The Indiana AI Health Claims Law (HB 1271, Public Law 88-2026) prohibits insurers from using any automated process or AI tool as the sole basis to downcode a health claim or deny prior authorization on medical necessity grounds unless a human has first reviewed the patient’s medical record. It was signed March 4, 2026 and has been in effect since July 1, 2026.
What the Indiana AI Health Claims Law Requires of Insurers
Beyond the human review requirement, insurers must disclose, in an easily accessible way, whenever AI was used in an adverse prior authorization determination or downcoding decision. The law also creates a new chapter of Indiana insurance code governing claim downcoding, giving these rules a dedicated statutory home.
Duties on the Provider Side
The law imposes a parallel duty on providers, who cannot submit health claims generated by AI without review by a person involved in developing the claim. The result is human accountability on both ends of the claims pipeline. Payers and provider organizations operating in Indiana should confirm that their AI-assisted claims tools include a documented human review step before decisions or submissions go out.
Source: Indiana General Assembly: HB 1271
Report a violation: If you believe a business is violating this law, you can file a complaint with the Indiana Attorney General Consumer Protection Division.
