ATLANTA — Georgia lawmakers are looking to limit how health insurance companies use artificial intelligence.
SB 444 passed the state Senate unanimously. It says, “decisions with regard to the provision of insurance coverage for healthcare services shall not be based solely on artificial intelligence systems.”
State Senator Kay Kirkpatrick, a retired orthopedic surgeon, is the bill’s sponsor.
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“There needs to be a human review of the information before they turn you down for your treatment that your doctor ordered,” Kirkpatrick told Channel 2 Consumer Investigator Justin Gray.
A survey by the National Association of Insurance Commissioners of 93 large health insurers found it is already happening.
Of those companies, 43% say they already use or plan to use AI for claim adjudication. Another 26% say they already use or plan to use it for benefit determinations.
Georgia Watch Executive Director Liz Coyle says there already is a large problem with insurance claim denials, and AI could make that worse.
“A doctor has said they need potentially life-saving procedures and to think that you’d let a robot make a life-and-death decision like that is completely unacceptable,” Coyle said.
Data compiled by KFF Health News found 20% of all claims across Affordable Care Act marketplace plans were denied in 2023. Those plans are required by law to disclose denials.
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There were concerns raised in a House committee on Wednesday that some of the language in the bill needed to define the human role more clearly in the claim process.
“A clinical peer could, for all intents and purposes, review it for a microsecond and sign it without truly making that review and letting it pass through 100% of the time,” said State Representative Todd Jones (R- Forsyth).
Senator Kirkpatrick says the doctors she talks to are excited about the role AI could play in speeding up and streamlining the frustrating bureaucracy of health insurance, but not when it comes to medical decisions.
“We’re not at the point where we can get rid of humans and doctors, and if I’m a patient, I want a doctor looking at my stuff before somebody says no,” Kirkpatrick said.
The bill is expected to be back up for a vote before the House Technology committee on March 17.
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