California’s SB 1120 Regulates AI in Health Plan Utilization Review and Management Activities Starting in January
On September 28, California Gov. Gavin Newsom signed Senate Bill 1120 Health Care Coverage: Utilization Review into law, amending § 1367.01 of the Health and Safety Code and § 10123.135 of the state’s Insurance Code. Effective January 1, the new law regulates how health care service plans and disability insurers, including specialized health care service plans and specialized health insurers, use artificial intelligence (AI), algorithms, and other software tools to ensure compliance with specified requirements—including fairness and non-discrimination standards—for utilization review and management processes. SB 1120 also applies to vendors contracted with covered health plans for services that include utilization review or utilization management functions. SB 1120 is just one of several wide-ranging AI-related laws California produced this legislative session. Overview of SB 1120 Health Care Coverage: Utilization Review SB 1120 aims to address the gr...