Maryland HB 820 (2025): Health Insurance — Utilization Review — Use of Artificial Intelligence
HB 820 — Chapter 747 of 2025 (signed May 20, 2025 — Gov. Moore)
- Effective date
- Oct 1, 2025
- Enforcement
- Maryland Insurance Administration / Insurance Commissioner
- Scope
- Health insurers and other carriers, pharmacy benefits managers and private review agents that use AI, algorithms or other software for utilization review. Determinations must rest on the enrollee's own clinical information, not solely a group dataset; the tool may not replace the health care provider's role, cause unfair discrimination or harm enrollees, and may not deny, delay or modify health care services. Tools must be open to Insurance Commissioner audit and reviewed at least quarterly; carriers' quarterly adverse-decision reports must say whether AI was used.
- Maximum penalty
- No penalty amount set in the Act; compliance is overseen through Insurance Commissioner audits and reviews.