Activities / What code does / Makes high-risk automated decisions
Makes health care decisions
health_care_decisions
Your app makes or scores decisions about a person's access to health care, such as coverage, prior authorization or triage.
- scope code
- in the registry since 1.4
- 16 laws in 12 jurisdictions name it
What triggers it
The lint's definition. It makes or scores decisions about a person's access to health care: eligibility, coverage, prior authorization, utilization review or triage. Diagnosis by a medical device is not this.
This covers a prior-authorization engine, a utilization-review model that recommends a denial, and a triage tool that sets who is seen first.
It implies Makes high-risk automated decisions, so the rules written for every such decision reach it too.
What does not
Diagnosis by a medical device is not this; it is a decision about a condition, not about access to care.
Often confused with Handles health records and Makes high-risk automated decisions.
The law it brings into scope
The kinds of law that name this activity in the LexLint law library, with the number of laws and jurisdictions in each, as of . The examples are chosen by rule, laws in force first and the widest jurisdiction first; each section's page lists every law.
| Area of law | Laws | Jurisdictions |
|---|---|---|
|
AI law
Tell people when they are dealing with an AI system or its output, and control the uses the law calls high-risk. |
16 | 12 |
This activity implies Makes high-risk automated decisions, so every law that names that activity reaches it too. These areas of law reach it only that way:
- Privacy law:
372 laws in
179 jurisdictions,
through Makes high-risk automated decisions
Have a legal basis for personal data, honor people's rights over it, and report a breach.
- Cybersecurity law:
91 laws in
67 jurisdictions,
through Makes high-risk automated decisions
Build software securely, handle reported flaws, and report incidents on a deadline.
- Product and AI liability law:
24 laws in
22 jurisdictions,
through Makes high-risk automated decisions
Answer in damages when defective software or an AI system causes harm.
The law written for health care decisions
Every law in the LexLint law library written for health care decisions, by jurisdiction, each country before its states and cities, as of . The domain tags are our reading of each law's scope, not the publisher's.
| Jurisdiction | Law |
|---|---|
 California |
|
 Colorado |
|
 Delaware |
|
 Georgia |
|
 Illinois |
|
 Indiana |
|
 Maine |
|
 Nebraska |
|
 Nevada |
|
 Rhode Island |
|
 Tennessee |
|
 Texas |
Every law that names Makes high-risk automated decisions reaches health care decisions too, because it covers automated decisions of every kind: 587 laws in 204 jurisdictions. 193 of those jurisdictions have no law written for health care decisions.
Counterparties that usually come with it
- a health plan or utilization-review organization
A component that cannot run as documented without one of these names
it in its ACTIVITIES.md under talks_to, with
required: true. That party's jurisdiction then joins the
run of every product that uses the component, and the finding says
why it is there. A default the deployer can change is asked about,
never added. Talking to a party never makes a product that party.
In a declaration
A library or framework that makes this possible enables
it; an application whose shipped code does it performs it.
For a library
For an application
History
In the registry since version 1.4, .
Added for Ensuring Transparency in Prior Authorization Act, artificial-intelligence utilization review restriction (Nebraska), the law that turns on it.
In the glossary: Makes health care decisions.
The activity registry is LexLint's open list; this page's text is licensed under Creative Commons Attribution 4.0.