PlainBillCongress, translated.Legislation. Context. Public interest.Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Congressional Research Service
No official summary is available in the imported record yet.
People & committees
Rep. Landsman, Greg [D-OH-1] · D–OH
Legislative record
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Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We also preserved the text version used in the PlainBill explanation below.
No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.
Source last updated: Oct 14, 2026. Consult Congress.gov for the current record.
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PlainBill explanation
Based on the full Introduced in House · 2026-09-01 text. This explanation has not received human editorial review. This overview describes the proposal’s major provisions; it does not establish what its real-world effects would be.
The bill would require covered health plans and insurers to put qualified, licensed health care professionals in charge of coverage denials and other adverse decisions involving medical judgment. Artificial intelligence could assist a review, but could not issue or dictate those decisions. People receiving an adverse decision would have to be told if artificial intelligence was used, and could request the review records. These are proposed requirements, not evidence of an enacted law.
A group health plan and a health insurance issuer offering group or individual health insurance coverage shall ensure that any adverse benefit determination, whether initially or upon appeal, involving clinical judgment— (1) is not issued by an artificial intelligence system and is not dictated or determined by the output of such system; (2) is made only by a licensed health care professional who is acting within the scope of the professional’s license and who has training and experience in the provision of the health care item or service that is the subject of the determination;
if an artificial intelligence system was used in connection with the determination— (A) a statement that such system was used; (B) a description of its role in the review process;
such materials shall be considered part of the administrative record and made available to the enrollee upon request.
2026-09-01: Introduced in House
Section 1 would name the legislation the Doctors Not AI Act of 2026. Its operative requirements refer to qualified licensed health care professionals, rather than limiting decision-making to physicians.
This Act may be cited as the Doctors Not AI Act of 2026.
is made only by a licensed health care professional who is acting within the scope of the professional’s license and who has training and experience in the provision of the health care item or service that is the subject of the determination;
Sections 2–4 would place parallel requirements in three laws. The Public Health Service Act provision expressly covers group health plans and insurers offering group or individual coverage. The Employee Retirement Income Security Act provision would amend that law’s claims procedure requirements. The Internal Revenue Code provision expressly covers group health plans.
The Public Health Service Act is amended by inserting after section 2719A (42 U.S.C. 300gg–19a) the following new section: 2719B. Clinical judgment and artificial intelligence (a) In general A group health plan and a health insurance issuer offering group or individual health insurance coverage shall ensure
(b) Claims procedure requirements Section 503 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1133) is amended—
Subchapter B of chapter 100 of the Internal Revenue Code of 1986 is amended by inserting after section 9815 the following new section: 9815A. Clinical judgment and artificial intelligence (a) In general A group health plan shall ensure
Each of the three laws would receive the same broad definition of an artificial intelligence system. It would include algorithms, predictive models, machine learning and automated decision software that process data and materially influence, automate or issue health coverage decisions.
The term artificial intelligence system means an engineered or machine-based system, including any algorithm, predictive model, machine learning system, or automated decision-making software, that processes data to generate predictions, classifications, recommendations, or decisions and that is used to materially influence, automate, or issue determinations regarding coverage of health care items or services.
The term artificial intelligence system means an engineered or machine-based system, including any algorithm, predictive model, machine learning system, or automated decision-making software, that processes data to generate predictions, classifications, recommendations, or decisions and that is used to materially influence, automate, or issue determinations regarding coverage of health care items or services.
The term artificial intelligence system means an engineered or machine-based system, including any algorithm, predictive model, machine learning system, or automated decision-making software, that processes data to generate predictions, classifications, recommendations, or decisions and that is used to materially influence, automate, or issue determinations regarding coverage of health care items or services.
The clinical-judgment requirements would reach adverse decisions based wholly or partly on medical necessity, appropriateness, experimental or investigational treatment limits, level or setting of care, effectiveness, clinical guidelines, review criteria or other standards evaluating a person’s condition or treatment needs.
means an adverse benefit determination that is based, in whole or in part, on medical necessity, appropriateness, experimental and investigational or similar exclusions or limits, level of care, health care setting, effectiveness, clinical guidelines, utilization review criteria, other standards requiring evaluation of the enrollee's medical condition or treatment needs, or generally accepted standards of care for such treatment needs.
means an adverse benefit determination that is based, in whole or in part, on medical necessity, appropriateness, experimental and investigational or similar exclusions or limits, level of care, health care setting, effectiveness, clinical guidelines, utilization review criteria, other standards requiring evaluation of the participant's or beneficiary's medical condition or treatment needs, or generally accepted standards of care for such treatment needs.
means an adverse benefit determination that is based, in whole or in part, on medical necessity, appropriateness, experimental and investigational or similar exclusions or limits, level of care, health care setting, effectiveness, clinical guidelines, utilization review criteria, other standards requiring evaluation of the participant’s or beneficiary’s medical condition or treatment needs, or generally accepted standards of care for such treatment needs.
The requirements would apply to initial adverse decisions and decisions on internal appeal—the plan’s own reconsideration of a decision.
The term adverse benefit determination includes an initial determination and a determination on internal appeal.
the term adverse benefit determination includes an initial determination and a determination on internal appeal
The term adverse benefit determination includes an initial determination and a determination on internal appeal.
For an adverse decision involving clinical judgment, an artificial intelligence system could neither issue the decision nor dictate its outcome. Only a licensed health care professional acting within their license and with training and experience in the particular item or service could make it.
(1) is not issued by an artificial intelligence system and is not dictated or determined by the output of such system; (2) is made only by a licensed health care professional who is acting within the scope of the professional’s license and who has training and experience in the provision of the health care item or service that is the subject of the determination;
(A) is not issued by an artificial intelligence system and is not dictated or determined by the output of such system; (B) is made only by a licensed health care professional who is acting within the scope of the professional’s license and who has training and experience in the provision of the health care item or service that is the subject of the determination;
(1) is not issued by an artificial intelligence system and is not dictated or determined by the output of such system; (2) is made only by a licensed health care professional who is acting within the scope of the professional’s license and who has training and experience in the provision of the health care item or service that is the subject of the determination;
The professional would have to independently evaluate the person’s medical circumstances and apply generally accepted standards of care. They could not assume an artificial intelligence output was valid or substitute it for their own clinical judgment.
reflects the independent clinical judgment of such professional, who shall conduct an independent evaluation of the enrollee’s individual medical circumstances and shall not treat any output of an artificial intelligence system as presumptively valid or defer to such output in lieu of independent clinical judgment applying generally accepted standards of care;
reflects the independent clinical judgment of such professional, who shall conduct an independent evaluation of the participant’s or beneficiary’s individual medical circumstances and shall not treat any output of an artificial intelligence system as presumptively valid or defer to such output in lieu of independent clinical judgment applying generally accepted standards of care;
reflects the independent clinical judgment of such professional, who shall conduct an independent evaluation of the participant’s or beneficiary’s individual medical circumstances and shall not treat any output of an artificial intelligence system as presumptively valid or defer to such output in lieu of independent clinical judgment applying generally accepted standards of care;
If artificial intelligence was used in connection with a covered adverse decision, the required notice would have to disclose that use, describe its role and identify the deciding professional’s name, license and credentials.
includes, in the notice required under section 2719, if an artificial intelligence system was used in connection with the determination— (A) a statement that such system was used; (B) a description of its role in the review process; and (C) the name, professional license, and credentials of the licensed health care professional who made the determination;
includes, in the notice required under paragraph (1), if an artificial intelligence system was used in connection with the determination— (i) a statement that such system was used; (ii) a description of its role in the review process; and (iii) the name, professional license, and credentials of the licensed health care professional who made the determination;
includes, in the notice required under this chapter, if an artificial intelligence system was used in connection with the determination— (A) a statement that such system was used; (B) a description of its role in the review process; and (C) the name, professional license, and credentials of the licensed health care professional who made the determination;
The decision file, called the administrative record, would have to document the artificial intelligence system used, its role and its outputs, scores, recommendations or determinations. The enrollee, participant or beneficiary could request those materials. The text also requires documentation demonstrating compliance with “subparagraph (C),” whose meaning differs across the provisions and is unclear in Sections 2 and 4.
(5) is supported by documentation maintained as part of the administrative record describing— (A) the artificial intelligence system used; (B) the role of such system in the review process; (C) any outputs, scores, recommendations, or determinations generated by such system; and (D) documentation demonstrating compliance with subparagraph (C); and such materials shall be considered part of the administrative record and made available to the enrollee upon request.
(E) is supported by documentation maintained as part of the administrative record describing— (i) the artificial intelligence system used; (ii) the role of such system in the review process; (iii) any outputs, scores, recommendations, or determinations generated by such system; and (iv) documentation demonstrating compliance with subparagraph (C); and such materials shall be considered part of the administrative record and made available to the participant or beneficiary upon request.
(C) reflects the independent clinical judgment of such professional
(5) is supported by documentation maintained as part of the administrative record describing— (A) the artificial intelligence system used; (B) the role of such system in the review process; (C) any outputs, scores, recommendations, or determinations generated by such system; and (D) documentation demonstrating compliance with subparagraph (C); and such materials shall be considered part of the administrative record and made available to the participant or beneficiary upon request.
Under each law’s parity provisions, artificial intelligence used in utilization review—reviewing whether health care meets coverage criteria—would count as a treatment limitation. This would bring that use within provisions comparing mental health and substance use disorder benefits with medical and surgical benefits.
(c) Parity treatment of artificial intelligence systems Section 2726 of the Public Health Service Act (42 U.S.C. 300gg–26) is amended—
with respect to mental health or substance use disorder benefits as compared to medical and surgical benefits, both as written and in operation.
The use of an artificial intelligence system in connection with utilization review shall constitute a treatment limitation for purposes of this section.
The use of an artificial intelligence system in connection with utilization review shall constitute a treatment limitation for purposes of this section.
The use of an artificial intelligence system in connection with utilization review shall constitute a treatment limitation for purposes of this section.
The bill would add an information requirement to each law’s parity provisions: whether artificial intelligence is used in, or materially influences, a limitation’s design, development, application or administration. If so, sufficient information about the system’s function, operation and effects would be required so the relevant Secretary could evaluate its treatment of mental health and substance use disorder benefits compared with medical and surgical benefits, both in written rules and actual operation.
Whether an artificial intelligence system is used in, or materially influences, the design, development, application, or administration of such limitation and, if so, sufficient information regarding the function, operation, and effects of such system to enable the Secretary to evaluate such function, operation, and effects under such limitation with respect to mental health or substance use disorder benefits as compared to medical and surgical benefits, both as written and in operation.
Whether an artificial intelligence system is used in, or materially influences, the design, development, application, or administration of such limitation and, if so, sufficient information regarding the function, operation, and effects of such system to enable the Secretary to evaluate such function, operation, and effects under such limitation with respect to mental health or substance use disorder benefits as compared to medical and surgical benefits, both as written and in operation.
Whether an artificial intelligence system is used in, or materially influences, the design, development, application, or administration of such limitation and, if so, sufficient information regarding the function, operation, and effects of such system to enable the Secretary to evaluate such function, operation, and effects under such limitation with respect to mental health or substance use disorder benefits as compared to medical and surgical benefits, both as written and in operation.
The amendments would apply to plan years beginning on or after the first January 1 that is at least 12 months after enactment. The actual starting date therefore depends on enactment and the start of the relevant plan year.
The amendments made by this Act shall apply to plan years beginning on or after January 1 of the first calendar year beginning not less than 12 months after the date of the enactment of this Act.
The supplied official-actions snapshot, updated October 14, 2026, records introduction in the House on September 1, 2026, and referral that day to Energy and Commerce, Ways and Means, and Education and Workforce for consideration of provisions within their respective jurisdictions.
Source snapshot updated 2026-10-14T08:05:27Z.
2026-09-01: Introduced in House
2026-09-01: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
A closer look
Reviewed version: Introduced in House · 2026-09-01. These findings describe provisions and who may benefit; they are not judgments of waste, corruption, or motive.
This review covers the supplied bill text. “None identified” does not rule out provisions in later versions or accompanying reports and disclosures.
Provisions outside the bill’s main subject, or policy changes attached to appropriations.
None identified in the reviewed text
No unrelated provision or appropriations policy rider was identified in the complete supplied introduced text. This conclusion is limited to that version and does not establish what appears in other versions or accompanying materials.
Spending directed to particular recipients or places outside ordinary competitive or formula-based allocation.
None identified in the reviewed text
No congressionally directed spending for particular recipients or places was identified in the complete supplied introduced text. This conclusion is limited to that version; formal earmark disclosures and accompanying materials were not supplied.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
None identified in the reviewed text
No materially narrow carve-out, special exemption or preferential exception was identified in the complete supplied introduced text under the requested definition. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials.
Full text preserved for this analysis. Legislative record snapshot: Oct 14, 2026. How PlainBill uses AI