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CA SB1120: Health care coverage: utilization review.

Enacted California · 2023–2024 session

Last verified Oct 12, 2026 · official bill text

SB1120 · where it stands

4 of 5 steps complete
  1. Introduced Complete
  2. Passed first chamber Complete
  3. Passed both chambers Complete
  4. Enacted Complete
  5. Effective Date not recorded
What do these statuses mean?
Introduced
Filed in the legislature; may be waiting for a committee hearing.
Passed a chamber
Approved by one or both chambers; awaiting further action.
Enacted
Signed into law, or became law without a signature or over a veto.
Effective date
The date the law says it takes effect. Once it has passed, the page shows "Effective" and the date. A court order can still block a law; if we know of one, the summary says so.
Dead / vetoed
Vetoed, failed, or the session ended without action.

In one paragraph

SB 1120 amended Health and Safety Code 1367.01 and Insurance Code 10123.135. Health plans and disability insurers that use an AI, algorithm or other software tool for utilization review must ensure it bases decisions on the enrollee's medical history and clinical circumstances, is applied fairly and equitably, does not supplant provider decisionmaking, and is open to inspection and review. Denials, delays or modifications for medical necessity must be made by a licensed physician or qualified health professional, not by the tool alone.

Plain-English summary, written with AI assistance. The official text controls.

What it means for business

Health plans, insurers, and utilization review vendors must document and govern AI tools and keep clinicians responsible for adverse determinations.

Key provisions

  1. Amends Health and Safety Code 1367.01 and Insurance Code 10123.135
  2. Applies to AI, algorithms, and software tools used in utilization review
  3. Determinations must rest on individual clinical information
  4. Fair and equitable application; no supplanting of provider decisionmaking
  5. Medical necessity denials must be made by a licensed clinician

Latest legislative action

Sep 28, 2024. Approved by the Governor September 28, 2024. Chaptered by Secretary of State - Chapter 879, Statutes of 2024.

Topics and industries

Related topics

AI HealthcareAI in Insurance

Affected industries

HealthcareFinance

This page is general information, not legal advice. Summaries are AI-assisted and may contain errors; read the statute for the controlling text and talk to a lawyer about your situation. Full disclaimer · Report an error

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AB 1979 Health care services: artificial intelligence. AB489 Health care professions: deceptive terms or letters: artificial intelligence. SB503 Health care services: artificial intelligence. AB3030 Health care services: artificial intelligence. SB579 Mental health and artificial intelligence working group. SB1146 Advertisement claims: health-related consumer products and services: digital rep

Same topic in other states

Nebraska LB77 Adopt the Ensuring Transparency in Prior Authorization Act and provide for insur Maryland HB820 Health Insurance - Utilization Review - Use of Artificial Intelligence Illinois SB3114 TRANSPARENCY IN DOWNCODING ACT Washington SB5395 Making improvements to transparency and accountability in the prior authorizatio Minnesota HF4188 Commerce policy bill (Laws 2026, chapter 124), including article 3, section 6 ba Alabama SB 63 Health care plans; to regulate the use of artificial intelligence in determinati