AI Frontier Institute

Health Claims & AI

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South Carolina Bill 443 (126th Session, 2025-2026) proposes to add Section 38-59-23 to Chapter 59, Title 38 of the South Carolina Code of Laws. The bill prohibits health insurers from taking any action on healthcare coverage decisions based solely on results generated by artificial intelligence or automated decision-making tools. It further requires a healthcare professional (as defined in Section 44-30-20) to supervise and meaningfully review any coverage decisions made using such tools, specifically when those tools inform decisions to modify or deny prior authorization requests from providers. The bill defines 'artificial intelligence' as a machine-based system that makes predictions, recommendations, or decisions based on human-defined objectives, and defines 'automated decision-making tool' as a system developed or modified to make, or be a controlling factor in making, consequential decisions. The act takes effect upon approval by the Governor.

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