HomeLegal DirectoryCA SB 1120 (AI prior auth)

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California SB 1120 — Physicians Make Decisions Act (AI prior authorization limits)

CA · Cal. Stats. 2024 Ch. 879; Cal. Health & Safety Code § 1367.01

California prohibits health insurers from using AI or algorithms to deny, delay, or modify medical care — only a qualified physician can make a coverage denial. The law applies to all California-regulated health plans, including commercial, Medi-Cal managed care, and Knox-Keene plans.

Technical detail

Cal. Stats. 2024 Ch. 879 (SB 1120) codified at Cal. Health & Safety Code § 1367.01 and Cal. Ins. Code § 10123.135. Requires that any decision to delay, deny, or modify health care services based on medical necessity be made by a licensed physician or licensed clinical professional. Prohibits AI from making the final adverse determination.

Who is protected: California enrollees in commercial and Medi-Cal managed care health plans

Who must comply: Health care service plans (Knox-Keene), disability insurers offering health coverage in California

Key facts

JurisdictionCA
LevelState
StatusIn effect
Protection strengthStronger protection
Effective date2025-01-01
Enacted2024-09-28
CitationCal. Stats. 2024 Ch. 879; Cal. Health & Safety Code § 1367.01
Enforced byCalifornia Department of Managed Health Care; California Department of Insurance
Private right of actionNo — agency enforcement only
PenaltiesDMHC administrative penalties up to $50,000 per violation under Cal. Health & Safety Code § 1368.04; license actions
Topicshealthcare AI · automated decision-making · consumer protection
Last verified2026-06-17
Official sourceCalifornia SB 1120 (2024) — Physicians Make Decisions Act ↗

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