{"id":319,"date":"2026-06-03T23:36:22","date_gmt":"2026-06-03T23:36:22","guid":{"rendered":"https:\/\/northcarolinamovingjournal.com\/?p=319"},"modified":"2026-06-03T23:36:22","modified_gmt":"2026-06-03T23:36:22","slug":"a-controversial-bill-to-rein-in-ai-use-in-medical-billing-advances-in-nc-senate","status":"publish","type":"post","link":"https:\/\/northcarolinamovingjournal.com\/?p=319","title":{"rendered":"A controversial bill to rein in AI use in medical billing advances in NC Senate"},"content":{"rendered":"
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Facing a sea of doctors and medical students dressed in their white coats, Senator Amy Galey (R-Alamance) made the case Wednesday for her bill to limit the use of artificial intelligence in Medicaid and commercial insurance.<\/p>\n

Read more A GOP county elections board member said he was warned against voting for a campus polling site<\/a><\/p>\n

Galey said while AI transcribers have helped practitioners with charting, her proposal, , would focus on the increasing adoption by hospital systems and other providers of AI systems designed to maximize billing.<\/p>\n

The amended bill presented to the Senate Health Committee would prohibit software developers from designing, training, or modifying AI systems for use in healthcare coding if the AI system is designed to \u201cpromote, incentivize or result in upcoding.\u201d<\/p>\n

Upcoding is choosing a higher billing code than warranted, a practice that is already illegal.<\/p>\n

Galey says a person with knowledge of coding and data analytics in the field of artificial intelligence could manipulate and then program medical codes to generate higher billing.<\/p>\n

\u201cWe are already looking at a billion-dollar Medicaid rebase for next year,\u201d said Galey. \u201cIf we don\u2019t get a handle on controlling these costs that are generated by a computer billing system which has an inherent bias in favor of higher bills, then we\u2019re just not going to be able to afford it.\u201d<\/p>\n

Sen. Julie Mayfield (D-Buncombe) questioned whether the bill needed to be clearer about applying only to intentional acts by software developers.<\/p>\n

\u201cWe wouldn\u2019t want someone to get caught up in this if it\u2019s unintentional, right?\u201d asked Mayfield.<\/p>\n

Galey said hospitals have a duty to make sure that whoever they\u2019re working with in their hospital billing system has affirmatively not tried to bill for more than the services that were rendered.<\/p>\n

Sen. Gale Adcock (D-Wake), a family nurse practitioner, said while the legislation has seen some improvements from the original version, she was unclear on why it would require doctors to submit an annual AI attestation of compliance to the state attorney general\u2019s office.<\/p>\n

\u201cIf alleged Medicaid overbilling is a driving concern, why do we need to create a new attestation process?\u201d questioned Adcock. \u201cJust [include] this in the Medicaid provider participation agreement, because that agreement already prohibits fraudulent upcoding.\u201d<\/p>\n

Sen. Gladys Robinson (D-Guilford) said her own local hospital system assured her that AI was only being used for notetaking, not upcoding in medical billing.<\/p>\n

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NC senators consider new restrictions on artificial intelligence in insurance and medical billing<\/p>\n

Read more Congress weighs cuts to states\u2019 already \u2018insufficient\u2019 election security dollars<\/a><\/p>\n<\/blockquote>\n