H.R. 10210

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The Doctors Not AI Act of 2026 restricts how health insurance companies and employer-sponsored health plans can use artificial intelligence systems when reviewing and denying insurance claims that involve clinical judgment. Under this bill, any decision to deny or limit coverage based on medical necessity, appropriateness, or clinical standards must be made by a licensed healthcare professional—not by an AI system—and the professional must independently evaluate the patient's medical circumstances rather than simply accepting the AI's recommendation. Insurance companies would be required to tell patients when AI was involved in their claim decision and provide documentation of the AI's role in the review process, and patients could request copies of this information. The bill also requires insurance companies to treat AI-based utilization reviews (the process of reviewing whether treatments are medically necessary) the same way they treat other coverage limitations, including requirements that mental health and substance use disorder benefits receive equal consideration as medical and surgical benefits. The law would take effect for health plans beginning January 1 of the first calendar year at least 12 months after enactment.

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