The Ongoing Report of ClingantryThe Report

Alabama's new law (signed April 17, 2026, effective October 1, 2026) says a health insurer can't rely only on AI to decide whether care gets covered — any decision to deny or reduce coverage has to be made by a qualified healthcare professional. Insurers must also tell enrollees that AI is used in coverage decisions, base prior-auth determinations on the individual patient's medical history rather than group data alone, and certify annually to the state that their AI is monitored for accuracy and doesn't discriminate. If you're in Alabama, this is leverage: after October 1, an AI-only denial is something you can push back on by law.

Georgia's SB 444, effective January 1, 2027, draws a clean line: insurers may use AI in prior authorization to automate paperwork and reduce administrative burden — but an adverse decision (denying or reducing care) can't be issued until a qualified clinical peer has actually conducted the review and participated in the decision. The AI also can't override that clinician's judgment. If you operate in Georgia, nothing changes today, but this is worth having on your 2027 compliance calendar now.

Colorado's AI law (requirements around AI systems not discriminating against patients) now takes effect June 30, 2026 — pushed back from its original February date. A companion healthcare-specific rule adds a plain but important protection: your staff can't let an AI system be the sole reason a patient's coverage or care is denied. A human still has to be involved in that decision.