Health Insurance - Utilization Review - Use of Artificial Intelligence (Chapter 747, 2025)
Maryland | HB 820
Categories
Key Requirements
Regulates AI, algorithms and other software tools used in utilization review: such tools may not be the sole basis for an adverse medical-necessity determination, must be applied consistently with the enrollee's individual clinical circumstances, and remain subject to state oversight and audit.
Regulated Parties
Carriers, pharmacy benefit managers and private review agents conducting utilization review in Maryland
Enforcement
Maryland Insurance Administration through carrier and private review agent oversight
Sources
Notes
Signing date confirmed by the Maryland General Assembly's list of bills signed by the Governor on May 20, 2025 (https://mgaleg.maryland.gov/Pubs/LegisLegal/2025RS-bills-signed-or-enacted-05-20-2025.pdf).
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