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California's new law mandates insurers to oversee AI-driven prior authorization requests starting January. This legislation aims to address concerns over wrongful denials of medical coverage linked to AI usage by health plans. The law has garnered attention from lawmakers on Capitol Hill, with discussions about potential national legislation to mirror California's approach.
The American Medical Association supports the California law, emphasizing the need for human oversight in AI decisions. Insurers like United Healthcare and Cigna faced lawsuits for improper denials due to AI, highlighting the urgency for regulatory measures. The House Task Force on AI is expected to release recommendations that could shape future AI regulations in healthcare.
• California's law requires oversight of AI in prior authorization by insurers.
• The AMA supports human review of AI-generated care denials.
AI refers to the simulation of human intelligence processes by machines, particularly in healthcare for processing claims.
Prior authorization is a health insurance company's approval process for certain treatments, which is now being regulated for AI use.
Algorithmic oversight involves ensuring that AI algorithms used in healthcare do not lead to discriminatory practices or wrongful denials.
United Healthcare is a health insurance company that faced lawsuits for improper AI-driven coverage denials.
Cigna is another insurer implicated in class-action lawsuits regarding AI misuse in prior authorization processes.
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