The gist

• Bans health insurers from letting artificial intelligence (AI) deny medical claims. Only licensed humans can make clinical coverage calls.

Who wins, who loses

• Wins: patients fighting claim denials, doctors, mental health advocates, families appealing insurance decisions.
• Loses: insurance companies using automated review tools; AI health-tech vendors selling claims software.

What it does

• Requires a licensed health professional to personally decide any claim denial involving medical judgment.
• Bars treating AI output as presumptively valid; the human must independently evaluate the patient.
• Forces insurers to disclose AI use, its role, and the reviewer's credentials in denial notices.
• Treats AI utilization review as a 'treatment limitation' under mental health parity rules.

Why should I care?

Insurance denials affect families' access to therapy, surgery, and medication. Supporters say AI tools have wrongly rejected claims in bulk, hurting patients who need care fast. Critics argue AI speeds up reviews and lowers costs, and that blanket bans slow legitimate decisions. Where do you land? Vote below and use "Tell Your Rep" to make sure your voice reaches Congress.