HR 10210 · Federal · introduced Sep 1, 2026In Committee

HR 10210

Doctors Not AI Act of 2026

High RiskCreates new compliance requirements or restricts common AI uses. Action needed.

TL;DR

Rep. Greg Landsman (D-OH) introduced the Doctors Not AI Act of 2026, which would restrict health insurers from using AI as the sole basis for denying, delaying, or modifying medical care decisions. The bill requires that a licensed human physician, not an algorithm, make final coverage determinations for patient care.

How This Might Impact Your Business

Health insurance companies would lose the ability to use AI tools like nH Predict or similar algorithms as the sole decision-maker for claims denials, prior authorizations, or coverage modifications.

Insurers using AI in utilization management would need to route final decisions through a licensed physician, adding staffing costs and slowing automated denial workflows.

Medicare Advantage plans, Medicaid managed care organizations, and ACA marketplace plans would face the strictest impact given federal jurisdiction over these programs.

AI vendors selling clinical decision-support tools to payers (Optum, EviCore, Cohere Health, and similar) would need to reposition products as physician-assist rather than autonomous decision engines.

Hospitals and provider groups could see faster appeals resolution and fewer algorithmic denials, improving revenue cycle predictability.

The bill sits in three House committees (Energy and Commerce, Ways and Means, Education and Workforce), signaling a long committee process before any floor vote.

No specific penalty structure or effective date is included in the referral text, so compliance timelines remain undefined pending committee markup.

What Should You Do

1

Health insurers should inventory every AI or algorithmic tool currently used in claims adjudication and prior authorization, and document which decisions have human physician review.

2

Health tech vendors selling to payers should prepare product documentation showing physician-in-the-loop workflows and update sales materials to emphasize decision-support positioning.

3

Hospital revenue cycle and legal teams should track this bill through Energy and Commerce Subcommittee on Health hearings, where the first markup is likely.

4

Compliance officers at Medicare Advantage and Medicaid MCO plans should brief boards on potential operational changes and staffing implications for utilization management departments.

5

Government affairs teams should engage with the three referred committees now, before markup, to shape definitions of 'AI use' and 'physician review' in any final language.

Who It Affects

Health InsuranceHealthcare AIHospitals and Health SystemsMedicare Advantage PlansHealth Tech VendorsUtilization Management Services

Sponsors

Status Timeline

  1. committee

    Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

    September 1, 2026

  2. committee

    Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

    September 1, 2026

AI-generated analysis for informational purposes only. Not legal advice. Always consult a qualified attorney for legal guidance.Last action Sep 1, 2026

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