Safeguard Health Ins. Utilization Reviews.

SB 287 prohibits health insurers from using artificial intelligence algorithms as the sole basis to deny, delay, or modify healthcare services based on medical necessity. The bill requires that only licensed and qualified healthcare providers make these determinations, and insurers must verify that third-party contractors (like pharmacy benefits managers) comply with this rule. It directly affects health insurers, pharmacy benefits managers, and the North Carolina State Health Plan for teachers and state employees, which must review its contracts and practices for compliance. The law takes effect 30 days after enactment and focuses on ensuring human medical judgment remains central to coverage decisions.