Law / United States / Georgia
Private Review Agent Artificial Intelligence Coverage Determinations Act (SB 444)
O.C.G.A. § 33-46-7.1, enacted by Ga. SB 444 (2025-2026 session)
A citation is an address, not a summary. The first part names the law; what follows narrows it to the exact section, article or paragraph.
In force in 107 days, effective 1 January 2027.
An AI sector rules rule binding private bodies.
As of 8 September 2026.
What it requires
- This law is enacted but does not take effect until January 1, 2027; what follows applies from that date.
- If you are a private review agent or utilization review entity making coverage determinations for healthcare services in Georgia, you may use artificial intelligence systems, artificial intelligence, or other software tools as part of a utilization review plan meeting the Insurance Commissioner's standards.
- Do not let such a system issue an adverse coverage determination on its own; have a natural person qualifying as a private review agent or utilization review entity conduct the utilization review, with a clinical peer participating, before any adverse determination issues.
- Do not let the system supersede the clinical peer's judgment.
What it reaches
Obligation class
Governance
What this law does
Drafted with AI from the cited sources under the direction of UnGovr staff. UnGovr holds editorial responsibility for this page.
SB 444, as passed by the General Assembly, adds O.C.G.A. § 33-46-7.1 to the private-review-agent certification chapter of the insurance code.
A private review agent or utilization review entity may use an artificial intelligence system or other software tool as part of a utilization review plan meeting the Insurance Commissioner's standards, but such a system may not issue an adverse coverage determination for healthcare services until a natural person qualifying as a private review agent or utilization review entity conducts the review with a clinical peer participating, and the system may never supersede that clinical peer's judgment. The Act sets its own effective date of January 1, 2027.
When LexLint raises it
high_risk_decisions