AI Frontier Institute

Relating To Health Care.

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Hawaii H.B. 1787 (33rd Legislature, 2026) amends Chapter 432E of the Hawaii Revised Statutes to regulate the use of artificial intelligence (AI), algorithms, and other software tools by health carriers and utilization review organizations in health insurance coverage and claims decisions. Section 2 adds two new sections to Part II of Chapter 432E. The first new section requires that any AI, algorithm, or software tool used in utilization review must base determinations on individual enrollee medical history and clinical circumstances (not solely on group datasets), be applied consistently across all enrollees, be open to audit by the insurance commissioner, avoid harm to enrollees, and have its performance reviewed and revised at least quarterly. It also requires written disclosure to enrollees on how such tools are used, and explicitly prohibits AI, algorithms, or software tools from being used to deny, delay, or modify determinations to provide health care services. The second new section requires that before any adverse action—including denial of prior authorization—is issued, a licensed health care provider must conduct an independent review exercising independent medical judgment, without relying solely on AI or algorithmic recommendations. Section 3 adds definitions of 'Algorithm,' 'Artificial intelligence,' and 'Prior authorization' to Section 432E-1. The Act takes effect upon approval.

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