An Act To Prohibit The Use Of Artificial Intelligence In The Denial Of Health Insurance Claims

LD 1301 prohibits Maine health insurance companies and their contractors from using artificial intelligence to deny, delay, or modify health insurance claims starting January 1, 2026. It requires that any denial based on medical necessity must be made by a clinical peer (a healthcare professional) who reviews the patient’s medical history and provider’s recommendation. The bill also mandates that AI use must be transparent to patients, cannot discriminate based on protected characteristics, and must be reviewed for accuracy. This directly affects health insurers and their third-party reviewers handling claim decisions in Maine.