Manatt Health Partner Randi Seigel and Manager Annie Fox were quoted in an article by InsideHealthPolicy on two pending California bills regulating health care artificial intelligence (AI) use in prior authorization and coverage decisions, as well as communications related to patients’ clinical information, respectively.
Senate Bill 1120, also known as the Physician Make Decisions Act, would require physicians to decide the patient’s final medical coverage necessities after AI tools were used, providing guidance consistent with the Centers for Medicare and Medicaid Services (CMS) for the Medicare Advantage plans. “[The California bill], similar to CMS’s guidance, appears to strike a fair balance between allowing a plan to use AI to improve efficiency in utilization review while ensuring that a human reviews decisions (and agrees with decisions) that would have an adverse impact of the plan’s members,” Seigel said.
The other bill, AB 3030, would require health providers who use AI to draft patient communications regarding clinical information to provide a disclaimer which includes instructions on how to contact a “human health care provider” or employee. According to Fox, the disclaimed notably is no longer required to state that a human reviewed the AI-generated communications.
InsideHealthPolicy subscribers can read the full article here.
Read more about how Manatt Health is tracking the latest AI legal developments in California here.