Field-Level Provenance: Why "Trust Me" Isn't Good Enough for AI in Healthcare

Last week I wrote about why healthcare benefit data is still trapped in PDFs . The response told me something: people in this space know the problem is real. But extraction is only half the story. The harder question is: when an AI system pulls a copay amount from a carrier document, can you prove where that number came from? Not "the AI said so." Not a confidence score with no backing. Can you point to a specific page, a specific table cell, a specific paragraph in the source PDF and say: this value came from here? That is field-level provenance. And in healthcare, it is no longer optional. The Regulatory Floor Just Rose In January 2026, two state laws went into effect that changed the baseline for AI-generated content in healthcare. California SB 942 requires AI systems to disclose when content is AI-generated and to maintain audit trails. Texas HB 149 mandates transparency about AI decision-making processes in regulated industries, with healthcare squarely in scope. These are not theoretical. They are enforceable. And they are just the beginning. CMS transparency mandates tighten every year. Gartner declared digital provenance an enterprise baseline for 2026. The industry is not moving toward provenance. It has arrived. The Problem with Self-Reported Citations Most AI extraction systems today work like this: a language model reads a document, extracts values, and reports where it found them. The model does the extraction AND the citation. It is grading its own homework. This seems fine until you look closer. A language model that hallucinates a copay amount will also hallucinate the page number it came from. The citation and the extraction fail together, silently, in the same direction. In a coverage dispute that ends up in a regulatory proceeding, "the AI told us it found this on page 3" is not evidence. It is hearsay from a statistical model. What Deposition-Grade Provenance Looks Like Field-level provenance means every extracted value carries metadata from an