Amends the Social Security Act to require behavioral health information disclosure, including provider access, wait times, payment statistics, and denial data. Specifies AI and technology use in denial processes. Aims to enhance transparency and informed choice in behavioral health coverage.
Analysis summaries, actor details, and coverage mappings were LLM-classified and may contain errors.
This is a binding legislative amendment to the Social Security Act with mandatory disclosure requirements enforced through federal regulatory authority.
The document has minimal coverage of 2-3 subdomains, with focus on AI system transparency (7.4) and potential discrimination risks (1.1, 1.3). Coverage is concentrated in system safety and fairness domains, specifically addressing transparency requirements for AI use in healthcare denial processes.
The document primarily governs the Health Care and Social Assistance sector, specifically Medicare Advantage organizations and behavioral health providers. It also has implications for the Finance and Insurance sector through health insurance plan requirements.
The document primarily addresses the Deploy and Operate and Monitor stages of the AI lifecycle, focusing on transparency requirements for AI systems already in use for healthcare denial decisions. It does not cover earlier stages like planning, data collection, or model development.
The document explicitly mentions AI technology, machine-learning technology, and decision support technology in the context of healthcare denial processes. It does not define specific AI categories like frontier AI, general purpose AI, or foundation models, but focuses on AI systems used for clinical decision-making.
United States Congress
The document is a Congressional act amending the Social Security Act, indicating Congress as the proposing authority.
Secretary of Health and Human Services; Centers for Medicare & Medicaid Services
The Secretary is explicitly granted authority to define terms and specify requirements, indicating enforcement authority through the Department of Health and Human Services and CMS.
Secretary of Health and Human Services; Centers for Medicare & Medicaid Services
The Secretary and CMS will monitor compliance through the required disclosure of behavioral health information and denial statistics on an annual basis.
Medicare Advantage organizations; behavioral health providers; health insurance plans
The document targets organizations offering Medicare Advantage plans that must disclose behavioral health information, including those using AI in denial processes. Behavioral health providers and patients are also affected stakeholders.
3 subdomains (3 Minimal)