Idaho House Bill 2472

Requires utilization review programs using algorithmic processes to ensure clinical peers make adverse determinations, comply with accreditation standards, and include policies for algorithm verification. Establishes registration every two years with proof of compliance. Sets appeal procedures for adverse determinations.

  • Authority: Idaho
  • Parent authority: State governments
  • Jurisdiction: United States
  • Collections: U.S. state and local documents
  • Most recent activity: Enacted
  • Most recent activity date: 2024-07-19

Risk subdomain coverage

Minimal coverage — Brief mention but no specific mitigations, recommendations or governance measures relating to the risk subdomain are described.

  • AI system security vulnerabilities
  • Lack of capability or robustness
  • Lack of transparency or interpretability

All other risk subdomains had no coverage in this document.

Risk Coverage Summary

The document has minimal coverage of AI risk domains, with primary focus on AI system security (2.2) through requirements for algorithm verification and accreditation. There is minimal coverage of lack of robustness (7.3) through medical necessity review requirements, and minimal coverage of lack of transparency (7.4) through clinical peer review mandates. The document addresses algorithmic processes in healthcare utilization review but does not extensively cover most AI risk categories.

Sector coverage

Good coverage — Comprehensive governance measures or mitigations with clear procedures relating to the sector are explicitly described.

  • Health Care & Social Assistance

All other sectors had no coverage in this document.

Sectors Summary

The document exclusively governs AI use in the Health Care and Social Assistance sector, specifically targeting utilization review programs and health care plans that use algorithmic automated processes for medical necessity determinations. No other economic sectors are regulated.

Legislative Status

Hard Law

Legislative Status Summary

This is a binding state legislative amendment to the Managed Care Reform and Patient Rights Act with mandatory requirements, enforcement mechanisms, and regulatory oversight by the Department of Insurance.

Actors

Proposer

  • Entity Types: AI_Governance_Actor
  • Summary: The document is a legislative amendment to the Managed Care Reform and Patient Rights Act, proposed through the state legislative process as indicated by the bill structure and statutory citations.

Target

  • Entity Types: AI_Deployer
  • Summary: The legislation explicitly targets health care plans and utilization review programs that use algorithmic automated processes for medical necessity determinations in healthcare services.

Enforcer

  • Entity Types: AI_Governance_Actor
  • Summary: The Department of Insurance has explicit enforcement authority including registration oversight, corrective action plans, cease and desist orders, and administrative hearings.

Monitor

  • Entity Types: AI_Governance_Actor
  • Summary: The Department monitors compliance through biennial registration requirements and proof of accreditation. Accreditation organizations provide ongoing monitoring of utilization review standards and algorithmic processes.

AI Lifecycle Stages

Lifecycle stages covered by the documents, as defined in the OECD Framework for the Classification of AI Systems

  • Plan and Design
  • Verify and Validate
  • Deploy
  • Operate and Monitor

AI Lifecycle Summary

The document primarily addresses the Deploy and Operate and Monitor stages of the AI lifecycle for algorithmic automated processes used in healthcare utilization review. It establishes requirements for deployment (accreditation, registration) and ongoing monitoring (biennial registration, program integrity systems, physician verification of algorithmic outputs).

Technical Scope

Terms relating to technical scope that are mentioned or implicitly referenced in the document

  • Predictive AI
  • Task-specific AI

Technical Scope Summary

The document explicitly addresses algorithmic automated processes used in utilization review for medical necessity determinations. It does not use standard AI terminology like 'AI models' or 'AI systems' but instead refers to 'algorithmic automated process' throughout. There is no mention of frontier AI, general purpose AI, foundation models, generative AI, or compute thresholds.

https://www.ilga.gov/legislation/BillStatus.asp?DocNum=2472&GAID=17&DocTypeID=HB&SessionID=112&GA=103
https://agora.eto.tech/instrument/1721
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