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California: Bill on medical treatment and AI referred to Committee
On February 21, 2024, Senate Bill 1120 to amend Section 1367.01 of the Health and Safety Code, and to amend Section 10123.135 of the Insurance Code, relating to healthcare coverage was referred to the Committee on Health, following its introduction by Senator Becker on February 13, 2024.
Scope of the bill
The bill, if enacted, would apply to a healthcare service plan and any entity with which it contracts for services that include utilization review or utilization management functions that prospectively, or concurrently reviews and approves, modifies, delays, or denies, based in whole or in part on medical necessity, requests by providers prior to, retrospectively, or concurrent with the provision of healthcare services to enrollees, or that delegates these functions to medical groups or independent practice associations or to other contracting providers.
Requirements under the bill
The bill would require physicians to supervise the use of artificial intelligence (AI) decision-making tools in cases where such tools are used to make decisions to approve, modify, or deny requests for the provision of healthcare services.
You can read the bill here and track its progress here.
Update: April 11, 2024
Bill unanimously approved by Senate Committee on Health
On April 10, 2024, Senator Josh Becker announced that the Senate Committee on Health unanimously approved the bill.
You can read the press release here, the bill here, and track its progress here.
Update: October 1, 2024
Bill signed by Governor
On September 28, 2024, the bill was signed by the Governor of California into law following its introduction to the California State Senate on February 13, 2024.
The Act requires a healthcare service plan or disability insurer, including a specialized healthcare service plan or specialized health insurer, that uses AI, algorithms, or other software tools for the purpose of utilization review or utilization management functions, or that contracts with or otherwise works through an entity that uses that type of tool, to ensure compliance with specified requirements. Such requirements include that the AI, algorithms, or other software tool base determinations on specified information and are fairly and equitably applied.
You can read the Act here and view its legislative history here.
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