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Human judgment must remain central to health insurance claims: California law
While SB 1120 does not entirely prohibit the use of AI technology, it mandates that human judgment remains central to coverage decisions
But this month, a new state law is taking on the latest twist in the debate, ensuring that a human’s perspective cannot literally be removed from such decisions by prohibiting coverage denials be made on the sole basis of artificial intelligence algorithms. According to 2024 data from the California Nurses Association, approximately 26% of insurance claims are denied, one of many factors that inspired the law’s primary author, state Sen. Josh Becker, a Menlo Park Democrat. Paula Wolfson, a manager at Avenidas Care Partners, a Peninsula-based nonprofit serving older adults, described the challenges her clients face when navigating insurance denials.
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