Legislative Session 94 (2025-2026))
Usage of artificial intelligence in the utilization review process prohibition provision
Related bill: HF1838
AI Generated Summary
Purpose
This bill aims to prohibit the use of artificial intelligence in the health insurance utilization review process, ensuring that decisions about medical necessity, coverage, and related determinations are not made or aided by AI.
Main Provisions
- Defines artificial intelligence (AI) using the federal definition found in United States Code title 15 section 9401.
- Adds a new subdivision (Subd. 2a) to Minnesota Statutes 2024 section 62M.02 to establish the AI-related definition within the state law.
- Prohibits the use of artificial intelligence in utilization review, including any part of the review, evaluation, determination, or appeals processes conducted by a utilization review organization (URO).
Definitions
- Artificial intelligence (AI): Defined by the bill to align with the federal definition in 15 U.S.C. 9401.
- Utilization review and utilization review organization (URO): Terms used to refer to entities and activities that assess the necessity, appropriateness, and efficiency of medical services for coverage and payment decisions.
Changes to Existing Law
- Amends Minnesota Statutes 2024 section 62M.02 by adding Subd. 2a to formally define AI within the context of utilization review.
- Establishes a clear regulatory ban on AI in all stages of utilization review (review, evaluation, determination, and appeals), effectively replacing any prior ambiguity about AI use in UR processes.
Enforcement and Scope
- The prohibition applies to all utilization review activities carried out by a URO (no exceptions stated in the excerpt).
- The amendment references Minnesota’s existing framework for utilization review under section 62M.02 and expands it to cover AI specifically.
Practical Implications
- Health plans and their utilization review organizations must rely on human review in decisions about medical necessity and related determinations; AI tools cannot be used to assist or automate these processes.
- Hospitals, clinics, and providers may see changes in how coverage decisions are communicated and processed if AI had previously played a role in UR activities.
Relevant Terms - artificial intelligence - AI - utilization review - utilization review organization - URO - review - evaluation - determination - appeals - Minnesota Statutes 2024 62M.02 - 62M.02 Subd. 2a - United States Code title 15 section 9401 - health insurance - medical necessity - compliance
If you’d like, I can adjust the language for an even more straightforward, kid-friendly read or add a quick Q&A section for common questions.
Past committee meetings
- Judiciary and Public Safety on: March 16, 2026 12:30
- Judiciary and Public Safety on: March 09, 2026 12:30
Actions
| Date | Chamber | Where | Type | Name | Committee Name |
|---|---|---|---|---|---|
| February 24, 2025 | Senate | Action | Introduction and first reading | ||
| February 24, 2025 | Senate | Action | Referred to | Commerce and Consumer Protection | |
| February 27, 2025 | Senate | Action | Authors added | ||
| March 10, 2025 | Senate | Action | Author added | ||
| February 26, 2026 | Senate | Action | Withdrawn and re-referred to | Judiciary and Public Safety | |
| March 04, 2026 | Senate | Action | Author stricken | ||
| March 18, 2026 | Senate | Action | Comm report: Amended, No recommendation, re-referred to | Commerce and Consumer Protection |
Citations
[
{
"analysis": {
"added": [
"Adds Subd.2a to 62M.02 defining artificial intelligence consistent with the federal definition."
],
"removed": [],
"summary": "Adds Subd.2a to Minnesota Statutes section 62M.02 to define artificial intelligence with a federal definition and support the AI-related provisions in the bill.",
"modified": [
"Amends 62M.02 to include a new subdivision defining AI and tying it to the utilization review context."
]
},
"citation": "62M.02",
"subdivision": "Subd.2a"
},
{
"analysis": {
"added": [
"Imposes a prohibition on the use of artificial intelligence in utilization review under section 62M.20."
],
"removed": [],
"summary": "Prohibits the use of artificial intelligence in utilization review under section 62M.20.",
"modified": [
"Codifies or clarifies the prohibition on AI in utilization review within 62M.20."
]
},
"citation": "62M.20",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Used to define artificial intelligence in the bill by referencing the federal definition in U.S.C. Title 15 §9401.",
"modified": [
"References federal definition of AI from U.S.C. Title 15 §9401 to define AI within Minnesota law."
]
},
"citation": "United States Code Title 15 Section 9401",
"subdivision": ""
}
]Progress through the legislative process
Amendment