TO:	Honorable Lacey Hull, Chair, House Committee on Human Services

FROM:	Jerry McGinty, Director, Legislative Budget Board

IN RE:	HB4585 by Spiller (Relating to the submission, payment, and audit of certain claims for and utilization review of health services, including services provided under the Medicaid managed care and child health plan programs.), As Introduced

The fiscal implications of the bill cannot be determined because it is unclear to what extent the prohibition on the use of artificial intelligence applications or other similar computer software would affect the ability of a utilization review agent to use decision-making software and because the prohibition would be broadly applicable to any utilization review function.

The bill would amend required contract provisions in the Medicaid and Children's Health Insurance Program (CHIP) managed care programs related to submission and payment of claims, audits of claims and overpayment recovery, and provider appeals. The bill would prohibit the delegation of utilization review to an artificial intelligence application or other similar computer software.

According to the Health and Human Services Commission, Employees Retirement System, and Teacher Retirement System, the fiscal implications of the bill cannot be determined because it is unclear to what extent the prohibition on the use of artificial intelligence applications or other similar computer software would affect the ability of a utilization review agent to use decision-making software and because the prohibition would be broadly applicable to any utilization review function.

It is assumed that any costs associated with the bill to the Department of Insurance and to institutions of higher education could be absorbed using existing resources.

LEGISLATIVE BUDGET BOARD
Austin, Texas

FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION


April 28, 2025