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usonian

(21,514 posts)

2. AFAICT, it only applies to AI assisted decisions.

Reply to Silent Type (Reply #1)

Mon Jan 6, 2025, 02:11 AM

Jan 2025

It doesn't seem to affect non-AI decisions.

From the summary linked above:

Existing California law mandates health care service plans and disability insurers to implement UR policies governing the approvals, modifications, delays, or denials of health care services before, after, or at the time services are rendered. SB 1120 expands the scope of California’s current laws to include the use of AI by health care service plans, disability insurers, and their contractors in UR or UM related decisions.

But IANAL.

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New California law prohibits using AI as (sole) basis to deny insurance claims [View all] usonian Jan 2025 OP

So, would that mean that Medicare can no longer deny claims for non-covered diagnoses, questionable services, Silent Type Jan 2025 #1

AFAICT, it only applies to AI assisted decisions. usonian Jan 2025 #2

What I'm saying is that AI is just a new name for what government programs and private insurers Silent Type Jan 2025 #3