NC Lawmakers Move to Regulate AI in Health Insurance
In brief
- North Carolina lawmakers are proposing a new law to limit the use of artificial intelligence in health insurance decisions.
- This law would stop insurers from using AI to deny claims or prior authorization requests without human involvement.
- The proposed law aims to prevent AI from causing higher healthcare costs through a practice called upcoding.
- Upcoding happens when hospitals and healthcare providers use higher billing codes to get more money from insurers.
- This can lead to higher premiums for patients.
- The law would require human review of billing codes to prevent AI from pushing towards more expensive codes.
- The new law could help reduce healthcare costs in North Carolina, which has some of the highest costs in the nation.
- Lawmakers will now review the proposal and decide whether to pass it into law.
Terms in this brief
- Upcoding
- A practice where healthcare providers use higher billing codes to receive more money from insurers, potentially increasing costs for patients. The proposed law aims to prevent AI from encouraging this by requiring human review of billing codes.
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