Landmark Law Prohibits Health Insurance Companies from Using AI to Deny Healthcare CoverageDecember 9, 2024The Physicians Make Decisions Act Ensures Health Care Decisions Are Made by Medical Professionals, Not AlgorithmsSacramento, CAAs 2025 approaches, Californians can look forward to strengthened patient protections under the new Physicians Make Decisions Act (SB 1120), authored by Senator Josh Becker (D-Menlo Park). This groundbreaking law ensures that decisions about medical treatments are made by licensed health care providers, not solely determined by artificial intelligence (AI) algorithms used by health insurers.Artificial intelligence has immense potential to enhance healthcare delivery, but it should never replace the expertise and judgment of physicians, said Senator Becker. An algorithm cannot fully understand a patients unique medical history or needs, and its misuse can lead to devastating consequences. SB 1120 ensures that human oversight remains at the heart of healthcare decisions, safeguarding Californians access to the quality care they deserve.Ensuring Human Oversight in Healthcare DecisionsIn recent years, insurers have increasingly turned to AI to process claims and prior authorization requests. While these tools can improve efficiency, they also raise concerns about inaccuracies and bias in healthcare decision-making. Errors in algorithm-driven denials of care have, in some cases, resulted in severe health outcomes or even loss of life.Under SB 1120, any denial, delay, or modification of care based on medical necessity must be reviewed and decided by a licensed physician or qualified health care provider with expertise in the specific clinical issues at hand. The law also establishes fair and equitable standards for companies using AI in their utilization review processes, preventing improper or unethical practices.California Leads the Nation in AI Regulation for HealthcareSponsored by the CMA, which represents 50,000 physicians statewide, SB 1120 sets a national precedent for ensuring AI in healthcare is used responsibly. This law reaffirms Californias commitment to equitable, patient-centered care while addressing legitimate concerns surrounding the expanding role of technology in healthcare.Other states are following California's lead in implementing laws to protect patients from utilizing AI to determine patient health care decisions.The Physicians Make Decisions Act will officially go into effect on January 1, 2025.