SB 815: AI can’t be the only reason to deny care

Caption

relating to use of artificial intelligence in utilization review conducted for health benefit plans.

Summary

Only a physician or licensed provider makes the medical-necessity call.

The bill bars companies that review health insurance claims from using an artificial intelligence program as the only basis for denying, delaying or changing a patient's care on medical-necessity grounds. Only a physician or licensed health care provider may make that medical-necessity call, and the state insurance commissioner may audit these companies' use of AI at any time. It reaches utilization review agents working for health benefit plans and the patients whose care they review, starting September 1, 2025.

Receipt

The receipt

89R-SB815 · 2025-01-16

SOLD BY

Sen. Charles SchwertnerRSenate 5

+ 3 coauthors

ITEM

relating to use of artificial intelligence in utilization review conducted for health benefit plans.

WHAT IT DOES

Only a physician or licensed provider makes the medical-necessity call.

The bill bars companies that review health insurance claims from using an artificial intelligence program as the only basis for denying, delaying or changing a patient's care on medical-necessity grounds. Only a physician or licensed health care provider may make that medical-necessity call, and the state insurance commissioner may audit these companies' use of AI at any time. It reaches utilization review agents working for health benefit plans and the patients whose care they review, starting September 1, 2025.

CHARGES

[ ] NONE FOUND

TOTAL

No significant fiscal implication to the State is anticipated.

LBB estimate · fiscal note version E · source

Sources

Fiscal note · version E · April 22, 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

Jan 16, 2025Received by the Secretary of the Senate
Jan 16, 2025Filed
Feb 7, 2025Read first time
Feb 7, 2025Referred to Business & Commerce
Feb 27, 2025Scheduled for public hearing on . . .
Feb 27, 2025Considered in public hearing
Feb 27, 2025Testimony taken in committee
Feb 27, 2025Left pending in committee
Mar 6, 2025Co-author authorized
Mar 11, 2025Considered in public hearing
Mar 11, 2025Vote taken in committee
Mar 13, 2025Reported favorably as substituted
Mar 13, 2025Committee report printed and distributed
Mar 18, 2025Placed on intent calendar
Mar 20, 2025Not again placed on intent calendar
Mar 25, 2025Placed on intent calendar
Mar 26, 2025Co-author authorized
Mar 26, 2025Rules suspended-Regular order of business
Mar 26, 2025Record vote
Mar 26, 2025Read 2nd time
Mar 26, 2025Amendment(s) offered FA1 Schwertner
Mar 26, 2025Amended
Mar 26, 2025Vote recorded in Journal
Mar 26, 2025Passed to engrossment as amended
Mar 26, 2025Record vote
Mar 26, 2025Three day rule suspended
Mar 26, 2025Record vote
Mar 26, 2025Read 3rd time
Mar 26, 2025Passed
Mar 26, 2025Record vote
Mar 26, 2025Reported engrossed
Mar 27, 2025Received from the Senate
Apr 9, 2025Read first time
Apr 9, 2025Referred to Insurance
Apr 23, 2025Scheduled for public hearing on . . .
Apr 23, 2025Considered in public hearing
Apr 23, 2025Testimony taken/registration(s) recorded in committee
Apr 23, 2025Left pending in committee
Apr 28, 2025Considered in formal meeting
Apr 28, 2025Reported favorably w/o amendment(s)
May 2, 2025Comte report filed with Committee Coordinator
May 2, 2025Committee report distributed
May 5, 2025Committee report sent to Calendars
May 20, 2025Considered in Calendars
May 23, 2025Placed on General State Calendar
May 23, 2025Read 2nd time
May 23, 2025Passed to 3rd reading
May 23, 2025Record vote RV#3418
May 23, 2025Statement(s) of vote recorded in Journal
May 24, 2025Rules suspended
May 24, 2025Additional sponsor(s) authorized
May 24, 2025Read 3rd time
May 24, 2025Passed
May 24, 2025Record vote RV#3465
May 24, 2025Statement(s) of vote recorded in Journal
May 25, 2025House passage reported
May 26, 2025Reported enrolled
May 26, 2025Signed in the Senate
May 27, 2025Signed in the House
May 27, 2025Sent to the Governor
Jun 20, 2025Signed by the Governor
Jun 20, 2025Effective on 9/1/25

FILED UNDER

No verified beat found.

SIGNED FOR BY

House · 116 yea · 13 nay

Senate · 30 yea · 0 nay

Sources

House: Final passage · May 24, 2025. Journal. Published stock for this vote. Snapshot 2026-10-19, Central time.

Senate: Final passage · Mar 26, 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

Charles Schwertner

Donors

Donors report through Texans for Charles Schwertner.

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.

Money

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

Votes6

House May 24, 2025

Yea: 116
Nay: 13
Present, not voting: 2
Absent: 10
Excused: 9

Names

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

House journal

Sources

Record 3465

SB 815 was passed by (Record 3465): 116 Yeas, 13 Nays, 2 Present, not voting.

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

Yea: 116 (published)
Nay: 13 (published)
Present, not voting: 2 (published)
Absent: 10 (derived from named list)
Excused: 9 (derived from named list)

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

House May 23, 2025

Yea: 127
Nay: 4
Present, not voting: 1
Absent: 8
Excused: 10

Names

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

House journal

Sources

Record 3418

SB 815 was passed to third reading by (Record 3418): 127 Yeas, 4 Nays, 1 Present, not voting.

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

Yea: 127 (published)
Nay: 4 (published)
Present, not voting: 1 (published)
Absent: 8 (derived from named list)
Excused: 10 (derived from named list)

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

Senate Mar 26, 2025

Yea: 30
Nay: 0
Present, not voting: 1
Absent: Not printed
Excused: Not printed

Names

MilesPresent, not voting

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

Senate journal

Names were not printed for yea. Only the named positions are included in member records.

Sources

The bill was read third time and was passed by the following vote: Yeas 30, Nays 0, Present-not voting 1. (Same as previous roll call)

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

Yea: 30 (published)
Nay: 0 (published)
Present, not voting: 1 (published)
Absent: Not printed
Excused: Not printed

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

Senate Mar 26, 2025

Yea: 30
Nay: 0
Present, not voting: 1
Absent: Not printed
Excused: Not printed

Names

MilesPresent, not voting

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

Senate journal

Names were not printed for yea. Only the named positions are included in member records.

Sources

Senator Schwertner moved that Senate Rule 7.18 and the Constitutional Rule requiring bills to be read on three several days be suspended and that CSSB 815 be placed on its third reading and final passage. The motion prevailed by the following vote: Yeas 30, Nays 0, Present-not voting 1.

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

Yea: 30 (published)
Nay: 0 (published)
Present, not voting: 1 (published)
Absent: Not printed
Excused: Not printed

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

Senate Mar 26, 2025

Yea: 30
Nay: 0
Present, not voting: 1
Absent: Not printed
Excused: Not printed

Names

MilesPresent, not voting

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

Senate journal

Names were not printed for yea. Only the named positions are included in member records.

Sources

CSSB 815 as amended was passed to engrossment by the following vote: Yeas 30, Nays 0, Present-not voting 1.

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

Yea: 30 (published)
Nay: 0 (published)
Present, not voting: 1 (published)
Absent: Not printed
Excused: Not printed

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

Senate Mar 26, 2025

Yea: 25
Nay: 5
Present, not voting: 1
Absent: 0
Excused: 0

Names

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

Senate journal

Sources

Senator Schwertner moved to suspend the regular order of business to take up for consideration CSSB 815 at this time on its second reading: CSSB 815, Relating to the use of certain automated systems or personnel in, and certain adverse determinations made in connection with, the health benefit claims process. The motion prevailed by the following vote: Yeas 25, Nays 5, Present-not voting 1.

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

Yea: 25 (published)
Nay: 5 (published)
Present, not voting: 1 (published)
Absent: 0 (derived from named list)
Excused: 0 (derived from named list)

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

Witnesses46

For: 39
Against: 4
On: 3

Names

For

Children's Hospital Association of Texas1 registration
Children’s Hospital Association of Texas1 registration
City of Fort Worth1 registration
DHR Health1 registration
Make Texans Healthy Again1 registration
NAMI Texas2 registrations
Patient Choice Coalition1 registration
Self; Texas Coalition for Patients1 registration
Self; Texas Medical Association1 registration
Self; Texas Ophthalmological Association1 registration
St. Luke’s Healthcare System1 registration
Teaching Hospitals of Texas2 registrations
Texas Academy of Family Physicians1 registration
Texas Academy of General Dentistry1 registration
Texas Allergy, Asthma, and Immunology Society1 registration
Texas Ambulatory Surgery Center Society1 registration
Texas Chapter American College of Physicians2 registrations
Texas Coalition For Patients1 registration
Texas College of Emergency Physicians1 registration
Texas college of emergency physicians1 registration
Texas Council of Community Centers1 registration
Texas Dermatology Society1 registration
Texas Health Resources1 registration
Texas Health Resources (THR)1 registration
Texas Healthcare and Bioscience Institute1 registration
Texas Hospital Association1 registration
Texas Medical Association2 registrations
Texas Pediatric Society2 registrations
Texas Radiological Society1 registration
Texas radiological society1 registration
Texas Society of Anesthesiologists1 registration
Texas Society of Pathologists1 registration
Texas society of pathologists1 registration
Texas Women's Healthcare Coalition1 registration

Against

Blue Cross Blue Shield of Texas1 registration
Self2 registrations
Texas Association of Health Plans1 registration

On

Health and Human Services Commission (HHSC)1 registration
Texas Department of Insurance2 registrations

Sources

46 parsed registrations across the loaded witness lists.

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

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

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 E · source

Sources

Fiscal note · version E · April 22, 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 Jan 16, 2025

06/20/2025 E Effective on 9/1/25

Texas Legislature Online · Introduced · Senate Committee Report · Engrossed · House Committee Report · Enrolled

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

Coauthors

César BlancoDSenate 29

Molly CookDSenate 15

Bryan HughesRSenate 1

Companion

HB 2922 by Spiller (identical)

Subjects

Artificial Intelligence (IQ7C5)

Electronic Information Systems

Health Care Providers

Insurance--Health & Accident

Insurance--Insurers & Agents

AUDITS & AUDITORS

COMPUTERS & SOFTWARE

HEALTH MAINTENANCE ORGANIZATIONS

PHYSICIANS

INSURANCE, COMMISSIONER OF

Text

The text as introduced · 167 words

89R5922 SCL-F

By: Schwertner
S.B. No. 815

A BILL TO BE ENTITLED

AN ACT

relating to use of artificial intelligence in utilization review

conducted for 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. USE OF ARTIFICIAL INTELLIGENCE-BASED

ALGORITHMS. (a) A utilization review agent may not use an

artificial intelligence-based algorithm as the sole basis of a

decision to wholly or partly deny, delay, or modify health care

services for an enrollee on the basis of medical necessity or

appropriateness of health care items and services. Only a

physician or licensed health care provider acting in accordance

with this chapter may determine medical necessity or

appropriateness of health care items and services.

(b) The commissioner may audit and inspect at any time a

utilization review agent's use of artificial intelligence for

utilization review.

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

House May 24, 2025

House May 23, 2025

Senate Mar 26, 2025

Senate Mar 26, 2025

Senate Mar 26, 2025

Senate Mar 26, 2025

For

Against

On

Companion