California Requires AI-Assisted Medical Necessity Decisions To Be Supervised By Health Care Professionals

A new California law requires that artificial intelligence (AI) algorithms or other software tools used to make medical necessity decisions must be supervised by a licensed, qualified physician or clinical professional who has reviewed a consumer’s medical history and other records. The decisions, in particular denials of medical necessity, cannot rest solely on a determination made by an AI algorithm. However, the law does not entirely prohibit the use of AI technology.

The law was the result of the “Physicians Make Decisions Act,” California Senate Bill 1120, which went into effect on January 1, 2025. The provisions apply to . . .