Binding law — not yet in force or stayed
AI may not issue an adverse determination before a review with a clinical peer, nor supersede the peer's judgment (Georgia SB 444)
From 2027-01-01, private review agents and utilization review entities may use artificial intelligence systems, artificial intelligence or other software tools only as part of a utilization review plan that accords with chapter 46 and the Commissioner's rules (O.C.G.A. 33-46-7.1(b)); such tools may automate tasks, reduce administrative burdens and participate in decision-making, but shall not issue an adverse determination to a patient until a natural person qualifying as a private review agent or a utilization review entity conducts a utilization review in which a clinical peer participates, and in no event may they supersede the judgment of that clinical peer (33-46-7.1(c)). Detect automated output that sets or sends an adverse determination with no clinical-peer review step.
ga-sb444.clinical-peer-review-before-adverse-determination · Ga. SB 444, sec. 1 (O.C.G.A. 33-46-7.1(c)) · official source · applies from 2027-01-01 · jurisdictions: US-GA