{
  "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."
    }
  ],
  "_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."
  }
}