California SB 1120 (Physicians Make Decisions Act) — Human Oversight

Yes. California SB 1120 (Physicians Make Decisions Act) addresses Human Oversight through 1 provision.

Does California SB 1120 (Physicians Make Decisions Act) require Human Oversight?

California • enforcing

Yes — 1 provision

This regulation imposes 5 specific requirements for Human Oversight across 1 provision:

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

Obligation:

enforcing

Effective:

Jan 1, 2025

Risk tier:

high-risk

Scope:

health care service plans, disability insurers, and their contractors

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

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