CMA bill to ensure health plan use of AI doesn't interfere with physician decision-making clears Senate Health Committee

April 11, 2024
Area(s) of Interest: Advocacy 

Anna Yap, M.D., testifies in support of SB 1120 at the Senate Health Committee’s April 10, 2024, hearing
Anna Yap, M.D., testifies in support of SB 1120 at the Senate Health Committee’s April 10, 2024, hearing

A bill sponsored by the California Medical Association (CMA) that would institute guardrails on the use of artificial intelligence (AI) in health care settings advanced out of the Senate Health Committee on Wednesday.

Senator Josh Becker’s Senate Bill 1120, known as the "Physicians Make Decisions Act," would require physician oversight of utilization review decisions made or assisted by a health plan’s AI decision making tools or algorithms. Recent news reports have highlighted instances and allegations of health plans using AI algorithms to wrongly deny medically necessary care.

“Artificial intelligence is an important and increasingly utilized tool in diagnosing and treating patients, but it should not be the final say on what kind of health care a patient receives,” said Becker. “An algorithm does not fully know and understand a patient’s medical history and needs and can lead to erroneous or biased decisions on medical treatment. The Physicians Make Decisions Act ensures that the human element will always determine quality medical treatments for patients.”

SB 1120 would also ensure that AI and algorithms used for utilization review purposes do not discriminate on the basis of race, color, religion, national origin, ancestry, age, sex, gender, gender identity, gender expression, sexual orientation, present or predicted disability, expected length of life, degree of medical dependency, quality of life or other health conditions.

“AI can be a powerful tool for supporting physicians and making clinical decisions, but we must be aware that they can be deeply flawed,” said Anna Yap, M.D., a Sacramento emergency medicine physician who represented CMA to testify in support of the bill. “AI models used by physicians to detect diseases, such as cancer, or suggest the most effective treatment are evaluated by the Food & Drug Administration, but the AI tools targeted in this bill, which are used by insurers in deciding whether those life-altering treatments should be paid for, are not subjected to the same scrutiny and have little independent oversight.”

“Senate Bill 1120 is an important step towards preserving the physician-patient relationship and ensuring that patients receive the highest quality of care. Artificial intelligence has its place in health care, but it should never replace the expertise and compassion of a trained physician,” said CMA President Tanya W. Spirtos, M.D. “Thank you to Senator Becker and the Senate Health Committee for advancing SB 1120, which prioritizes patient safety and quality care.”

The bill will next be heard in the Senate Appropriations Committee.

To receive updates on these bills as they make their way through the legislative process, make sure to subscribe to CMA Newswire.


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