The American College of Radiology (ACR) is monitoring a growing wave of state legislation targeting the use of AI in insurance coverage decisions.
Specifically, seven bills across five states would restrict or regulate AI use in prior authorization and claims processing, ACR said in a March 26 statement. Measures under consideration include Alabama Senate Bill 63, which would require insurers to use patient-specific clinical information and disclose AI use in utilization review; Minnesota Senate File 1856, which would ban AI use in utilization review outright; and Michigan House Bill 4537, which would block Medicaid from using AI to deny, modify, or delay claims. Similar bills are pending in New Hampshire, Wisconsin, and Massachusetts.
In addition, several states are also considering broader governance measures for AI used in care delivery. California Assembly Bill 2575 would require disclosure of AI tools used in patient care and strengthen accountability around harm tied to AI-informed clinical decisions; a hearing is scheduled for April 7. Iowa House Study Bill 766, which proposes a licensing and oversight structure for AI-augmented and autonomous service providers, was recommended for passage out of subcommittee on March 24.
The ACR's State Government Relations Committee said it is available to assist state societies considering advancing AI-related legislation.
![A normal mammogram confirmed by three-year radiologic follow-up illustrates reader-marked regions of interest (ROIs) during (A) unaided (round 1) and (B) artificial intelligence (AI)–assisted (round 2) reading. Each colored dot represents an ROI for recall by a human reader. Readers could mark more than one ROI per case, represented by multiple dots of the same color. During AI-assisted reading, the AI system displayed three visible prompts: two with suspicion of malignancy scores of 35% (left mediolateral oblique [L MLO] and craniocaudal [L CC]) and one with a suspicion of malignancy score of 10% (right craniocaudal [R CC]), shown as polygonal overlays. Without AI, six of 10 readers (60%) marked a false-positive ROI. With AI assistance, this fell to two of 10 (20%). R MLO = right mediolateral oblique.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/07/2026-07-14-radiology-mammogram-ai-auto-bias.H0bYO8QlWs.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
