Maryland HB 820 (AI in insurance utilization review)
Maryland Health Insurance — Utilization Review — Use of Artificial Intelligence (HB 820)
Maryland · 2025 Md. Laws ch. 747 (HB 820); Md. Code, Ins. 15-10A-06, 15-10B-05.1
- Status
- In effect
- Took effect
- October 1, 2025
- Applies to
- Health insurance carriers, pharmacy benefits managers, and private review agents conducting utilization review in Maryland.
- Enforced by
- Maryland Insurance Administration / Maryland Insurance Commissioner.
When a Maryland carrier, pharmacy benefits manager, or private review agent uses artificial intelligence or an algorithm in utilization review, the tool's determinations must be based on the individual patient's clinical history, not solely on a group dataset. The AI may not replace the role of the reviewing provider, must not result in unfair discrimination, must remain open to audit, and may not deny, delay, or modify care in a way that harms enrollees. Carriers must report to the Insurance Commissioner quarterly on adverse decisions, including whether AI was used.
Who is protected: Enrollees and patients of Maryland health plans subject to utilization review.
Legal detail
2025 Md. Laws ch. 747 (HB 820) amends Md. Code, Ins. 15-10A-06 and 15-10B-05.1 to govern AI in utilization review (individualized clinical basis, no sole reliance on group data, no provider replacement, no unfair discrimination, audit access) and to require quarterly carrier reporting of adverse decisions and AI use.
Key facts
| Jurisdiction | Maryland |
|---|---|
| Level | State |
| Strength | Moderate |
| Enacted | May 20, 2025 |
| Citation | 2025 Md. Laws ch. 747 (HB 820); Md. Code, Ins. 15-10A-06, 15-10B-05.1 |
| Private right of action | No, agency enforcement only |
| Penalties | Enforced through the Maryland Insurance Commissioner's existing authority over carriers and private review agents; no new standalone penalty. |
| Topics | healthcare AI · insurance AI · automated decision-making |
| Bill text | Maryland General Assembly — HB 820 (2025), Chapter 747 |
More AI rules in Maryland
- MD HB 1339 (Automated Decision Systems, 2026) · In effect
- Maryland AI Ready Schools Act, SB 720 (2026) · In effect
- Maryland EO 01.01.2026.16 data center framework (2026) · In effect
- Maryland Online Data Privacy Act · In effect
- MD NCII Deepfake Law · In effect
- Maryland CSAM Law (computer-generated images) · In effect
Related healthcare AI rules elsewhere
- Missouri AI Therapy Chatbot Ban (SB 1019) · In effect
- PA v. Character.AI (Fake Psychiatrist Chatbot) · Blocked / in litigation
- RI Therapy Chatbot Ban (2026) · In effect
- RI AI Companion Self-Harm Safety (2026) · Enacted (not yet in effect)
- California AB 489 (AI healthcare chatbot misrepresentation ban) · In effect
- AZ HB 2175 (AI Insurance Denial — Physician Review) · In effect
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