SB 1822: bill making insurers disclose AI in care approvals

Caption

relating to the use of artificial intelligence-based algorithms in utilization review conducted for certain health benefit plans.

Caption from analyzed text · version I.

Summary

Publicly, and in writing to patients and doctors.

The bill makes health insurers and HMOs say publicly, and in writing to patients and doctors, whether they or their review agents use artificial intelligence to decide whether care is approved. It requires any AI used in those approval reviews, and the data it was trained on, to have minimized bias based on race, sex, age, disability and similar traits and to follow evidence-based clinical guidelines. Every year by December 31, insurers or their review agents must send those AI tools and training data to the Texas Department of Insurance for review, with a signed statement that they meet these rules.

Labels

Labels: GOT HALFWAY. Passed the Senate on Apr 9, 2025. Died in the House: left pending in the Insurance committee.

Receipt

The receipt

89R-SB1822 · 2025-03-03

SOLD BY

Sen. Nathan JohnsonDSenate 16

ITEM

relating to the use of artificial intelligence-based algorithms in utilization review conducted for certain health benefit plans.

WHAT IT DOES

Publicly, and in writing to patients and doctors.

The bill makes health insurers and HMOs say publicly, and in writing to patients and doctors, whether they or their review agents use artificial intelligence to decide whether care is approved. It requires any AI used in those approval reviews, and the data it was trained on, to have minimized bias based on race, sex, age, disability and similar traits and to follow evidence-based clinical guidelines. Every year by December 31, insurers or their review agents must send those AI tools and training data to the Texas Department of Insurance for review, with a signed statement that they meet these rules.

CHARGES

[ ] NONE FOUND

TOTAL

No significant fiscal implication to the State is anticipated.

LBB estimate · fiscal note version S · source

Sources

Fiscal note · version S · March 28, 2025

No first-year general revenue figure available here.

LBB published estimates · flow over the stated periods.

Source snapshot 2026-10-19, Central time.

HISTORY

Mar 3, 2025Received by the Secretary of the Senate
Mar 3, 2025Filed
Mar 13, 2025Read first time
Mar 13, 2025Referred to Health & Human Services
Mar 18, 2025Scheduled for public hearing on . . .
Mar 18, 2025Considered in public hearing
Mar 18, 2025Testimony taken in committee
Mar 18, 2025Left pending in committee
Mar 26, 2025Considered in public hearing
Mar 26, 2025Vote taken in committee
Mar 31, 2025Reported favorably as substituted
Mar 31, 2025Committee report printed and distributed
Apr 1, 2025Placed on intent calendar
Apr 9, 2025Rules suspended-Regular order of business
Apr 9, 2025Record vote
Apr 9, 2025Read 2nd time & passed to engrossment
Apr 9, 2025Record vote
Apr 9, 2025Three day rule suspended
Apr 9, 2025Record vote
Apr 9, 2025Read 3rd time
Apr 9, 2025Passed
Apr 9, 2025Record vote
Apr 9, 2025Reported engrossed
Apr 10, 2025Received from the Senate
Apr 22, 2025Read first time
Apr 22, 2025Referred to Insurance
May 7, 2025Scheduled for public hearing on . . .
May 7, 2025Considered in public hearing
May 7, 2025Testimony taken/registration(s) recorded in committee
May 7, 2025Left pending in committee

FILED UNDER

No verified beat found.

SIGNED FOR BY

Senate · 24 yea · 6 nay

Sources

Senate: Final passage · Apr 9, 2025. Journal. Published stock for this vote. Snapshot 2026-10-19, Central time.

All floor motions and other positions below.

No flags

THANK YOU FOR CHECKING THE RECEIPT

CAMPAIGN PAID FOR BY

Nathan Johnson

Donors

Daniel Cocanougher$250,000Texas Sands PAC$130KMarguerite Hoffman$125,000

Not tied to this bill.

Sources

The author's campaign account only. Own money and internal transfers are separate on the member page.

Derived itemized flow · Jul 1, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Daniel Cocanougher$250,000.00

Texas Sands PAC$129,500.00

Texas Sands PAC

$129,500.00

Cash: $129,500.00
Paid by others: $0.00
Total: $129,500.00

Also funds 121 other sitting lawmakers.

Derived recipient stock · Jul 3, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.

TEC account match.

Team

Sources

Derived itemized flow · Nov 27, 2024 to May 12, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 100990378, 101033698, 101040111, 101052272.

Marguerite Hoffman$125,000.00

Money

Missing data does not establish zero giving. Display amounts are rounded.

×

Texas Sands PAC

$129,500.00

Cash: $129,500.00
Paid by others: $0.00
Total: $129,500.00

Also funds 121 other sitting lawmakers.

Derived recipient stock · Jul 3, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.

TEC account match.

Team

Sources

Derived itemized flow · Nov 27, 2024 to May 12, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 100990378, 101033698, 101040111, 101052272.

Votes4

Senate Apr 9, 2025

Yea: 24
Nay: 6
Present, not voting: Not printed
Absent: 0
Excused: 1

Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Sources

The bill was read third time and was passed by the following vote: Yeas 24, Nays 6. (Same as previous roll call)

Published stock of positions for this vote, except where marked derived.

Yea: 24 (published)
Nay: 6 (published)
Present, not voting: Not printed
Absent: 0 (derived from named list)
Excused: 1 (derived from named list)

Senate journal. Source snapshot 2026-10-19, Central time.

Senate Apr 9, 2025

Yea: 24
Nay: 6
Present, not voting: Not printed
Absent: 0
Excused: 1

Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Sources

Senator Johnson moved that Senate Rule 7.18 and the Constitutional Rule requiring bills to be read on three several days be suspended and that CSSB 1822 be placed on its third reading and final passage. The motion prevailed by the following vote: Yeas 24, Nays 6.

Published stock of positions for this vote, except where marked derived.

Yea: 24 (published)
Nay: 6 (published)
Present, not voting: Not printed
Absent: 0 (derived from named list)
Excused: 1 (derived from named list)

Senate journal. Source snapshot 2026-10-19, Central time.

Senate Apr 9, 2025

Yea: 24
Nay: 6
Present, not voting: Not printed
Absent: 0
Excused: 1

Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Sources

The bill was read second time and was passed to engrossment by the following vote: Yeas 24, Nays 6. (Same as previous roll call)

Published stock of positions for this vote, except where marked derived.

Yea: 24 (published)
Nay: 6 (published)
Present, not voting: Not printed
Absent: 0 (derived from named list)
Excused: 1 (derived from named list)

Senate journal. Source snapshot 2026-10-19, Central time.

Senate Apr 9, 2025

Yea: 24
Nay: 6
Present, not voting: Not printed
Absent: 0
Excused: 1

Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Sources

Senator Johnson moved to suspend the regular order of business to take up for consideration CSSB 1822 at this time on its second reading: CSSB 1822, Relating to the use of artificial intelligence-based algorithms in utilization review conducted for certain health benefit plans. The motion prevailed by the following vote: Yeas 24, Nays 6.

Published stock of positions for this vote, except where marked derived.

Yea: 24 (published)
Nay: 6 (published)
Present, not voting: Not printed
Absent: 0 (derived from named list)
Excused: 1 (derived from named list)

Senate journal. Source snapshot 2026-10-19, Central time.

Witnesses21

For: 14
Against: 4
On: 3

Names

For

DHR Health1 registration
Make Texans Healthy Again1 registration
National Association of Benefits and Insurance Professionals1 registration
Self1 registration
Self; Coalition of Texans with Disabilities1 registration
Texas Academy of Family Physicians1 registration
Texas Coalition for Patients1 registration
Texas Council of Community Centers1 registration
Texas Health Resources1 registration
Texas Hospital Association1 registration
Texas Medical Association2 registrations
Texas Orthopaedic Association1 registration
Texas Watch1 registration

Against

Self4 registrations

On

Health and Human Services Commission1 registration
Texas Association of Health Plans1 registration
Texas Department of Insurance1 registration

Sources

21 parsed registrations across the loaded witness lists.

Derived stock of witness registrations. Repeated appearances count separately. Organizations and self-representation appear as printed.

Senate witness list. Source snapshot 2026-10-20, Central time.

Fiscal

No significant fiscal implication to the State is anticipated.

LBB estimate · fiscal note version S · source

Sources

Fiscal note · version S · March 28, 2025

No first-year general revenue figure available here.

LBB published estimates · flow over the stated periods.

Source snapshot 2026-10-19, Central time.

How this was graded

Analysis of text version I by claude-opus-5-5, Oct 20, 2026, against the published rubric.

Sources

Texas Senate · Filed Mar 3, 2025

05/07/2025 H Left pending in committee

Texas Legislature Online · Introduced · Senate Committee Report · Engrossed

Data snapshot Oct 26, 2026 at 4:20 AM CDT. Grades, charges, quotes and corrections follow the published record.

House committee · Insurance · Final status: Died in committee

Senate committee · Health & Human Services · Committee vote 8 aye, 1 nay · Out of committee

Subjects

Artificial Intelligence (IQ7C5)

Electronic Information Systems

Insurance--Health & Accident

DISCRIMINATION

INSURANCE, COMMISSIONER OF

INSURANCE, TEXAS DEPARTMENT OF

Text

The text as introduced · 319 words

89R10420 SCL-D

By: Johnson
S.B. No. 1822

A BILL TO BE ENTITLED

AN ACT

relating to the use of artificial intelligence-based algorithms in

utilization review conducted for certain health benefit plans.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Subchapter D, Chapter 4201, Insurance Code, is

amended by adding Section 4201.156 to read as follows:

Sec. 4201.156. ARTIFICIAL INTELLIGENCE-BASED ALGORITHMS.

(a) An issuer of a health insurance policy or a health maintenance

organization that is the issuer of a health benefit plan shall

publish on a publicly accessible part of the issuer's Internet

website and provide in writing to each insured or enrollee, and any

physician or health care provider contracting with the issuer or

providing services to an insured or enrollee, a disclosure

regarding whether the issuer or the issuer's utilization review

agent uses artificial intelligence-based algorithms in conducting

utilization review.

(b) An issuer described by Subsection (a) or a utilization

review agent for an issuer described by Subsection (a) shall ensure

that any artificial intelligence-based algorithm used by the issuer

or agent in conducting utilization review and the training data

sets the algorithm uses:

(1) have minimized the risk of bias based on an

individual's race, color, religion, ancestry, age, sex, gender,

national origin, or disability; and

(2) comply with evidence-based clinical guidelines.

(c) Not later than December 31 of each year, an issuer

described by Subsection (a) or a utilization review agent for an

issuer described by Subsection (a) shall submit to the department

for review, in the form and manner prescribed by the commissioner,

any artificial intelligence-based algorithm used by the issuer or

agent in conducting utilization review and each training data set

the algorithm uses. The issuer or agent must include with the

submission an attestation to the department that the algorithm and

training data sets comply with Subsection (b).

SECTION 2. This Act takes effect September 1, 2025.

Verdict: No flags

The receipt

SOLD BY

ITEM

WHAT IT DOES

CHARGES

TOTAL

HISTORY

SIGNED FOR BY

Donors

Texas Sands PAC

Texas Sands PAC

Senate Apr 9, 2025

Senate Apr 9, 2025

Senate Apr 9, 2025

Senate Apr 9, 2025

For

Against

On