Regulatory Assessment

HL-UR-0907 PASS

TX · health · utilization review · decided 2026-10-17 05:56 UTC · Harborline Health Plan, Inc. (fictional)

On 2026-10-17, 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 2026-10-17 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 2026-10-17 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: 2026-10-17
Rules version: 2026.10+c4982313
Corpus snapshot: 2026-10-30-9c5dad5a
Engine: regbench-engine/0.5.0 · deterministic-1
Fingerprint: cdbbe259c3d60484819724a4 (pattern grouping, not an integrity check)
Input digest: fa312b76e5031dc3ff81320a9a23e54204f0e0cb8f1a0e720114d2b462cd23d4
Evaluated: 2026-10-31 05:42:55 UTC
Exhibit C case file: yes

Ledger

Entry: #6410 · assessment · recorded 2026-10-17T05:57:59+00:00
Hash: 35c40eec1da925b2d1fb4fc582d04c6b1be64d8e9ef9a16d5bce8066fc63b3cf
Previous: 48afd65cee2345675e1a59a98c51467c24f8a843721d1ba623b3e95243a6ca1d
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 0.082
Human review: none
Adverse to consumer: False
Notice: not recorded · reasons: False · specific: False · external data disclosed: False
Appeal channel: –
Consumer token: tok_9c302d037c