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STATE OF OKLAHOMA
2nd Session of the 60th Legislature (2026)
SENATE BILL 2038 By: Goodwin
AS INTRODUCED
An Act relating to health insurance; defining terms;
prohibiting issue of certain outcomes by artificial
intelligence; prohibiting certain health insurance
issuer from issuing certain outcome from the use of
certain AI system; requiring certain decisions to be
reviewed by certain licensed health care provider;
requiring certain health insurance issuer to provide
certain disclosure to certain claimant; allowing
certain promulgation of rules by Insurance
Commissioner; allowing Commissioner to investigate
and review use of AI by certain issuer; providing for
codification; and declaring an emergency.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6568 of Title 36, unless there
is created a duplication in numbering, reads as follows:
As used in this act:
1. “Adverse consumer outcome” means a decision by a health
insurance issuer that is subject to insurance regulatory standards
enforced by the Insurance Department that adversely impacts the
consumer in a manner that violates those standards or any claim
denial;
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2. “AI system” means a machine-based system that can, with
varying levels of autonomy, for a given set of objectives, generate
outputs such as productions, recommendations, content such as text,
images, videos, or sounds, or other outputs influencing decisions
made in real or virtual environments. AI system includes the term
artificial intelligence;
3. “Artificial intelligence” means a computer system, program,
or set of algorithms capable of performing tasks on producing
outposts that imitate intelligent human behaviors;
4. “Health insurance coverage” means benefits consisting of
medical care and items and services paid for as medical care,
provided directly, through insurance or through reimbursement, under
any hospital or medical service policy or certificate, hospital or
medical service plan contract, or health maintenance organization
contract offered by a health insurance issuer;
5. “Health insurance issuer” means the same as described in
Section 103 of Title 36 of the Oklahoma Statutes; and
6. “Medical necessity” means the same as defined in Section
7310 of Title 63 of the Oklahoma Statutes.
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6569 of Title 36, unless there
is created a duplication in numbering, reads as follows:
A. A licensed professional shall issue any final adverse
consumer outcome issued by a health insurance issuer. A health
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insurance issuer authorized to do business in this state shall not
issue an adverse consumer outcome with regard to denial, reduction,
or termination of health insurance coverage or benefits that results
from the use or application of any AI system. Any review process
concerning denial, reduction, or termination of insurance plans or
benefits that results from the use of AI systems shall be reviewed
by a licensed professional and all such final decisions shall be
issued by a licensed professional. A health insurance issuer shall
provide a disclosure notice to the claimant that such final decision
was issued by a professional, not an AI system.
B. No insurer shall issue a final adverse consumer outcome on a
claim without consulting with the claimant’s provider on medical
necessity. All final decisions on medical necessity shall be made
by a licensed health care provider, not an insurer. Such provider
shall have the opportunity to review all non-privileged information
relating to such claim.
C. The Commissioner may investigate and review the development,
investigation, and use of AI systems necessary to ensure compliance
with this act.
D. Any insurer who violates any provisions of this act may be
subject to a fine not more than Ten Thousand Dollars ($10,000.00)
per violation.
E. The Commissioner may promulgate rules necessary to enforce
the provisions of this act.
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SECTION 3. It being immediately necessary for the preservation
of the public peace, health or safety, an emergency is hereby
declared to exist, by reason whereof this resolution shall take
effect and be in full force from and after its passage and approval.
60-2-3029 CAD 1/15/2026 10:57:30 AM