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New California law prohibits using AI as basis to deny health insurance claims
(www.mercurynews.com)
I wish the other states could have nice things too
this post was submitted on 06 Jan 2025
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That's kinda the good thing about it. If one state, like CA, can make it cost-prohibitive to do two different ways, then if they want to keep their business in CA, they have to play by the same rules everywhere.
In most markets. Insurance is essentially state-by-state though.
No, it is not. Not all countries are stupid enough to have so many systems for the same thing. Or be stupid enough to have 3 bids for the provider of the same benefits highly used by many in 1 state (e.g. California’s C-IV, LRS & CalWIN).
I bet a work around is having the AI assess things, present recommendations, and then a human “makes the final call” by agreeing with the AI. Of course the human is free to make any decision. But you know how it will go.
Apparently that is the case already. HN title has been changed to
Human judgment[!] must remain central to health insurance claims: California law
The headline is misleading. The bill allows AI and algorithms to be used, as long as it doesn't supplant a licensed medical professional deciding (K.1.D), or violate civil rights along with a few other things, but it's not outright prohibited as the headline could be interpreted.
Section K.1 of SB 1120
https://leginfo.legislature.ca.gov/faces/billTextClient.xhtm...
(old title was some thing like New California law prohibits using AI as basis to deny health insurance claims)
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