California SB 1120 (Physicians Make Decisions Act)

Jurisdiction:

California

enforcing

Effective:

Jan 1, 2025

Authority:

California Department of Managed Health Care

Official text Verified May 21, 2026

Obligations Covered

Human Oversight

Provisions (1)

Physician Supervision of AI #

Obligation:

Human Oversight

enforcing

Effective:

Jan 1, 2025

Risk tier:

high-risk

Scope:

health care service plans, disability insurers, and their contractors

Requirements

Requirement	Details
Physician-only determinations	Only licensed physicians or qualified professionals may deny, delay, or modify services based on medical necessity — AI cannot make these calls
Clinical basis	AI tools must base utilization review determinations on enrollee clinical history, provider circumstances, and medical records
Non-supplanting	AI must not supplant provider decision-making in utilization review
Non-discrimination	AI must be equitably applied and not discriminate
Auditability	AI tools used for UR/UM must be auditable

Penalties

Violation	Fine
Non-compliance	CA Department of Insurance + AG enforcement

Cite this regulation

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Attribution: EveryAILaw, PAICE.work PBC. “California SB 1120 (Physicians Make Decisions Act)”, EveryAILaw.com, May 21, 2026. https://everyailaw.com/regulation/california-sb1120/

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