Industry Watch Alert
Sources
- Executive Office of the Governor Ron DeSantis.
Governor Ron DeSantis Announces Proposal for Citizen Bill of Rights for Artificial Intelligence.
Press Release, December 4, 2025.
Executive Summary
- Florida is proposing enforceable limits on how AI may be used in insurance and healthcare decision-making.
- AI could not serve as the sole basis for claims adjustment or denial, reinforcing the requirement for documented human review.
- Behavioral health AI tools would be barred from delivering licensed therapy or simulating licensed professionals.
- Organizations using AI with members or providers would be required to disclose AI use clearly and consistently.
- Health plans relying on third-party vendors would face increased pressure to verify AI governance, transparency, and compliance.
- Florida’s approach functions as an early indicator of how other states may regulate AI in payer operations.
Why This Matters Now
This proposal is about reasserting accountability, not banning AI.
For payers and UM organizations, the bill directly addresses areas that already carry regulatory and reputational risk:
- Claims and UM workflows
Any reliance on AI-driven logic for approvals, denials, or prioritization would need demonstrable human oversight and auditability. - Vendor dependency
Plans using AI-enabled vendors for utilization review, care navigation, or member outreach would be responsible for verifying how those tools function, what data they use, and where decision authority resides. - Behavioral health exposure
The proposal draws a hard line between supportive AI tools and licensed clinical care, underscoring the risk of AI overreach in mental health contexts.
In effect, Florida is codifying what many payers are already being asked to prove during audits and disputes: that AI assists decisions but does not replace accountable professionals.
In Closing
Florida’s Artificial Intelligence Bill of Rights proposal answers a question that payer leaders are already facing: how fast can AI move without outpacing governance?
The message is clear. AI adoption will continue, but regulators expect transparency, documented human oversight, and defensible decision-making, especially in claims, utilization management, and behavioral health. Florida is just one of many making tangible moves. Organizations that already operate with these principles will be better positioned as AI regulation evolves.
FAQ
What is Florida’s Artificial Intelligence Bill of Rights?
Florida’s Artificial Intelligence Bill of Rights is a proposed legislative framework announced by Governor Ron DeSantis on December 4, 2025. It is designed to protect consumer privacy, require transparency when AI is used, restrict certain foreign-developed AI tools, limit unconsented use of personal data, and set boundaries for AI use in healthcare, insurance, and mental health services.
How would Florida’s AI Bill of Rights affect health insurance claims and utilization management?
The proposal would prohibit insurers from using artificial intelligence as the sole factor in claims adjustment or denial. Health plans that use AI in claims or utilization management would be required to disclose its role and allow regulators to inspect AI models to confirm compliance with unfair insurance trade practice laws.
Does Florida’s proposal prohibit AI in behavioral health or member support?
No. The proposal does not ban AI in behavioral health broadly. It prohibits AI from delivering licensed therapy or impersonating licensed professionals. AI tools could remain supportive or informational, but licensed clinicians would retain responsibility for diagnoses, counseling, and clinical decisions.
Is Florida’s AI Bill of Rights likely to influence other states or federal policy?
Yes. State-level AI frameworks like Florida’s are widely viewed as bellwethers. While details may vary, the emphasis on transparency, limits on automated decision-making, and human oversight is likely to appear in other state regulatory efforts and payer-specific guidance.
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