A Michigan lawmaker, a doctor, and an attorney are working to bring more oversight to how insurance companies use artificial intelligence to process claims and make treatment decisions.
State Rep. Carrie Rheingans is pushing to pass two bills that would require more transparency from insurers who use AI to process claims, issue prior authorizations, and dictate treatment plans.
"AI is not a physician, AI does not have a medical degree. AI is not licensed by the State of Michigan as a provider," Rheingans said.
Rheingans said she believes that if left unchecked, the practice could dismantle the healthcare system and put patients' health in jeopardy.
"Fewer things covered by insurance, fewer things available at hospitals till we get down to just the bare minimum in both places," Rheingans said.
According to a survey conducted by the National Association of Insurance Commissioners, 71% of medical health insurers are currently using — or planning to use — AI. The survey found that 68% planned to use the programming for prior authorization approval processes.
Dr. Bobby Mukkamala with the American Medical Association said those statistics are troubling.
"That use of unregulated AI with no real guidelines or parameters, no human backup is going to be a problem," Mukkamala said.
Mukkamala also runs a private practice with his wife. The practice has had to hire a person dedicated to navigating prior authorizations, and Mukkamala said the workload has grown heavier since AI was introduced into the process.
"Instead of having them talking to our patients they are talking to an insurance company or typing on a keyboard and now talking to AI. We've got a human on one side and AI on the other," Mukkamala said.
Attorney Kristina Giyaur is a partner at MD-RX Law in New York, a firm that specializes in taking on insurance companies. Giyaur said the ways AI is being used by health insurers represent a dangerous slope.
"A lot of people will abandon treatment. Prescribers won't follow through because of lack of time. So its a problem," Giyaur said.
Right now, there are no regulations in place requiring insurance companies to disclose whether they are using AI to process claims, leaving no way of knowing how many are doing so.
Giyaur said it is a step in the right direction that some Michigan lawmakers are working to change that.
"It should not be the end instance in whether or not a patient is able to receive care," Giyaur said.
The bills Rheingans has introduced are [BILL NUMBERS/STATUS PENDING].
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