CHICAGO — State laws regulating artificial intelligence are on the rise, and industry leaders should step up to help lawmakers manage the technology, experts said Friday at the HIMSS AI Leadership Strategy Summit.
More than 1,000 bills on AI have been introduced at the state level this year, including about 280 that relate to health technology, said Tina Joros, vice president of policy and innovation at health IT firm Veradigm.
That compares to around 500 to 700 bills last year, depending on how the legislation is counted, she said during a panel discussion Friday.
“Definitely an increase over three to five years ago,” Joros said. “It’s just a flood.”
The rise comes as federal oversight over many aspects of health AI is relatively nascent, and the Trump administration has signaled it wants to pursue a deregulatory path to spur development of the technology in the U.S.
Meanwhile, the healthcare sector has moved to implement AI for a variety of tasks, including assisting with clinical documentation, triaging imaging results or data analysis.
Still, the technology comes with risks, like the potential for inaccuracies or biases that could lead to patient harm. Some states are interested in filling the regulation gap — and the healthcare sector should weigh in on how those laws are crafted as they work to roll out these tools, experts said.
State laws around healthcare AI have so far been thoughtful and helpful, said Daniel Smith, chief medical information officer at Michigan health system Corewell Health. However, if the regulations become too broad, AI use at the organization could be at risk.
“So what we would hope for is that what’s getting built out in our legal frameworks are taking a more of a risk-based assessment, so those lower risk opportunities can still flourish quickly and not be held back,” Smith said.
Where states are looking to regulate health AI
A significant portion of the health AI legislation this year is related to prohibiting or monitoring the use of AI in insurers’ utilization management processes, said Sarah Jaromin, a policy specialist in the health program at the National Conference of State Legislatures.
Some insurers have already faced scrutiny from Congress for using AI to deny claims or prior authorization requests, where a provider has to receive approval before offering a drug or service.
Last year, a Senate report criticized Medicare Advantage insurers UnitedHealthcare, Humana and CVS for allegedly using predictive algorithms to inappropriately refuse coverage for post-acute care.
States are looking to regulate the practice too. For example, Arizona passed a law this spring that requires payers to have a person verify claims denials or rejected prior authorization requests. Maryland also passed a law this year overseeing insurers’ use of the technology in claims management.
Another significant area for legislation is regulating the use of mental health chatbots, Jaromin said. For example, a law passed in New York would require AI chatbots to put safeguards in place to detect signs of suicidal ideation or self-harm.
Proponents say AI mental health tools could provide quick and accessible support, but other experts argue they might not be effective enough to replace a human therapist — and could be unsafe.
AI and mental health has also received more public attention in recent months amid news reports on teens who died by suicide after developing deep relationships with chatbots.
“Sometimes it’s like what you see in the news, and then you'll see some state regulation there,” Jaromin said. “And I think that’s what's happening with the payers and the mental health chatbots as well.”
Engaging with lawmakers
State lawmakers likely don’t have expertise in healthcare or AI, experts said.
Additionally, many of the legislators who are making decisions on AI policy likely have limited knowledge on what they’re voting on, largely because no one in the community has come to speak to them about the impact, said State Sen. Bo Watson, R-Tenn.
Healthcare leaders should meet with legislators and offer themselves as a resource to policymakers, he said. And though it’s a challenging task in politics, they should approach lawmakers without bias or self-interest.
“State government is the infrastructure of our political system,” he said. “It is critically important that you engage yourself in your state government, and you engage yourself with your state legislators, because ultimately they will be making 95% to 98% of the decisions that will have impact on your business model.”
