AI Frontier Institute

Promotes transparency and accountability in the use of artificial intelligence by health insurers to manage coverage and claims.

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Rhode Island H 7190 (2026) has not been enacted. The House Health & Human Services Committee recommended on 2026-03-03 that it be held for further study. If enacted, it would add Chapter 84 to Title 27 (Insurance), the "Transparency and Accountability in Artificial Intelligence Use by Health Insurers to Manage Coverage and Claims Act." The chapter would regulate how health insurers use AI in non-administrative claims and coverage management. Under § 27-84-3, insurers would have to disclose to the Office of the Health Insurance Commissioner (OHIC) and the Department of Business Regulation (DBR) how they use AI. That disclosure would cover model types, the role of AI in decisions, training datasets, performance metrics, governance and risk policies, and decisions where AI made or was a substantial factor. Insurers would have to provide enforcement-related information, including documents and software, on request. They would also have to keep records of AI decisions, including adverse benefit determinations, for at least five years. DBR/OHIC would report to the governor, Senate president and House speaker within 18 months of the effective date and annually after that. The reports would give per-insurer details on models, AI's role, training, testing and bias mitigation, and performance metrics such as approval, denial, appeal and reversal rates and reviewer time. Under § 27-84-4, a non-administrative adverse benefit determination made or substantially influenced by AI regarding medically necessary care would have to be reviewed and approved by a provider with the same license status as the ordering provider. The rationale would have to be documented in the case record. If that review is not done, the determination would be reversed. Appeals would follow the process in chapter 18.9 of title 27. Under § 27-84-5, OHIC, working with DBR, would write implementing rules, and insurers would bear the compliance costs. Section 27-84-6 is a severability clause. The act would take effect upon passage (Section 2).

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