California’s ‘Super Significant’ Law Restricts Payers’ Use of AI
-
Jan 10, 2025
A California law that went into effect on Jan. 1 places stricter restrictions on payers’ use of artificial intelligence (AI) in coverage decisions, continuing a trend that the Biden administration and some states have looked at implementing. Two health care attorneys tell AIS Health, a division of MMIT, that the impact of the California law on health plans depends on guidance from the state that could come in the next few months. They add that they expect plans across the country to pay close attention to California’s implementation of the law because other states often follow California’s lead when it comes to health care regulation.
The law, known as the Physicians Make Decisions Act or SB 1120, requires that payers have physicians or other licensed providers make decisions about the medical necessity of treatments rather than relying solely on AI, algorithms or other software tools. It also mandates that the AI or other tools used by insurers must meet certain standards such as being fair and equitable and base decisions on individuals’ specific conditions and medical history and providers’ input.
Read more
© 2024 MMIT
The Latest
Meet Our Reporters
Meet Our Reporters
GAIN THERAPEUTIC AREA-SPECIFIC INTEL TO DRIVE ACCESS FOR YOUR BRAND
Sign up for publications to get unmatched business intelligence delivered to your inbox.