Lexology December 23, 2024
SB 1120 (the “Bill”), which takes effect on January 1, 2025, amends existing California law to adopt guardrails around the use of artificial intelligence tools for the purpose of utilization management.[1] As discussed in a prior Proskauer alert, the Bill represents one of the latest attempts by the California legislature to regulate the use of AI in the health care industry.
Overview of the Bill’s Requirements
The Bill addresses utilization management and utilization review (“UM/UR”) requirements for “health care service plans”, “disability insurers”, “specialized health insurers,” and their contractors (“Covered Plans”). In addition, the UM/UR requirements apply to Medi-Cal managed care plans, so long as federal funding is not jeopardized by the rules. Notably, these requirements apply to UM/UR functions...
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