Bill > SB1120

This bill would require health care service plans and disability insurers, including those that use artificial intelligence, algorithms, or other software tools for utilization review or utilization management functions, to ensure compliance with certain requirements. These include basing determinations on the enrollee's or insured's medical history and individual clinical circumstances, not discriminating against enrollees or insureds, and ensuring the tools are fairly and equitably applied. The bill also specifies that a licensed physician or other competent health care professional must make the determination of medical necessity, not the artificial intelligence or software tool. The bill would impose a state-mandated local program, but no reimbursement would be required.

Budget and Finance, Business and Industry, Health and Social Services

https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202320240SB1120