HomeLegal DirectoryIndiana HB 1271 (no AI-only claim downcoding)

In effect Limited protection

Indiana House Bill 1271 (2026) — Payment of Health Claims

Indiana · Ind. House Enrolled Act 1271 (2026 Reg. Sess.), eff. July 1, 2026

Indiana bars health insurers from relying on an automated process or artificial intelligence as the only reason for downcoding a claim on medical-necessity grounds; a qualified health professional must review the patient's medical record before such a downcode is applied. Health care providers likewise may not use AI to submit a claim without a human reviewing the record. Insurers must also tell providers when AI played a role in an adverse prior-authorization decision or a downcode, and providers keep appeal rights.

Technical detail

HB 1271 (P.L. 2026, eff. July 1, 2026) adds a chapter to IC Title 27 on downcoding, prohibiting an insurer from using an automated system or AI as the sole basis to downcode a medical-necessity claim without human review of the medical record, and requiring disclosure when AI is used for an adverse prior-authorization or downcoding determination.

Who is protected: Health care providers and the insured patients whose claims are downcoded or denied.

Who must comply: Health insurers and other payers operating in Indiana, plus health care providers submitting claims.

Key facts

JurisdictionIndiana
LevelState
StatusIn effect
Protection strengthLimited protection
Effective date2026-07-01
Enacted2026-03-13
CitationInd. House Enrolled Act 1271 (2026 Reg. Sess.), eff. July 1, 2026
Enforced byIndiana Department of Insurance
PenaltiesNo new penalty is created; the existing enforcement and penalty provisions of the Indiana insurance code apply.
Topicshealthcare AI · insurance AI · automated decision-making
Last verified2026-07-08
Official sourceIndiana General Assembly — House Bill 1271 (Payment of health claims), 2026 Regular Session ↗

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