Regulatory Assessment

HL-UR-0905 PASS

TX · health · utilization review · decided 2026-10-15 23:21 UTC · Harborline Health Plan, Inc. (fictional)

On 2026-10-15, 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. A human reviewed the output by a nurse. The outcome was not adverse to the consumer. RegBench applied 5 rule(s) in force on 2026-10-15 and recorded no findings.

PASS: 0 finding(s) under rules 2026.10+dbe5ddf6, corpus 2026-10-30-5f07c521. No regulatory finding; the case file is recorded.

Findings (0)

No finding under the rules in force on 2026-10-15 for this state, line and stage. The case file is recorded all the same.

Point in time

Law as of: 2026-10-15
Rules version: 2026.10+dbe5ddf6
Corpus snapshot: 2026-10-30-5f07c521
Engine: regbench-engine/0.4.0 · deterministic-1
Fingerprint: 944b7816cb4e90fe816bf10b
Evaluated: 2026-10-30 11:23:24 UTC
Exhibit C case file: yes

Ledger

Entry: #905 · assessment · recorded 2026-10-15T23:24:58+00:00
Hash: a08cd0b085730be1f2e5d080d600a3dcc17c960ba5dc09964ef19eb3672ca530
Previous: 7b03be2959511d54c01be0c38abc778a6277106abfb59202d8e90f39f3bcd713
Stored copy intact: yes, hashes match

Verify the whole chain Case file JSON

Carrier review

No review item: the disposition was PASS.

Recorded facts

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 0.266
Human review: yes (nurse)
Adverse to consumer: False
Notice: not recorded · reasons: False · specific: False · external data disclosed: False
Appeal channel: –
Consumer token: tok_acf3c387ae