2026 Regular Session HB 4054

• At the request of: (at the request of Joint Legislative Committee on Information Management and Technology for Representative Nancy Nathanson)
• Bill Title: Relating to downcoding.

Catchline/Summary

Digest: Tells some health insurers to inform health care providers when they use AI to downcode a claim for reimbursement. (Flesch Readability Score: 62.8).

Requires certain health insurers offering a health benefit plan in this state that provide utilization review or have utilization review provided on their behalf to notify a health care provider each time the insurer uses artificial intelligence or other automated technology to automatically downcode a claim for reimbursement submitted by the provider. Requires insurers to make an appeals process available to a provider who has had a claim automatically downcoded using artificial intelligence or other automated technology.

• Fiscal Impact: May Have Fiscal Impact, But No Statement Yet Issued
• Revenue Impact: May Have Revenue Impact, But No Statement Yet Issued
• Current Location: In House Committee
• Current Committee: Joint Committee On Information Management and Technology