Regulatory Assessment

HL-UR-0911 PASS

TX · health · utilization review · decided 2026-09-16 13:22 UTC · Harborline Health Plan, Inc. (fictional)

On 2026-09-16, ur-auto v2.0 (a third-party system from ClinPath AI (fictional)) produced 'approve' in a TX health utilization review transaction. Inputs included clinical criteria, medical records. No human reviewed the output before it took effect. The outcome was not adverse to the consumer. RegBench applied 5 rule(s) in force on 2026-09-16 and recorded no findings.

PASS: 0 finding(s) under rules 2026.10+c4982313, corpus 2026-10-30-9c5dad5a. No configured check fired; the case file is recorded. This is not a compliance conclusion.

Coverage: supported. 4 state-specific and 0 general black-letter rule(s) applied to this TX health utilization review transaction. Only the configured checks were run; a result is not a legal opinion on compliance. 5 of 30 rules applied.

Evidence (carrier asserted). Supplied by the carrier and not verified by RegBench: ai_system.governance_attested, ai_system.model_doc_ref, ai_system.testing_report_ref, inputs.data_source_refs.

Findings (0)

No configured check fired under the rules in force on 2026-09-16 for this state, line and stage. That is not a compliance conclusion; the case file is recorded all the same.

Point in time

Law as of: 2026-09-16
Rules version: 2026.10+c4982313
Corpus snapshot: 2026-10-30-9c5dad5a
Engine: regbench-engine/0.5.0 · deterministic-1
Fingerprint: 9fc4a78007066ff7947c52f1 (pattern grouping, not an integrity check)
Input digest: 1300c008bf9b9f220c87ef0e1f8cbcc86796abc814b4f7c6b113243acde40552
Evaluated: 2026-10-31 05:42:55 UTC
Exhibit C case file: yes

Ledger

Entry: #6414 · assessment · recorded 2026-09-16T13:23:48+00:00
Hash: d3628f2c2f2e1b932e0b2de66c5db2d85540f4e8735515b81770957c532cf0aa
Previous: b9cd2aa57bf19c45c91c7a43fa66d59571ada2cbeb318b217eac1efd141e6e82
Stored copy intact: yes, hashes match
Assessed input intact: yes, revision 1 matches the input digest

Verify the whole chain Case file JSON

Carrier review

No review item: the disposition was PASS.

Recorded facts revision 1

As asserted by the carrier. References are recorded, not verified: RegBench holds no copy of the documents they name.

AI system: ur-auto v2.0 · third party (ClinPath AI (fictional)) · high-risk class: utilization review
Governance attested: True
Testing report: test://harborline/ur-auto/2026Q2
Model documentation: doc://harborline/ur-auto/2.0
Feature classes: clinical_criteria, medical_records
Protected factors used: none
External data (ECDIS): False
Consumer report / credit: False / False
Data sources: ehr://harborline/clinical-record

Decision: approve · score 0.227
Human review: none
Adverse to consumer: False
Notice: not recorded · reasons: False · specific: False · external data disclosed: False
Appeal channel: –
Consumer token: tok_8a70576f15