Kansas Senate Bill SB467

Kansas 2025-2026 Regular Session

• Introduced: 2/3/26
• Refer: 2/4/26

Caption

Enacting the use of artificial intelligence in medical decisions transparency act and requiring that all medical necessity determinations be made by a competent licensed physician or healthcare professional.

Summary

SB 467 creates the “Use of Artificial Intelligence in Medical Decisions Transparency Act” and applies it to Kansas health insurers and utilization review organizations that use artificial intelligence, algorithms, or other software tools in utilization review or utilization management. The bill is aimed at decisions to approve, modify, delay, or deny health care services when medical necessity is at issue. It requires such tools to consider an enrollee’s clinical history, the requesting provider’s clinical circumstances, and other relevant medical record information, and prohibits decisions based solely on group datasets or in a way that supplants provider judgment. The bill goes further by stating that AI or software tools may not deny, delay, or modify services based in whole or in part on medical necessity. Under the bill, only a licensed physician or a licensed health care professional competent to evaluate the specific clinical issues may make medical necessity determinations. Health insurers must also adopt written policies and procedures describing their review processes, ensure those processes are grounded in clinical principles and criteria, file those policies with the Kansas Department of Insurance, and disclose them to insureds, providers, and the public upon request.

Impact

If enacted, SB 467 would significantly restrict how Kansas health insurers and utilization review organizations use AI and other automated tools in coverage and utilization decisions. It would amend the practical operation of utilization review by requiring human clinical decision-making for medical necessity determinations and by imposing transparency, documentation, and disclosure obligations on insurers. The bill would also place oversight authority with the Kansas Department of Insurance through required filing of insurer policies and procedures, while reinforcing compliance with HIPAA and anti-discrimination requirements.

Sentiment

Based on the bill text and the absence of recorded committee testimony or votes, the available record suggests a policy approach that is protective of patients and providers and skeptical of automated medical decision-making. The bill’s framing emphasizes transparency, clinical judgment, and safeguards against harm, which indicates support for limiting insurer reliance on AI in health coverage decisions. No contrary public testimony or vote history is available in the provided materials to show organized opposition or amendment activity.

Contention

The main point of contention is likely to be whether the bill goes too far in prohibiting AI from making or materially influencing medical necessity determinations. Supporters would likely argue that only clinicians should decide medical necessity and that automated tools can be opaque, biased, or overly restrictive. Opponents, likely among insurers and utilization review entities, may argue that the bill limits efficiency, increases administrative burden, and could reduce the use of predictive tools that help standardize reviews. Another possible issue is the bill’s broad language about software tools and medical necessity, which could raise questions about how much human review is required and how insurers can continue using decision-support technology without violating the act.