March 26, 2026

State lawmakers are pursuing a wide range of artificial intelligence (AI) proposals that broadly fall into three themes: restrictions on AI use in prior authorization or claims processing; healthcare-specific guardrails for clinical AI tools; and broader transparency and privacy requirements for AI-driven consumer communications and data practices.

ACR® draws attention to a major trend in state legislatures to mandate human review of insurance coverage denials and prohibit determinations made solely by AI. Seven bills are under consideration in five states:

  • Alabama Senate Bill (SB) 63 would regulate AI in coverage decisions by requiring insurers to use patient-specific clinical information and disclose AI use in utilization review. It is engrossed and was last placed on the House calendar March 17.
  • Minnesota Senate File 1856 would ban AI use in utilization review. It was referred to the Senate Commerce and Consumer Protection Committee March 18.
  • New Hampshire House Bill (HB) 1406 would require records on AI use and mandate that qualified healthcare professionals make adverse determinations. The bill is pending in the Senate Commerce Committee.
  • Wisconsin SB 1066 would bar insurers and self-insured plans from using AI to deny certain prior authorization requests. It is pending in the Senate Utilities, Technology and Tourism Committee. A related bill, Wisconsin Assembly Bill (AB) 1109, failed March 23.
  • Michigan HB 4537 would block Medicaid from using AI to deny, modify or delay claims. It was referred to the House Communications and Technology Committee March 19.
  • Massachusetts SB 2632 would reserve medical necessity decisions to licensed professionals. It is in the Joint Health Care Financing Committee.

ACR also notes several states are considering measures related to governance and accountability for AI used in care delivery.

  • California AB 2575 would require disclosure of AI tools used in patient care, reinforce that workers may override AI outputs without retaliation, and strengthen accountability around harm tied to AI-informed clinical decisions. The bill was referred to the Assembly Health Committee March 19 and is scheduled for a hearing April 7.
  • Iowa House Study Bill 766 proposes a broad licensing and oversight structure for AI-augmented and autonomous service providers. It was referred to House Appropriations March 18, and was recommended for passage out of subcommittee on March 24.
  • Massachusetts SB 2632 would limit the use of AI and other software tools in healthcare decision-making by preserving licensed professionals’ responsibility for care decisions and adding guardrails around how those tools may be used in healthcare settings. The bill is pending before the Joint Health Care Financing Committee.

ACR’s State Government Relations Committee is available to assist state societies considering advancing legislation related to AI in healthcare. For more information or if you have questions, contact Eugenia Brandt, ACR Senior Government Relations Director.

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