Private Review Agents; certain decisions with regard to the provision of insurance coverage for healthcare services shall not be based solely on artificial intelligence systems; provide

The definition of 'artificial intelligence system' was expanded from a general description of data systems using AI to a specific definition requiring the system to emulate human cognitive processes like learning, reasoning, and planning.

A new mandatory requirement was added stating that AI systems cannot issue an adverse determination to a patient until a natural person conducting a utilization review with a clinical peer has reviewed the case.

The original language allowing AI to be the sole basis for an adverse determination was removed and replaced with language explicitly prohibiting AI from superseding the judgment of a clinical peer.

The header status was updated to indicate the bill has passed the Senate, which is a procedural change rather than a substantive policy alteration.