AI in claims downcoding and prior authorization

What the law does

Indiana P.L. 88-2026 (HB 1271) bars insurers from using AI as the sole basis to downcode a claim for medical necessity without a human review of the medical record. Providers may not submit a benefits claim with AI alone. Insurers must disclose when AI is used in an adverse prior-authorization decision or in downcoding. The Act took effect July 1, 2026.