Maryland Healthcare AI Utilization Review (HB 820)
In effect since October 1, 2025.
Overview
Requires AI tools used in healthcare coverage decisions to base determinations on individual patient data, not group datasets. Final utilization review decisions must be made by a physician in the same specialty. Carriers must report whether AI was used in adverse decisions. Does not ban AI in healthcare: it requires AI to use individual patient data and mandates human physician final decisions.
This is a sector-specific state law with AI-related duties.
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Maryland AI regulation guide lists every tracked rule for this jurisdiction with timelines and obligation tallies.
Who this applies to
This regulation applies to both companies that build AI products and companies that use AI tools from other vendors.
AI categories covered
- Healthcare AI
- Insurance
Specific AI use cases:
- Insurance prior authorization
- clinical decision support
- insurance claims ai
- Insurance underwriting
- Diagnostic and clinical AI
What this requires you to do
Human oversight required
Ensure human oversight. A human must be able to review and override AI-driven decisions.
Transparency notice required
Provide transparency notices. Inform affected individuals that AI is being used and how it influences decisions.
Record-keeping required
Maintain records. Keep documentation of your AI systems, decisions made, and compliance activities.
Enforcement and penalties
Misdemeanor criminal charges, monetary penalties, administrative actions including license suspension or revocation, cease-and-desist, restitution.
Legislative history
How this law got here
Latest
effectiveTakes effect
- signed
Approved by Governor (Chapter 747)
- signed
Senate Third Reading Passed 47-0
- signed
House Third Reading Passed 135-0
- introduced
Introduced in House
Earliest
Cross-referenced regulations
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Source and verification
View source texthttps://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB0820?ys=2025RS
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