{
  "count": 51,
  "records": [
    {
      "jurisdiction": "AK",
      "name": "Alaska",
      "posture": "adopted_model_bulletin",
      "citation": "Bulletin B 24-01",
      "action_date": "2024-02-01",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map"
      },
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "AL",
      "name": "Alabama",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": [
        {
          "type": "statute",
          "citation": "SB 63 (2026 Regular Session), enrolled",
          "subject": "Where AI is used to determine medical necessity on prior authorization, determinations must be based on the enrollee's medical history, clinical circumstances presented by the requesting provider, and additional clinical information in the medical record. The plan provider must CERTIFY ANNUALLY to the department that the AI (a) does not rely on a group dataset to make determinations, (b) is fairly and equitably applied consistent with HHS regulation and guidance, and (c) does not discriminate directly or indirectly against any subscriber group or enrollee. A determination to deny, delay or modify based on medical necessity must ALWAYS be made by a licensed physician or other competent health care professional evaluating the AI's recommendation against the enrollee's specific clinical circumstances.",
          "quote": "Section 2. This act shall become effective on October 1, 2026.",
          "status": "enacted",
          "enacted": "2026-04-17",
          "effective": "2026-10-01",
          "source": "https://alison.legislature.state.al.us/files/pdf/SearchableInstruments/2026RS/SB63-enr.pdf",
          "confidence": "primary",
          "verified_on": "2026-08-21",
          "correction": "No effective date was previously recorded. Enrolled text: October 1, 2026."
        }
      ]
    },
    {
      "jurisdiction": "AR",
      "name": "Arkansas",
      "posture": "adopted_model_bulletin",
      "citation": "Bulletin 13-2024",
      "action_date": "2024-07-31",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map"
      },
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "AZ",
      "name": "Arizona",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": [
        {
          "type": "statute",
          "citation": "HB 2175 (57th Legislature, 1st Regular Session), Chapter 165",
          "title": "claims; prior authorization; conduct",
          "subject": "Adds A.R.S. 20-3103 and 20-3407. Before a health care insurer may issue a direct denial of a prior authorization involving medical necessity, the medical director must individually review the denial, exercise independent medical judgment, and may not rely solely on recommendations from any other source.",
          "quote": "THE MEDICAL DIRECTOR SHALL INDIVIDUALLY REVIEW THE DENIAL. DURING EACH INDIVIDUAL REVIEW, THE MEDICAL DIRECTOR SHALL EXERCISE INDEPENDENT MEDICAL JUDGMENT AND MAY NOT RELY SOLELY ON RECOMMENDATIONS FROM ANY OTHER SOURCE.",
          "ai_specific": false,
          "scope_note": "The enrolled text does NOT contain the phrase 'artificial intelligence' anywhere. The provision is AI-relevant because 'any other source' captures an algorithmic recommendation, but this is not an AI-specific statute. Listing it as one would overstate what Arizona enacted.",
          "status": "enacted",
          "enacted": "2025-05-12",
          "effective": "2026-06-30",
          "source": "https://www.azleg.gov/legtext/57leg/1R/bills/HB2175S.pdf",
          "confidence": "primary",
          "verified_on": "2026-08-21",
          "correction": "Previously recorded as a 2026 law. It is 57th Legislature 1st Regular Session, signed 2025-05-12."
        }
      ]
    },
    {
      "jurisdiction": "CA",
      "name": "California",
      "posture": "own_framework",
      "citation": "Bulletin 2022-5",
      "action_date": "2022-06-30",
      "date_qualifier": "issued",
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map"
      },
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "CO",
      "name": "Colorado",
      "posture": "own_framework",
      "citation": "3 CCR 702-10",
      "action_date": "2023-11-13",
      "date_qualifier": "effective",
      "amended_effective": "2025-10-15",
      "verbatim_vs_modified": null,
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map"
      },
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "CT",
      "name": "Connecticut",
      "posture": "adopted_model_bulletin",
      "citation": "Bulletin No. MC-25",
      "action_date": "2024-02-26",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map"
      },
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "DC",
      "name": "District of Columbia",
      "posture": "adopted_model_bulletin",
      "citation": "Bulletin 24-IB-002-05/21",
      "action_date": "2024-05-21",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map"
      },
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "DE",
      "name": "Delaware",
      "posture": "adopted_model_bulletin",
      "citation": "Domestic and Foreign Bulletin No. 148",
      "action_date": "2025-02-05",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map"
      },
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "FL",
      "name": "Florida",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": [
        {
          "type": "bill",
          "citation": "HB 527 (2026)",
          "title": "Mandatory Human Reviews of Insurance Claim Denials",
          "subject": "Would have barred reducing or denying a claim solely on an AI or machine-learning system review.",
          "status": "died",
          "status_detail": "House passed the committee substitute 108-0 on 2026-03-05; died in the Senate Rules Committee on 2026-03-13. Did not become law.",
          "source": "https://www.flsenate.gov/Session/Bill/2026/527",
          "confidence": "primary",
          "verified_on": "2026-08-21"
        },
        {
          "type": "bill",
          "citation": "SB 202 (2026)",
          "subject": "Senate companion to HB 527 on AI as sole basis for claim denial or reduction.",
          "status": "died",
          "status_detail": "Died in the Senate Banking and Insurance Committee. Did not become law.",
          "source": "https://www.flsenate.gov/Session/Bill/2026/202",
          "confidence": "secondary",
          "verified_on": "2026-08-21"
        },
        {
          "type": "regulatory-program",
          "citation": "NAIC AI Systems Evaluation Tool — multistate pilot",
          "subject": "Regulator information-gathering on insurer AI use. Florida is one of 12 participating states in the pilot running January-September 2026. A pilot is not a legal obligation on carriers; it is included because it signals where regulator attention is going.",
          "status": "participating",
          "effective": null,
          "source": "https://content.naic.org/insurance-topics/artificial-intelligence",
          "confidence": "secondary",
          "verified_on": "2026-08-21"
        }
      ]
    },
    {
      "jurisdiction": "GA",
      "name": "Georgia",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": [
        {
          "type": "statute",
          "citation": "SB 444 (2025-2026 Regular Session)",
          "subject": "Coverage decisions for healthcare services may not be based solely on AI systems. AI may automate tasks and participate in decision-making, but may not issue an adverse determination until a natural person qualifying as a private review agent or utilization review entity conducts a review in which a clinical peer participates; AI may not supersede that clinical peer's judgment.",
          "status": "enacted",
          "enacted": "2026-05-05",
          "effective": "2027-01-01",
          "status_detail": "Senate 49-0-5 (2026-02-11); House 166-0-10 (2026-03-19); Senate agreed to House substitute (2026-03-25).",
          "source": "https://gov.georgia.gov/document/2026-signed-legislation/sb-444/download",
          "confidence": "primary",
          "verified_on": "2026-08-20"
        }
      ],
      "retracted": [
        {
          "citation": "SB 544",
          "reason": "REMOVED 2026-08-21. Recorded on secondary reporting as a health-insurer AI prior-authorization law, and separately described elsewhere as the Conversational Artificial Intelligence Safety Act. The signed act obtained from the Governor's own 2026 signed-legislation record is neither: it is a homestead exemption from Butts County ad valorem taxes for residents aged 62 or older. Zero occurrences of 'artificial intelligence', 'insurer' or 'prior authorization' in the enrolled text. Both secondary sources were wrong about the same bill number.",
          "source": "https://gov.georgia.gov/document/2026-signed-legislation/sb-544/download",
          "verified_on": "2026-08-21"
        }
      ]
    },
    {
      "jurisdiction": "HI",
      "name": "Hawaii",
      "posture": "adopted_model_bulletin",
      "citation": "Insurance Commissioner Memorandum No. 2025-13A",
      "action_date": "2025-12-10",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": "minimal_or_none",
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map",
        "verbatim_vs_modified": "secondary-unverified"
      },
      "notes": "Secondary source; not verified against state bulletin text. Do not rely on for compliance.",
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "IA",
      "name": "Iowa",
      "posture": "adopted_model_bulletin",
      "citation": "Insurance Division Bulletin 24-04",
      "action_date": "2024-11-07",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map"
      },
      "source_id": "naic-adoption-map",
      "other_activity": [
        {
          "type": "statute",
          "citation": "HF 2635 (91st General Assembly), Acts Chapter 1087",
          "title": "A bill for an act relating to health carriers standards of conduct; utilization review organizations, artificial intelligence, audits, and prior authorizations; certificate of need processes; and including applicability provisions",
          "subject": "An AI-based algorithm may be used for initial review of a prior authorization request, but may not be the sole basis to deny, delay or downgrade a medical-necessity request. Human clinical judgment must be incorporated into adverse determinations.",
          "status": "enacted",
          "enacted": "2026-05-13",
          "effective": "2026-07-01",
          "source": "https://www.legis.iowa.gov/legislation/billTracking/billHistory?ga=91&billName=HF2635",
          "confidence": "primary",
          "verified_on": "2026-08-21"
        }
      ]
    },
    {
      "jurisdiction": "ID",
      "name": "Idaho",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": []
    },
    {
      "jurisdiction": "IL",
      "name": "Illinois",
      "posture": "adopted_model_bulletin",
      "citation": "Company Bulletin 2024-08",
      "action_date": "2024-03-13",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map"
      },
      "source_id": "naic-adoption-map",
      "other_activity": [
        {
          "type": "statute",
          "citation": "SB 3114, Public Act 104-0568, Transparency in Downcoding Act",
          "subject": "Bars automated downcoding of medical claims: every downcoding determination must be made or reviewed by a natural person following coding guidelines. Also bars payors from using downcoding in a targeted or discriminatory manner against health care professionals treating complex conditions, and requires physicians be clearly notified when a claim is downcoded.",
          "quote": "made or reviewed by a natural person",
          "status": "enacted",
          "enacted": "2026-07-10",
          "effective": "2028-01-01",
          "source": "https://www.ilga.gov/Legislation/BillStatus?DocNum=3114&GAID=18&DocTypeID=SB&SessionID=114",
          "confidence": "primary",
          "verified_on": "2026-08-21"
        }
      ]
    },
    {
      "jurisdiction": "IN",
      "name": "Indiana",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": [
        {
          "type": "statute",
          "citation": "HB 1271 (2026), House Enrolled Act, adding IC 27-1-52",
          "title": "Downcoding of health benefits claims",
          "subject": "Sec. 9 runs in BOTH directions and adds a disclosure duty. (a) An insurer may not use an automated process, system or tool, including AI, as the sole basis to downcode a claim based on medical necessity without review of the covered individual's medical record by an employee or contractor of the insurer. (b) A provider may not use an automated tool, including AI, to submit a claim without review by a provider or other person involved in developing it. (c) An insurer must disclose, in an easily accessible and readable manner, when AI is used to make an adverse determination on a prior authorization request or to downcode a claim.",
          "quote": "Sec. 9. (a) An insurer may not use an automated: (1) process; (2) system; or (3) tool, including artificial intelligence; as the sole basis to downcode a claim based on medical necessity without the review of the covered individual's medical record by an employee or contractor of the insurer. ... (c) An insurer must disclose in an easily accessible and readable manner when artificial intelligence is used to: (1) make an adverse determination on a prior authorization request; or (2) downcode a claim.",
          "status": "enacted",
          "enacted": "2026-03-04",
          "effective": "2026-07-01",
          "source": "https://iga.in.gov/pdf-documents/124/2026/house/bills/HB1271/HB1271.07.ENRS.pdf",
          "confidence": "primary",
          "verified_on": "2026-08-21"
        }
      ]
    },
    {
      "jurisdiction": "KS",
      "name": "Kansas",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": []
    },
    {
      "jurisdiction": "KY",
      "name": "Kentucky",
      "posture": "adopted_model_bulletin",
      "citation": "Bulletin No. 2024-02",
      "action_date": "2024-04-16",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": "minimal_or_none",
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map",
        "verbatim_vs_modified": "secondary-unverified"
      },
      "notes": "Secondary source; not verified against state bulletin text. Do not rely on for compliance.",
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "LA",
      "name": "Louisiana",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": []
    },
    {
      "jurisdiction": "MA",
      "name": "Massachusetts",
      "posture": "adopted_model_bulletin",
      "citation": "Bulletin No. 2024-10",
      "action_date": "2024-12-09",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": "minimal_or_none",
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map",
        "verbatim_vs_modified": "secondary-unverified"
      },
      "notes": "Secondary source; not verified against state bulletin text. Do not rely on for compliance.",
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "MD",
      "name": "Maryland",
      "posture": "adopted_model_bulletin",
      "citation": "Bulletin No. 24-11",
      "action_date": "2024-04-22",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": "minimal_or_none",
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map",
        "verbatim_vs_modified": "secondary-unverified"
      },
      "notes": "Secondary source; not verified against state bulletin text. Do not rely on for compliance.",
      "source_id": "naic-adoption-map",
      "other_activity": [
        {
          "type": "statute",
          "citation": "HB 1563 (2026 Regular Session), Chapter 165",
          "title": "Emergency Room Services and Post-Acute Care - Coverage and Facility Studies",
          "subject": "QUARTERLY carrier reporting to the Insurance Commissioner. The report must include the number of adverse decisions issued under § 15-10A-02(f), whether the adverse decision involved a prior authorization or step therapy protocol, the type of service at issue, and whether an artificial intelligence, algorithm or other software tool was used in making the adverse decision.",
          "quote": "(a)(1) On a quarterly basis, each carrier shall submit to the Commissioner ... the number of adverse decisions issued by the carrier under § 15-10A-02(f) of this subtitle, whether the adverse decision involved a prior authorization or step therapy protocol, the type of service at issue in the adverse decisions, and whether an artificial intelligence, algorithm, or other software tool was used in making the adverse decision",
          "status": "enacted",
          "enacted": "2026-04-28",
          "effective": "2026-06-01",
          "status_detail": "The act's title concerns emergency room and post-acute care coverage and gives no indication of an AI provision. The duty is real and is easy to miss from the title alone — which is how it came to be disputed here.",
          "source": "https://mgaleg.maryland.gov/2026RS/Chapters_noln/CH_165_hb1563t.pdf",
          "confidence": "primary",
          "verified_on": "2026-08-21"
        },
        {
          "type": "statute",
          "citation": "HB 820 (2025 Regular Session), Chapter 747",
          "title": "Health Insurance - Utilization Review - Use of Artificial Intelligence",
          "subject": "Substantially more than a guardrail adoption. Carriers, pharmacy benefits managers and private review agents using AI, an algorithm or other software tool for utilization review must base determinations on the individual patient's medical history, clinical circumstances and relevant records, and may NOT base decisions solely on group datasets. AI may not replace provider decision-making, must not discriminate unfairly against enrollees, and must be applied equitably. Carriers must maintain WRITTEN POLICIES for AI use, conduct QUARTERLY REVIEWS of AI performance, protect patient data privacy, and ensure the tools do not cause patient harm. AI may not deny, delay or modify health care services.",
          "status": "enacted",
          "effective": "2025-10-01",
          "source": "https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB0820?ys=2025RS",
          "confidence": "primary",
          "verified_on": "2026-08-21",
          "correction": "Previously recorded only as 'adopted the CMS guardrails'. That understated it severely: this is a dedicated AI utilization-review statute with written-policy and quarterly-review duties. Together with HB 1563's quarterly reporting, Maryland has the most developed AI utilization review regime of any state tracked here."
        }
      ]
    },
    {
      "jurisdiction": "ME",
      "name": "Maine",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": [
        {
          "type": "statute",
          "citation": "LD 2082 (132nd Legislature), Public Law Chapter 687",
          "title": "An Act to Regulate the Use of Artificial Intelligence in Providing Certain Mental Health Services",
          "subject": "Bars AI from making independent therapeutic decisions, engaging in therapeutic communication with clients, or generating treatment plans or recommendations without clinician review, and bars offering therapy to the public through AI rather than a licensed professional. Limits AI to administrative and supplementary roles under the licensee's full responsibility. Supplementary use is conditioned on a recorded or transcribed session with the client informed in writing and giving written, revocable consent.",
          "status": "enacted",
          "enacted": "2026-04-13",
          "effective": "2026-07-29",
          "source": "https://legislature.maine.gov/legis/bills/getPDF.asp?item=3&paper=HP1397&snum=132",
          "confidence": "primary",
          "verified_on": "2026-08-21",
          "correction": "Citation was wrong. Recorded as 'HB 2082'; Maine numbers bills as Legislative Documents, so the correct citation is LD 2082, enacted as Public Law Chapter 687."
        }
      ]
    },
    {
      "jurisdiction": "MI",
      "name": "Michigan",
      "posture": "adopted_model_bulletin",
      "citation": "Bulletin 2024-20-INS",
      "action_date": "2024-08-07",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map"
      },
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "MN",
      "name": "Minnesota",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": [
        {
          "type": "bill",
          "citation": "SF 1886 (2025-2026)",
          "title": "Individual communication with artificial intelligence disclosure requirement provision",
          "subject": "Would make it an unfair or deceptive trade practice for a business to fail to disclose that a person is having a textual or spoken conversation with AI, and would require an opt-out to reach a human. Attorney General enforcement plus a private right of action, actual damages and statutory damages capped at $1,000 per violation.",
          "ai_specific": true,
          "scope_note": "GENERAL-PURPOSE, NOT INSURANCE-SPECIFIC. It would reach insurers as businesses, in the same way a general consumer-protection statute does, but it is not an insurance-regulatory measure. Kept for that reason and flagged so it is not mistaken for one.",
          "status": "unconfirmed",
          "status_detail": "Previously recorded as 'pending'. Final disposition for the 2026 session could not be confirmed from the legislature's record; a separate Minnesota AI Transparency Act (HF 4654) is also referenced by secondary sources. Status unresolved.",
          "source": "https://www.revisor.mn.gov/",
          "confidence": "secondary",
          "verified_on": "2026-08-21",
          "correction": "Citation was a placeholder ('consumer AI disclosure bill'). Actual: SF 1886."
        }
      ]
    },
    {
      "jurisdiction": "MO",
      "name": "Missouri",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": []
    },
    {
      "jurisdiction": "MS",
      "name": "Mississippi",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": []
    },
    {
      "jurisdiction": "MT",
      "name": "Montana",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": [
        {
          "type": "bill",
          "citation": "HB 556 (2025 Regular Session)",
          "title": "Generally revise usage of artificial intelligence in certain health insurance",
          "sponsor": "Rep. Jill Cohenour (D-East Helena, HD 83)",
          "subject": "Would have required health insurance issuers using AI for utilization review and management to base determinations on the covered person's medical history, individual clinical circumstances and relevant clinical information, rather than solely on group datasets. Substantively similar to Maryland HB 820, which was enacted.",
          "status": "died",
          "status_detail": "Introduced 2025-02-18. Tabled in House Business and Labor Committee 2025-03-01 by 20-0. Missed the general-bill transmittal deadline 2025-03-12. Died in process 2025-05-20. Never enacted; no effective date.",
          "source": "https://projects.montanafreepress.org/capitol-tracker-2025/bills/hb-556/",
          "primary_url": "https://bills.legmt.gov/",
          "confidence": "secondary-cited",
          "verified_on": "2026-08-22",
          "discovered_by": "discovery pipeline, 2026-08-22"
        }
      ]
    },
    {
      "jurisdiction": "NC",
      "name": "North Carolina",
      "posture": "adopted_model_bulletin",
      "citation": "Bulletin No. 24-B-19",
      "action_date": "2024-12-18",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": "minimal_or_none",
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map",
        "verbatim_vs_modified": "secondary-unverified"
      },
      "notes": "Secondary source; not verified against state bulletin text. Do not rely on for compliance.",
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "ND",
      "name": "North Dakota",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": []
    },
    {
      "jurisdiction": "NE",
      "name": "Nebraska",
      "posture": "adopted_model_bulletin",
      "citation": "Insurance Guidance Document No. IGD--H1",
      "action_date": "2024-06-11",
      "date_qualifier": "issued",
      "amended_effective": null,
      "verbatim_vs_modified": "minimal_or_none",
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map",
        "verbatim_vs_modified": "secondary-unverified"
      },
      "notes": "Secondary source; not verified against state bulletin text. Do not rely on for compliance.",
      "source_id": "naic-adoption-map",
      "other_activity": [
        {
          "type": "statute",
          "citation": "LB 77 (109th Legislature), Ensuring Transparency in Prior Authorization Act",
          "subject": "Sec. 12: an AI-based algorithm may not be the sole basis of a utilization review agent's decision to deny, delay or modify care on medical-necessity grounds; the agent must disclose AI use to the department, to every in-network provider, to every enrollee AND on its public website; and the department may audit the automated utilization management system at any time, including via a contracted third party.",
          "quote": "Sec. 12. (1) An artificial intelligence-based algorithm shall not be the sole basis of a utilization review agent's decision to deny, delay, or modify health care services based, in whole or in part, on medical necessity. (2) A utilization review agent shall disclose to the department, to each health care provider in its network, to each enrollee, and on its public website if artificial intelligence-based algorithms are used or will be used in the utilization review process. (3) The department may, at any time, audit a utilization review agent's automated utilization management system.",
          "status": "enacted",
          "enacted": "2025-06-04",
          "effective": "2026-01-01",
          "source": "https://nebraskalegislature.gov/FloorDocs/109/PDF/Slip/LB77.pdf",
          "confidence": "primary",
          "verified_on": "2026-08-21",
          "correction": "Previously framed as a 2026 law. LB 77 was signed 2025-06-04 (109th Legislature); standardized prior-authorization forms took effect 2026-01-01."
        }
      ]
    },
    {
      "jurisdiction": "NH",
      "name": "New Hampshire",
      "posture": "adopted_model_bulletin",
      "citation": "Bulletin Docket #INS 24-011-AB",
      "action_date": "2024-02-20",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map"
      },
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "NJ",
      "name": "New Jersey",
      "posture": "adopted_model_bulletin",
      "citation": "Insurance Bulletin No. 25-03",
      "action_date": "2025-02-11",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": "minimal_or_none",
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map",
        "verbatim_vs_modified": "secondary-unverified"
      },
      "notes": "Secondary source; not verified against state bulletin text. Do not rely on for compliance.",
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "NM",
      "name": "New Mexico",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": []
    },
    {
      "jurisdiction": "NV",
      "name": "Nevada",
      "posture": "adopted_model_bulletin",
      "citation": "Bulletin 24-001",
      "action_date": "2024-02-23",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map"
      },
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "NY",
      "name": "New York",
      "posture": "own_framework",
      "citation": "Insurance Circular Letter No. 7",
      "action_date": "2024-07-11",
      "date_qualifier": "issued",
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map"
      },
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "OH",
      "name": "Ohio",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": [
        {
          "type": "bill",
          "citation": "SB 164 (136th General Assembly)",
          "title": "Regulate the use of artificial intelligence by health insurers",
          "sponsor": "Sen. Al Cutrona",
          "affects": "R.C. 3902.50 (amends), R.C. 3902.80 (enacts)",
          "subject": "health-insurer AI",
          "status": "pending",
          "status_detail": "In Senate Financial Institutions, Insurance and Technology Committee; not passed by either chamber.",
          "source": "https://www.legislature.ohio.gov/legislation/136/sb164",
          "confidence": "primary"
        }
      ]
    },
    {
      "jurisdiction": "OK",
      "name": "Oklahoma",
      "posture": "adopted_model_bulletin",
      "citation": "Bulletin No. 2024-11",
      "action_date": "2024-11-14",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": "minimal_or_none",
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map",
        "verbatim_vs_modified": "secondary-unverified"
      },
      "notes": "Secondary source; not verified against state bulletin text. Do not rely on for compliance.",
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "OR",
      "name": "Oregon",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": []
    },
    {
      "jurisdiction": "PA",
      "name": "Pennsylvania",
      "posture": "adopted_model_bulletin",
      "citation": "Insurance Notice 2024-04, 54 Pa.B. 1910",
      "action_date": "2024-04-06",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": "minimal_or_none",
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map",
        "verbatim_vs_modified": "secondary-unverified"
      },
      "notes": "Secondary source; not verified against state bulletin text. Do not rely on for compliance.",
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "RI",
      "name": "Rhode Island",
      "posture": "adopted_model_bulletin",
      "citation": "Insurance Bulletin No. 2024-03",
      "action_date": "2024-03-15",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": "minimal_or_none",
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map",
        "verbatim_vs_modified": "secondary-unverified"
      },
      "notes": "Secondary source; not verified against state bulletin text. Do not rely on for compliance.",
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "SC",
      "name": "South Carolina",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": []
    },
    {
      "jurisdiction": "SD",
      "name": "South Dakota",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": []
    },
    {
      "jurisdiction": "TN",
      "name": "Tennessee",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": [
        {
          "type": "statute",
          "citation": "SB 1580, Public Chapter 647",
          "title": "An act to amend Tennessee Code Annotated, Title 33; Title 47 and Title 63, relative to mental health",
          "subject": "Bars developers/deployers of an AI system from advertising or representing that it is, or can act as, a qualified mental health professional. Targets consumer-facing representations, not clinician-supervised use. Violations are unfair or deceptive acts under the Tennessee Consumer Protection Act; civil penalties up to $5,000 per violation; explicit private right of action.",
          "status": "enacted",
          "enacted": "2026-04-01",
          "effective": "2026-07-01",
          "source": "https://capitol.tn.gov/Bills/114/Bill/SB1580.pdf",
          "confidence": "primary",
          "verified_on": "2026-08-20"
        }
      ]
    },
    {
      "jurisdiction": "TX",
      "name": "Texas",
      "posture": "own_framework",
      "citation": "Bulletin # B-0036-20",
      "action_date": "2020-09-30",
      "date_qualifier": "issued",
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map"
      },
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "UT",
      "name": "Utah",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": [
        {
          "type": "statute",
          "citation": "SB 319 (2026 General Session)",
          "title": "Health Insurance Preauthorization Amendments",
          "subject": "Insurer must disclose whether AI is used in reviewing an authorization request; sets maximum decision timeframes and minimum validity periods for chronic/long-term care authorizations; a person reviewing an adverse preauthorization determination must exercise independent medical judgment and not rely solely on recommendations from any other source.",
          "status": "enacted",
          "enacted": "2026-03-19",
          "effective": "2026-05-06",
          "source": "https://le.utah.gov/Session/2026/bills/enrolled/SB0319.pdf",
          "confidence": "primary",
          "verified_on": "2026-08-20",
          "correction": "Previously recorded effective 2027-01-01. Actual: 2026-05-06 — already in force."
        }
      ]
    },
    {
      "jurisdiction": "VA",
      "name": "Virginia",
      "posture": "adopted_model_bulletin",
      "citation": "Administrative Letter 2024-01",
      "action_date": "2024-07-22",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map"
      },
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "VT",
      "name": "Vermont",
      "posture": "adopted_model_bulletin",
      "citation": "Insurance Bulletin No. 229",
      "action_date": "2024-03-12",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": "minimal_or_none",
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map",
        "verbatim_vs_modified": "secondary-unverified"
      },
      "notes": "Secondary source; not verified against state bulletin text. Do not rely on for compliance.",
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "WA",
      "name": "Washington",
      "posture": "adopted_model_bulletin",
      "citation": "Technical Assistance Advisory 2024-02",
      "action_date": "2024-04-22",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map"
      },
      "source_id": "naic-adoption-map",
      "other_activity": [
        {
          "type": "statute",
          "citation": "SB 5395 (E2SSB 5395), Chapter 157, 2026 Laws",
          "title": "Making improvements to transparency and accountability in the prior authorization determination process",
          "subject": "Medical-necessity determinations may be made only by a licensed physician or licensed health professional. AI, an algorithm or related software tool may NOT be the sole means used to deny, delay or modify health care services. Algorithms MAY be used to process and approve prior authorization requests — the restriction is on denial without human review, not on AI use.",
          "status": "enacted",
          "enacted": "2026-03-23",
          "effective": "2026-06-11",
          "source": "https://app.leg.wa.gov/billsummary?BillNumber=5395&Year=2025",
          "confidence": "primary",
          "verified_on": "2026-08-20"
        }
      ]
    },
    {
      "jurisdiction": "WI",
      "name": "Wisconsin",
      "posture": "adopted_model_bulletin",
      "citation": "Insurance Bulletin",
      "action_date": "2025-03-18",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": "minimal_or_none",
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map",
        "verbatim_vs_modified": "secondary-unverified"
      },
      "notes": "Secondary source; not verified against state bulletin text. Do not rely on for compliance.",
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "WV",
      "name": "West Virginia",
      "posture": "adopted_model_bulletin",
      "citation": "Insurance Bulletin No. 24-06",
      "action_date": "2024-08-09",
      "date_qualifier": "adopted",
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "provenance": {
        "posture": "naic-adoption-map",
        "citation": "naic-adoption-map",
        "action_date": "naic-adoption-map"
      },
      "source_id": "naic-adoption-map"
    },
    {
      "jurisdiction": "WY",
      "name": "Wyoming",
      "posture": "no_model_bulletin",
      "citation": null,
      "action_date": null,
      "date_qualifier": null,
      "amended_effective": null,
      "verbatim_vs_modified": null,
      "source_id": "legislative-research",
      "provenance": {
        "posture": "naic-adoption-map-absence"
      },
      "other_activity": []
    }
  ],
  "_provenance": {
    "source": "Implementation of NAIC Model Bulletin: Use of AI Systems by Insurers",
    "url": "https://content.naic.org/sites/default/files/legal-adoption-map-ai-model-bulletin.pdf",
    "source_as_of": "2026-08-06",
    "retrieved": "2026-08-18",
    "caveat": "Index, not authority. Confirm against the issuing regulator's own bulletin before relying on this for a compliance decision."
  }
}