Providing for artificial intelligence in facilities, for artificial intelligence use by insurers and for artificial intelligence use by MA or CHIP managed care plans; imposing duties on the Department of Health, the Insurance Department and the Department of Human Services; and imposing penalties.
SB1113 would create a new regulatory framework for the use of artificial intelligence in three health-related settings: health care facilities, health insurers, and Medical Assistance (MA) or CHIP managed care plans. In each setting, the bill requires disclosure when AI is used for clinical decision-making or utilization review, including notices in written communications and on public websites. It also requires that AI not replace human professional judgment, that its use be periodically reviewed for accuracy and reliability, and that patient or enrollee data be used only for the stated purpose of the AI system and consistent with state and federal privacy law.
The bill also requires annual AI compliance statements to be filed with the relevant state department, describing the function of the AI system, its decision logic, the training data used, and how the entity oversees compliance. The Department of Health, Insurance Department, and Department of Human Services would each be responsible for oversight in their respective sectors, including issuing reports to the General Assembly, setting record-retention rules, and adopting regulations or guidance. Third-party vendors supplying AI tools would also be subject to the chapter, while certain tools such as administrative, scheduling, scribe, static decision-support, and clinical calculator tools are exempt.
SB1113 would amend Titles 35 and 40 of the Pennsylvania Consolidated Statutes by adding new chapters governing AI use in health care facilities, insurers, and MA/CHIP managed care plans. It would impose new disclosure, documentation, reporting, oversight, and record-retention obligations on regulated entities, and authorize civil penalties, injunctions, and plans of correction for violations. It would also make violations by insurers and MA/CHIP managed care plans subject to the Unfair Insurance Practices Act, while giving the relevant departments authority to issue implementing regulations and guidance.
Based on the bill text and the absence of recorded committee debate or votes, the measure appears to reflect a generally cautious, oversight-oriented approach to AI in health care rather than an outright ban. Its sponsors span a broad group of senators, suggesting interest in bipartisan or cross-faction support for consumer protection, transparency, and human oversight. The bill’s structure indicates concern about AI’s role in clinical and coverage decisions, but not opposition to AI use itself when properly disclosed and supervised.
The main points of contention are likely to be the scope of disclosure and reporting requirements, the extent of state oversight into proprietary AI systems, and the burden placed on facilities, insurers, managed care plans, and third-party vendors to provide logic trees, training data descriptions, and compliance evidence. Health care and insurance stakeholders may object to the administrative and compliance costs, while patient advocates are likely to support the transparency and anti-discrimination provisions. Another likely issue is the bill’s requirement that AI not supersede human judgment in clinical and utilization review decisions, which could be viewed as necessary patient protection by supporters and as potentially limiting operational efficiency by opponents.