Law / United States / Minnesota
Utilization Review, AI-Only Adverse Determination Prohibition
Minn. Stat. § 62M.09, subd. 3(f) (2026 Minn. Laws ch. 124, art. 3, § 6)
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 provision does not take effect until January 1, 2027, and applies to health plans offered, sold, issued, or renewed on or after that date; what follows applies from then.
- If you are a utilization review organization, do not use automated processing alone, without a clinician review by an appropriate health professional, to make an adverse determination on a health care service, admission, or extension of stay.
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.
A 2026 amendment to the utilization review act adds paragraph (f) to section 62M.09, subdivision 3, barring a utilization review organization from using any form of automated processing alone, without a clinician review by an appropriate health professional as the rest of the subdivision already requires, when making an adverse determination on a health care service, admission, or extension of stay.
A utilization review organization under this chapter is a private entity, such as an insurance company, prepaid limited health service organization, or health plan company, rather than a state agency. The amendment reached enactment as section 6 of House File 4188, an omnibus commerce policy bill, after a conference committee substituted new language for the entire bill (a delete-everything amendment).
House File 2500, a stand-alone bill on the same subject, was introduced in 2025 and never advanced past its initial committee referral. Its companion, Senate File 1856, was amended in committee in 2026 but received no recommendation and no floor vote in either chamber. The House repassed the conference report 121-13 on May 16, 2026, and the Senate 49-15 on May 17, 2026; the governor approved the act, filed as 2026 Minnesota Session Law chapter 124, on May 27, 2026.
The amendment's own effective-date clause makes it effective January 1, 2027, applying to health plans offered, sold, issued, or renewed on or after that date.
When LexLint raises it
high_risk_decisions
Read the law
session law text, 2026 Minn. Laws ch. 124, art. 3, § 6, Office of the Revisor of Statutes (revisor.mn.gov)
no working codified-page URL for the amended subdivision resolves before its effective date, so the session law text is the primary source here