As health insurance companies across the nation use artificial intelligence more often to decide what gets covered, patients and doctors may be getting left in the dark about the algorithms that deny their claims.

And in Alabama, lawmakers don’t plan to do anything to regulate the rapidly evolving practice for at least another year.

“There’s ongoing discussions about what we need to do, what direction this needs to go in,” said Mark Jackson, executive director of the Alabama Medical Association. “And so I don’t think there was any rush to try to get it done this session and instead we’ll let everybody who’s got an interest in it be involved.”

It’s not clear exactly how insurance companies are using AI in Alabama or how often. But, the Alabama Department of Insurance told AL.com that “most insurers use AI in some form or fashion.”

A public hearing was scheduled in the Alabama legislature this week on a bill that would require insurance companies to tell patients and doctors when they use AI to deny or approve claims, and limit how insurance companies can use the technology. But in a meeting that lasted just five minutes, Rep. Corley Ellis, R-Columbiana, announced that House Bill 515 would instead be revisited during the legislative session next spring.

“We’re actually going to carry that bill over at the sponsor’s request,” said Corley, the vice chair of the insurance committee.

Rep. Mark Shirey, R-Mobile, who sponsored the bill, did not return a call for comment on Wednesday.

The bill says “the decision to cover or deny a treatment would always be made by a competent health care professional, who may consult with or consider a recommendation by artificial intelligence, but must also consider the particular circumstances of the insured as assessed by the attending health care provider.”

The Alabama Hospital Association, Jackson and the Department of Insurance all told AL.com that human oversight is critical if AI is going to continue to be used.

“In the interest of consumer protection, the department would like to have a human involved when AI is utilized, particularly where claims denials are concerned,” a Department of Insurance spokesperson said in an email.

Jackson, executive director of the Medical Association, said they are still trying to navigate the “unchartered waters” of AI before moving forward with legislation.

“We’re all still learning and before we pass something that we don’t understand the full consequences of, let’s do our due diligence and make sure everything in that bill is the proper way to go about it.”

Ellis said that interest groups such as the medical association and Blue Cross Blue Shield of Alabama, the state’s largest health insurer, have already been discussing the legislation, adding that he wants them to work together to come up with a better bill for next year along with the Department of Insurance and the Alabama Hospital Association.

“What I want to do is encourage that conversation to go on in the off season, in hopes that we come back with a bill that encompasses everything,” Ellis said.

The Alabama Hospital Association told AL.com they were not involved in any discussions about the bill before it was introduced, though they do support it.

“We’re supportive of what it does, and we would welcome the opportunity to be engaged with whatever discussions may occur in the off season. It’s a big issue, and I think it’s something that does need to be addressed,” said Danne Howard, deputy director of the hospital association.

Howard added that she doesn’t know how widely AI is used to process claims in Alabama but “it’s a growing concern nationally.”

Blue Cross Blue Shield of Alabama said in an email that:

“Blue Cross and Blue Shield of Alabama, along with our vendors acting on our behalf, do not use artificial intelligence for a final determination of a prior authorization request. However, we are striving to implement AI technology in the future to speed up the approval process, which could include the initial approval determination.”

Shirey’s bill in the Alabama legislature would have required the Alabama Department of Insurance to provide enforcement of AI standards. It also would have allowed patients to sue health insurance companies that violated the law.

Jackson said he doesn’t think any harm will come to patients as they wait another year for the bill to be discussed.

“We need to make sure we can make improvements where we can and that will be beneficial to all.”