Indiana HB 1271 — Prohibits AI as the Sole Basis for Downcoding Health Insurance Claims

Indiana's HB 1271, enacted March 4, 2026 and effective July 1, 2026, bars health insurers from using AI tools as the sole basis to 'downcode' a claim (reduce it to a cheaper billing code) without a health professional reviewing the patient's medical record. It also bars health care providers from using AI to submit claims without a review by the provider or a billing professional. Unlike most 2026 health-AI laws, it is not limited to prior authorization.

Technical detail

Indiana HB 1271 (2026) prohibits health insurers from using AI as the sole basis for downcoding a claim absent a health professional's review of the beneficiary's medical record, and prohibits providers from using AI to submit claims without review by the provider or a billing professional. Not limited to the prior-authorization process. Effective July 1, 2026.

Who is protected: Indiana patients and providers whose claims could be reduced or denied via AI

Who must comply: Health insurers and health care providers in Indiana using AI in claims processing

Key facts

More AI rules in Indiana

• Indiana Consumer Data Protection Act · In effect
• IN NCII Deepfake Law · In effect
• Indiana HB 1271 (no AI-only claim downcoding) · In effect
• Indiana SB 256 (foreign-adversary AI vendor & student rules) · In effect

Related healthcare AI rules elsewhere

• ACA § 1557 (AI in patient care) · In effect
• FDA AI/ML SaMD Action Plan · In effect
• FDA GMLP Principles · In effect
• Colorado AI Act (repealed) · Repealed / replaced
• SB 26-189 (Colorado ADMT Law) · Enacted (not yet in effect)
• AI Companion Safeguards Law · In effect