Governor Gavin Newsom has signed CMA-Sponsored Senate Bill 1120 (SB 1120), also known as The Physicians Make Decisions Act, authored by Senator Josh Becker (D-Menlo Park). This landmark legislation protects patients’ access to essential medical treatments by requiring health insurers to ensure proper oversight by qualified healthcare providers when using artificial intelligence (AI) algorithms in medical decision-making processes.
“Artificial intelligence is an important and increasingly utilized tool in diagnosing and treating patients, but it should not be the final say on what kind of healthcare a patient receives,” said Senator Becker. “An algorithm does not fully know and understand a patient’s medical history and needs, and it can lead to erroneous or biased decisions about medical treatment. The Physicians Make Decisions Act ensures that the human element will always determine quality medical treatments for patients.”
California Medical Association (CMA) President Tanya W. Spirtos, M.D., added, “As physicians, we recognize that AI can be a powerful tool to improve healthcare, but it should never replace the expertise and decision-making of physicians. We applaud Senator Becker and Governor Newsom for enacting this critical measure to safeguard the health and safety of our patients.”
The increasing reliance on AI by health insurance plans to process claims and prior authorization requests has sparked both optimism and concern. While AI has the potential to enhance efficiency and access to care, its unchecked use raises legitimate concerns about inaccuracies, biases, and wrongful denials of care. Such errors can have severe consequences, including negative health outcomes or even death.
SB 1120 directly addresses these challenges by requiring that any denial, delay, or modification of healthcare services based on medical necessity be determined by a licensed physician or another healthcare provider with the clinical expertise relevant to the case. Additionally, the bill mandates fair and equitable standards for insurers that incorporate AI into their utilization review processes, ensuring human oversight remains central to decision-making.
By reinforcing human judgment and setting standards for ethical AI use, The Physicians Make Decisions Act aims to uphold the integrity of California’s healthcare system and prioritize patient well-being above all else.
SB 1120 takes effect on January 1, 2024.
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