Bipartisan House bill would require insurers to explain AI-based claim denials

Legislators introduced a bill that would force health insurers to provide a specific, human-understandable reason for any claim denial made using an automated system or artificial intelligence. The proposal aims to address opaque "black-box" denials, where providers and patients cannot challenge a decision because the algorithm's logic is not disclosed. While the bill is in early stages, it signals growing regulatory scrutiny on payer AI tools and could reshape appeal workflows. For now, document all instances where a denial reason cites "automated review" or "clinical criteria" without actionable detail, as this builds the case for challenging such policies.