HF2500

Purpose

Explain and limit how prior authorization decisions are made by health carriers in Minnesota. The bill adds a prohibition to prevent using automated tools in the determination process for approving or denying a prior authorization request.

Main provisions

• Adds a new subdivision to Minnesota Statutes 2024 section 62A.59.
• Subdivision 3: Algorithm and artificial intelligence use prohibited.
• A health carrier is prohibited from using an algorithm or artificial intelligence program when making a determination to approve or deny a prior authorization request.

Significant changes to existing law

• Establishes a clear ban on using algorithms or AI in the decision-making process for prior authorization determinations.
• Creates a new statutory prohibition within the existing framework governing health insurance prior authorizations (section 62A.59).

Implications and considerations

• The bill changes how health plans must handle prior authorization reviews by removing automated decision-making tools from the process.
• It explicitly restricts the use of algorithmic or AI-based systems for approving or denying prior authorizations, requiring that such determinations be made without those technologies.

Additional context

• The change is enacted through amending Minnesota Statutes 2024, specifically by adding a subdivision to Section 62A.59.

Relevant Terms - algorithm - artificial intelligence - AI - health carrier - prior authorization - prior authorization request review - determination - approve - deny - Minnesota Statutes 2024 section 62A.59 - Subd.3 - prohibited - automated decision-making - health insurance