Healthcare Legislators Tackle AI Claims and Medical Debt Relief (NCOIL Recap)
Key Takeaways
The National Council of Insurance Legislators (NCOIL) Annual Meeting 2025 included the adoption of the NCOIL prior authorization reform model and updates to dental benefits contracting, with a focus on improving patient access and administrative efficiency.
Artificial intelligence insurance regulation was a key topic, as committees discussed a model act requiring human oversight in claim denials and considered new governance standards for insurers using AI.
Legislators and regulators examined the impact of expiring ACA tax credits on healthcare affordability and market stability, highlighting ongoing concerns about rising premiums and underlying cost drivers.
The NCOIL 2025 Annual Meeting also featured sessions on Medicare, Medicaid, maternal health, and ICHRAs, with several issues set for further discussion at the upcoming spring meeting.
The National Council of Insurance Legislators (NCOIL) held its annual meeting in Atlanta recently. The meeting covered a wide-ranging agenda with various committees and sessions addressing significant healthcare issues.
Health Insurance Committee Adopts Key Reform Measures
Notably, the Health Insurance and Long-Term Care Issues Committee adopted the NCOIL Prior Authorization Reform Model Act and readopted policy on dental benefits contracting with amendments related to virtual credit cards. The Committee also considered draft model policy to require non-disproportionate share hospitals to screen patients for charity care and financial assistance eligibility, and prohibit creditors and debt collectors from reporting medical debt related to lifesaving and emergency care.
AI Regulation in Insurance Claims Takes Center Stage
Artificial intelligence also emerged as a focus with the Financial Services and Multi-Lines Issues Committee continuing discussion on the Model Act Regarding Insurers’ Use of Artificial Intelligence. The policy is modeled after a bill introduced in Florida and would require an insurer’s decision to deny a claim to be made by a qualified human professional. Alternative approaches were discussed, with one stakeholder offering draft language to establish governance requirements for insurers using AI.
ACA Tax Credits and Healthcare Affordability Discussions
NCOIL also held general sessions on Medicare and Medicaid as well as vision care, and committees heard presentations on maternal health, state innovation waivers, and Individual Coverage Health Reimbursement Arrangements (ICHRAs). Additionally, legislators had a robust discussion with the insurance commissioners from several states on expiring enhanced ACA tax credits and the impact on affordability and market stability. Regulators tied rising premiums not only to the loss of the subsidies, but also to other underlying cost drivers, including utilization, consolidation, drug pricing, and PBM practices.
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