Healthcare AI laws by state
AI Laws USA tracks 62 U.S. AI rules on healthcare AI across federal, state, county, and city government. Each entry links to its official source.
Federal healthcare AI rules (16)
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In effect
FDA PCCP Guidance (AI/ML devices)
United States · Effective December 4, 2024 · FDA Guidance (Dec. 4, 2024); 21 U.S.C. § 360e-4
FDA finalized a framework that lets manufacturers update an AI-enabled medical device after clearance without filing a new submission for each change — but only if they pre-specify what changes are allowed, how they'll be validated, and how transparency to clinicians and patients will be preserved.
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In effect
FTC HBNR Rule (AI health apps)
United States · Effective July 29, 2024 · 16 C.F.R. Part 318; 89 Fed. Reg. 47028
Health apps and connected devices — including AI-powered mental health and fitness tools — must notify users, the FTC, and (in some cases) the media within 60 days of a breach of identifiable health information. The 2024 amendments confirm that AI-generated inferences about health are covered.
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In effect
HHS § 1557 Rule (AI clinical tools)
United States · Effective July 5, 2024 · 45 C.F.R. § 92.210; 89 Fed. Reg. 37522
HHS's Section 1557 rule bans discrimination in 'patient care decision-support tools,' which includes AI and algorithmic clinical tools. Covered health programs and providers must identify when a tool relies on patient race, age, disability, or other protected traits and take steps to mitigate the risk of discrimination.
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In effect
CMS MA Rule (AI prior auth)
United States · Effective January 1, 2024 · 42 C.F.R. § 422.101(c); 88 Fed. Reg. 22120 (Apr. 12, 2023)
Medicare Advantage plans cannot use algorithms or AI to deny medically necessary care. Any algorithm-driven coverage decision must comply with traditional Medicare coverage criteria and consider the individual patient's circumstances — not just generic model output.
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Blocked / in litigation
Lokken v. UnitedHealth (nH Predict)
D. Minn. · Effective November 14, 2023 · Estate of Lokken v. UnitedHealth Group, Inc., No. 0:23-cv-03514 (D. Minn.)
Families of deceased Medicare Advantage patients sued UnitedHealth in November 2023 over the 'nH Predict' algorithm, alleging the AI tool overrode physicians and prematurely terminated post-acute care coverage with an error rate above 90 percent in appeals — accelerating patient harms and deaths. On March 9, 2026, the court issued a significant discovery order compelling UnitedHealth to produce broad documentation of the nH Predict algorithm, including training data, model documentation, and internal performance audits.
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In effect
VA Trustworthy AI Framework
United States · Effective September 22, 2023 · VA Directive 1003.2; VA AI Strategy (Sept. 2023)
The VA's Trustworthy AI Framework governs how AI may be used across VA healthcare, benefits, and operations. AI used in benefits or clinical decisions requires human review, bias testing, and an AI use-case inventory submitted to OMB.
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Blocked / in litigation
Cigna PXDX AI Denial Class Action
E.D. Cal. · Effective July 24, 2023 · Kisting-Leung v. Cigna Corp., No. 2:23-cv-01477 (E.D. Cal.)
Patients sued Cigna in 2023 alleging its 'PxDx' algorithm reviewed and denied roughly 300,000 claims in two months — averaging 1.2 seconds per denial — without genuine physician review, violating California and federal law. Triggered a wave of similar AI healthcare-denial suits against UnitedHealth (NaviHealth) and Humana.
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In effect
FDA GMLP Principles
United States · Effective October 27, 2021 · FDA/HC/MHRA GMLP Guiding Principles (Oct. 27, 2021)
Joint guiding principles by FDA, Health Canada, and the UK MHRA on safe development of ML-enabled medical devices. Updated by FDA's 2024 Transparency Guiding Principles.
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In effect
FDA AI/ML SaMD Action Plan
United States · Effective January 12, 2021 · FDA AI/ML SaMD Action Plan (Jan. 12, 2021)
FDA's 5-part roadmap for regulating AI/ML-based Software as a Medical Device, including a proposed Predetermined Change Control Plan framework that lets developers update models without full FDA re-review.
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In effect
FDA 510(k) — surgical robots
United States · Effective May 28, 1976 · 21 U.S.C. § 360(k); 21 C.F.R. Part 807
Robotically-assisted surgical devices (RASD) — like Intuitive's da Vinci or Stryker's Mako — are FDA-regulated medical devices. Most clear the market through the 510(k) pathway by showing substantial equivalence to a predicate device. The FDA issued a 2019 safety communication and continues to police off-label robotic mastectomy and AI-software updates under its evolving 'Predetermined Change Control Plan' authority.
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In effect
ACA § 1557 (AI in patient care)
United States · Effective May 1, 2025 · 42 U.S.C. § 18116; 45 C.F.R. § 92.210
A 2024 HHS rule says hospitals, insurers, and other covered health entities may not discriminate through clinical algorithms and AI decision-support tools, and must make reasonable efforts to find and fix bias in those tools. The requirement took effect May 1, 2025, but HHS has stayed quiet on enforcement, so its practical protection is uncertain while it stays on the books.
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In effect
FSMB AI Guidance
United States · Effective April 26, 2024 · FSMB Policy (Apr. 26, 2024)
FSMB adopted a national framework guiding all U.S. state medical boards on what physicians must do when using AI: maintain transparency with patients, ensure AI tools are appropriate to use, supervise AI outputs, and protect patient privacy. States are adopting it as the model framework.
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In effect
FDA AI Drug/Bio Guidance
United States · Effective May 10, 2023 · FDA Discussion Paper (May 2023); CDER/CBER Draft Guidance (Jan. 2025)
FDA published a framework setting expectations for how drug and biologics companies use AI/ML across drug discovery, clinical trials, postmarket safety surveillance, and manufacturing. The framework signals that AI used in regulatory submissions must be transparent, validated, and reproducible.
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Proposed / pending
2026-08281
United States · HHS 2026-08281
The Food and Drug Administration (FDA or the Agency) is issuing this request for information to solicit input on a proposed pilot program to assess how artificial intelligence (AI)-enabled technologies can improve efficiency, speed, and quality of decision- making in early phase clinical trials. Early-phase clinical trials represent a critical bottleneck in drug development, often characterized by high uncertainty, limited patient populations, and inefficient decision- making processes. This pilot program aims to explore how advances in AI and data science can improve trial efficiency, enhance
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Proposed / pending
US H.R. 10210 Doctors Not AI Act (AI in health insurance claim review)
United States · H.R. 10210, 119th Cong. (2026)
A bipartisan House bill that would set rules for how group health plans and health insurers use artificial intelligence when reviewing claims, by amending the Public Health Service Act, ERISA and the Internal Revenue Code. It was introduced on Sept. 1, 2026 and sent to three committees. It has not passed either chamber.
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Proposed / pending
US H.R. 9862 Responsible AI for Veterans Act (independent evaluation of VHA AI)
United States · H.R. 9862, 119th Cong. (2026)
A House bill that would direct the Secretary of Veterans Affairs to seek an agreement with a federally funded research and development center for an independent evaluation of the artificial intelligence systems used by the Veterans Health Administration. It was introduced on July 22, 2026 and sent to the Veterans' Affairs Committee. It has not passed either chamber.
State healthcare AI rules (44)
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Enacted (not yet in effect)
California SB 1119 Adam's Law, companion chatbots (2026)
California · Effective July 1, 2027 · Cal. S.B. 1119 (2025-2026 Reg. Sess.), Stats. 2026, ch. 190 — Adam's Law, Bus. & Prof. Code § 21810 et seq. (approved September 10, 2026; main duties operative July 1, 2027)
California Senate Bill 1119, which the law itself names "Adam's Law" (press coverage calls it the Adam Raine Law), was signed by Governor Gavin Newsom on September 10, 2026 (Chapter 190). Starting July 1, 2027, companies that run companion chatbots must protect users under 18. By default, a child can chat for no more than one hour at a time and two hours a day, and only a parent can change those limits. Operators must have a crisis plan that points a child to crisis services, must tell a parent as soon as practicable if the chatbot detects a credible threat of suicide or self-harm, must assess risks to children before launching a new or substantially changed chatbot, and must publish a child safety policy. Public prosecutors can seek civil penalties of up to $5,000 per affected child, or $15,000 if the violation was intentional, and a harmed child or their parent can sue for actual damages.
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Enacted (not yet in effect)
Illinois SB 3114 — Transparency in Downcoding Act
Illinois · Effective January 1, 2028 · Illinois PA 104-0568 (SB 3114), approved July 10, 2026; effective January 1, 2028 (Transparency in Downcoding Act)
Illinois Senate Bill 3114, the Transparency in Downcoding Act (Public Act 104-0568), signed by Governor Pritzker on July 10, 2026 and effective January 1, 2028, limits how health insurers and other payors can use algorithms to 'downcode' medical claims (pay a claim at a lower billing code than submitted). A payor may use automated tools to flag claims that might justify downcoding, but may not use any algorithm or automated process that bypasses evaluation of all the information the billing professional submitted, and every downcoding determination must be made or reviewed by a natural person following AMA CPT coding guidelines. Payors cannot downcode based solely on diagnosis codes or target professionals who treat complex or chronic patients, and must give notice and a dispute process. Medicaid managed care organizations must also comply.
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Enacted (not yet in effect)
RI AI Companion Self-Harm Safety (2026)
Rhode Island · Effective January 1, 2027 · R.I. Pub. Laws 2026, ch. 376 (S 2195 Sub A as amended) and ch. 375 (H 7350 Sub A as amended), R.I. Gen. Laws ch. 6-64 — enacted June 22, 2026; effective January 1, 2027
Rhode Island enacted S 2195 / H 7350 on June 22, 2026, and the law takes effect January 1, 2027. Companies that offer AI companion chatbots must build in protocols for users who express possible suicidal thoughts, self-harm or intent to physically harm others, and must then point the user to crisis services such as a suicide hotline or crisis text line. The chatbot must tell users at the start of a conversation, and at least every three hours during it, that they are not talking to a human. Starting July 1, 2027, operators must file yearly reports with the Attorney General on how often the safety protocols were triggered. The Attorney General enforces the law, with civil penalties up to $15,000 per day, directed to suicide prevention programs.
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Enacted (not yet in effect)
Iowa HF 2635 (no AI-only prior-auth denials)
Iowa · Effective January 1, 2027 · Iowa H.F. 2635, 91st Gen. Assemb. (2026), Sec. 514F.8(2A), eff. Jan. 1, 2027
Iowa lets a utilization review organization use an AI-based algorithm or system to conduct an initial review of a prior-authorization request, but forbids relying on AI as the sole basis to deny, delay, or downgrade a medical-necessity prior-authorization request. A qualified human reviewer — a clinical peer or qualified reviewer — must make the binding determination.
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In effect
Alabama SB 63 (AI in prior authorization, eff. Oct 2026)
Alabama · Effective October 1, 2026 · Ala. Act 2026-589 (SB 63, 2026 Regular Session), approved April 16, 2026, effective October 1, 2026
Alabama's SB 63 (Act 2026-589), approved April 16, 2026 and effective October 1, 2026, limits how health insurers use AI in prior authorization. When an insurer uses AI to decide whether a requested service is medically necessary, the decision must be based on the patient's own medical history and the clinical circumstances presented by the requesting provider. Any decision to deny, delay or modify a prior-authorization request on medical-necessity grounds must always be made by a licensed physician or other qualified health care professional, not by AI. Insurers must certify every year to the Alabama Department of Insurance that their AI does not rely on a group dataset, is applied fairly and equitably, and does not discriminate against any subscriber group or enrollee. They must also disclose their use of AI in utilization review prominently in their written policies and procedures and review the AI's outcomes periodically for accuracy and reliability.
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In effect
Missouri AI Therapy Chatbot Ban (SB 1019)
Missouri · Effective August 28, 2026 · Mo. SB 1019 (2026 Reg. Sess.); MMPA enforcement; effective Aug 28, 2026
Missouri's 2026 health-care law bans companies and individuals from advertising or claiming that an AI chatbot can act as a mental-health professional or provide therapy services. Marketing an AI 'therapist' is treated as an unlawful business practice the state Attorney General can pursue, with fines of $10,000 for a first violation and $20,000 for each later violation.
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In effect
AZ HB 2175 (AI Insurance Denial — Physician Review)
Arizona · Effective July 1, 2026 · Ariz. HB 2175 (57th Leg., 1st R.S. 2025), signed May 12, 2025, eff. July 1, 2026
Arizona HB 2175 requires health insurers and managed-care organizations to have a licensed physician or medical director individually review each case before denying a health insurance claim or prior-authorization request based on medical necessity or experimental status. Insurers may not rely solely on AI algorithms, automated decision-support tools, or algorithmic recommendations to deny coverage. The law directly targets automated prior-authorization systems that issue denials without physician involvement. Signed May 12, 2025, effective July 1, 2026. Arizona is among the first states to specifically prohibit AI-only health insurance denials by statute.
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In effect
RI Therapy Chatbot Ban (2026)
Rhode Island · Effective June 22, 2026 · R.I. Pub. Laws 2026, ch. 373 (H 7349 Sub A) and ch. 374 (S 2197 Sub A as amended); R.I. Gen. Laws ch. 40.1-5.5, approved June 22, 2026
Rhode Island Governor Dan McKee signed H 7349 / S 2197 on June 22, 2026, prohibiting any person or business from providing therapy or psychotherapy services using artificial intelligence. Only licensed mental health professionals may conduct such sessions. The law targets AI companion chatbots and virtual therapy products that may lead users to believe they are receiving licensed mental health care from a human professional.
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Blocked / in litigation
PA v. Character.AI (Fake Psychiatrist Chatbot)
Pennsylvania · Effective May 1, 2026 · Commonwealth v. Character Technologies, Inc. (Pa. Commonwealth Ct., filed May 1, 2026)
Pennsylvania Attorney General Josh Shapiro filed suit in Commonwealth Court on May 1, 2026, alleging that Character.AI's companion chatbot 'Emilie' impersonated a licensed Pennsylvania psychiatrist and provided ongoing psychiatric advice and treatment to users without a license. The Shapiro administration seeks a preliminary injunction requiring Character.AI to clearly disclose that its chatbots are not licensed mental health professionals and cannot provide medical treatment.
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In effect
California AB 489 (AI healthcare chatbot misrepresentation ban)
California · Effective January 1, 2026 · Cal. Bus. & Prof. Code §§ 4999.8–4999.9 (AB 489, Ch. 615, Stats. 2025), effective January 1, 2026
California AB 489, signed October 11, 2025 and in effect since January 1, 2026, stops AI and generative-AI products from using terms, letters or phrases in their advertising or functionality that indicate or imply that the care, advice, reports or assessments they offer come from a licensed human health care professional (for example, 'M.D.' or 'R.N.'). It extends California's existing bans on falsely implying a health care license to the companies that develop or deploy AI. Each prohibited use counts as a separate violation, and the relevant health care licensing boards can enforce, including by seeking an injunction.
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In effect
Nebraska LB 77 (no AI-only prior-auth denials)
Nebraska · Effective January 1, 2026 · Neb. LB 77 (109th Leg., 2025), operative Jan. 1, 2026
Nebraska's Ensuring Transparency in Prior Authorization Act bars utilization review agents from using an AI-based algorithm or automated system as the sole basis for denying, delaying, or modifying a health care service based, in whole or in part, on medical necessity. Any prior authorization denial based on medical necessity must involve human clinical review, not AI alone. The law also requires a single standardized prior authorization form of no more than two pages, streamlining the administrative process. Signed June 4, 2025 by Governor Pillen; effective January 1, 2026.
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In effect
Maryland HB 820 (AI in insurance utilization review)
Maryland · Effective October 1, 2025 · 2025 Md. Laws ch. 747 (HB 820); Md. Code, Ins. 15-10A-06, 15-10B-05.1
When a Maryland carrier, pharmacy benefits manager, or private review agent uses artificial intelligence or an algorithm in utilization review, the tool's determinations must be based on the individual patient's clinical history, not solely on a group dataset. The AI may not replace the role of the reviewing provider, must not result in unfair discrimination, must remain open to audit, and may not deny, delay, or modify care in a way that harms enrollees. Carriers must report to the Insurance Commissioner quarterly on adverse decisions, including whether AI was used.
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In effect
IL WOPR (AI therapy ban)
IL · Effective August 1, 2025 · P.A. 104-0054; 225 ILCS 8/
Illinois banned AI-only therapy and made it unlawful for AI products to claim or imply they can provide mental-health treatment without a licensed clinician supervising. Aimed at consumer-protection harms from companion/therapy chatbots that misrepresent clinical credentials.
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In effect
SB 1120 (CA Physicians Make Decisions Act)
California · Effective January 1, 2025 · Cal. Health & Safety Code § 1367.01; Cal. Ins. Code § 10123.135 (SB 1120, Stats. 2024, ch. 879)
California was the first U.S. state to directly prohibit health insurance plans from using AI to deny, delay, or modify care. Under SB 1120, when a plan uses AI or algorithms in utilization review, a licensed physician or other qualified clinician — not an AI system — must make every medical-necessity determination. AI tools can assist in data analysis, but the final coverage decision must come from a licensed human. Insurers must disclose AI use and make their algorithms available for regulatory audits. Signed September 28, 2024; effective January 1, 2025.
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Enacted (not yet in effect)
Idaho Conversational AI Safety Act (chatbot disclosure + crisis protocol)
Idaho · Effective July 1, 2027 · Idaho SB 1297 (2026), ch. 249
Idaho's Conversational AI Safety Act requires operators of conversational AI services to clearly disclose that a user is interacting with AI whenever a reasonable person could be misled into thinking it is human. Operators must adopt a protocol to respond to users who express suicidal ideation, including making reasonable efforts to refer them to crisis resources, and may not claim to provide professional mental or behavioral health care. There are added protections for minor users, including persistent AI disclosures and parental controls for younger children.
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Enacted (not yet in effect)
Iowa SF 2417 (Conversational AI Safety Act)
Iowa · Effective July 1, 2027 · Iowa S.F. 2417, 91st Gen. Assemb. (2026), applies July 1, 2027
Iowa requires operators of conversational AI services to clearly disclose that a user is interacting with artificial intelligence — through a persistent disclaimer or a notice repeated at least every three hours of continuous use — whenever a reasonable person might otherwise believe they are talking to a human. Operators must adopt protocols to respond to user messages about suicidal ideation or self-harm, including referring the user to crisis resources, and may not represent that the service provides professional psychological or behavioral health care, with extra safeguards for minors.
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Enacted (not yet in effect)
Nebraska LB 525 (AI chatbot disclosure & crisis protocol)
Nebraska · Effective July 1, 2027 · Neb. Laws 2026, LB 525, Secs. 12-18 (Conversational Artificial Intelligence Safety Act)
Nebraska's Conversational Artificial Intelligence Safety Act regulates publicly available AI chatbots that simulate human conversation. When a reasonable person would be misled into thinking they are talking to a human, the operator must clearly disclose that they are interacting with AI, and minors must always be told they are interacting with AI. Operators must adopt a protocol for responding to messages about suicidal thoughts or self-harm by referring users to crisis services, and must not program the service to claim it provides professional mental or behavioral health care.
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Enacted (not yet in effect)
Utah SB 319 (insurers must disclose AI use in prior authorization)
Utah · Effective January 1, 2027 · Utah Code 31A-22-650(2)(d), (3) (S.B. 319, 2026)
Utah requires health insurers that use AI in reviewing prior-authorization requests to be transparent about it. If applicable, an insurer must post a conspicuous notice on its public website that it uses AI in authorization review, and disclose that AI use to the state Insurance Department, each in-network provider, and each enrollee. The rules sit within a broader prior-authorization overhaul.
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Enacted (not yet in effect)
SB 26-189 (Colorado ADMT Law)
Colorado · Effective January 1, 2027 · SB 26-189 (Colo. 2026)
Colorado's replacement AI law focuses on transparency rather than broad anti-discrimination duties. Starting January 1, 2027, companies using automated decision-making technology to materially influence consequential decisions (employment, housing, lending, insurance, healthcare) must notify consumers before use and provide post-decision disclosures; developers must give deployers technical documentation.
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Enacted (not yet in effect)
SB 444 (GA AI Insurance Review)
Georgia · Effective January 1, 2027 · Ga. SB 444 (2026), sponsored by Sen. Kay Kirkpatrick
Health insurers in Georgia can't let AI alone decide your coverage. Decisions about insurance coverage for healthcare services cannot be based solely on AI systems or software tools — a qualified human reviewer must be part of every coverage determination, especially before denying treatment. Effective January 1, 2027.
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Enacted (not yet in effect)
HB 2225 (WA Chatbot Safety)
Washington · Effective January 1, 2027 · Wash. ESHB 2225, Ch. 168, Laws of 2026 (new chapter in Title 19 RCW); enforced via ch. 19.86 RCW
Washington requires AI companion chatbots to clearly tell users they are talking to an AI, not a person — at the start of a conversation and at least every three hours (every hour for known minors or bots aimed at minors). Operators must have crisis protocols that refer users expressing suicidal thoughts or self-harm to a suicide hotline or crisis text line, and must shield minors from sexual content and manipulative engagement tactics. Violations are unfair or deceptive practices under Washington's Consumer Protection Act, so consumers can sue and the Attorney General can enforce. Effective January 1, 2027.
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In effect
CT SB 5 (2026 AI Act)
Connecticut · Effective October 1, 2026 · Conn. Public Act 26-15 (SB 5, 2026)
After years of failed attempts, Connecticut enacted a comprehensive AI law in 2026 (Public Act 26-15, signed May 27, 2026). Starting October 1, 2026, employers filing federal layoff (WARN) notices must tell the state whether the layoffs relate to AI, and state anti-discrimination law makes clear that using automated hiring or employment-decision technology is no defense to a discrimination complaint. Strict AI companion-chatbot rules, especially for children, start January 1, 2027. Duties on developers and employers that use automated employment-decision technology apply to tools deployed on or after October 1, 2027.
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In effect
Maine AI-in-Therapy Law (licensed pros only)
Maine · Effective July 29, 2026 · P.L. 2025, ch. 687 (L.D. 2082 / H.P. 1397, 132nd Legis.); 10 M.R.S. Sec. 1500-EE
Maine bars anyone from providing, advertising, or offering therapy or psychotherapy to the public — including through internet-based AI — unless the services are delivered by a licensed professional. Licensed professionals may use AI only for administrative or supplementary support, and only if they retain full responsibility for its outputs; using AI for supplementary support requires written client notice and consent. AI may not make independent therapeutic decisions, engage in therapeutic communication with clients, or generate treatment plans without the licensee's review and approval.
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In effect
Indiana HB 1271 (no AI-only claim downcoding)
Indiana · Effective July 1, 2026 · Ind. House Enrolled Act 1271 (2026 Reg. Sess.), eff. July 1, 2026
Indiana bars health insurers from relying on an automated process or artificial intelligence as the only reason for downcoding a claim on medical-necessity grounds; an employee or contractor of the insurer must review the patient's medical record before such a downcode is applied. Health care providers likewise may not use AI to submit a claim without a human reviewing it. Insurers must disclose, in an easy-to-find and readable way, when AI is used to deny a prior-authorization request or to downcode a claim, must explain each downcode, and must give providers at least 180 days to appeal. The rules took effect July 1, 2026 and do not apply to Medicaid.
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In effect
Tennessee SB 1580 (AI can't claim to be a mental health professional)
Tennessee · Effective July 1, 2026 · 2026 Tenn. Pub. Ch. 647 (SB 1580); enforced under Tenn. Code Ann. 47-18-101 et seq. (TCPA)
Tennessee makes it unlawful for anyone who develops or deploys an artificial intelligence system to advertise or represent to the public that the system is, or can act as, a qualified mental health professional. Violations are treated as unfair or deceptive acts under the Tennessee Consumer Protection Act. The law authorizes a civil penalty of up to $5,000 per violation, along with injunctive relief and damages, and includes a private right of action for affected individuals.
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In effect
Wyo. Stat. 6-4-701 (felony to build/distribute AI systems meant to promote self-harm)
Wyoming · Effective July 1, 2026 · Wyo. Stat. Ann. 6-4-701; 2026 Wyo. Sess. Laws (HB0102 / HEA 32)
This new Wyoming crime targets AI systems built to encourage people to hurt themselves. It is a felony to knowingly develop or distribute an AI system specifically designed to promote self-harm, when done with intent or knowledge that others will use it that way. 'Self-harm' covers self-directed behavior causing or risking bodily injury, serious bodily injury, or death. Prompt-only systems, bona fide education, law enforcement, licensed health care, and platform hosting are exempted.
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In effect
Washington SB 5395 (limits AI in health-insurance prior-auth denials)
Washington · Effective June 11, 2026 · Engrossed Second Substitute S.B. 5395, 2025-26 Reg. Sess. (Wash.)
Washington bars health carriers from using AI to deny, delay, or modify health care services on its own; a denial based on medical necessity must be made by a licensed health professional. Where AI is used in prior authorization, it must be applied fairly, comply with anti-discrimination law, and base determinations on the individual enrollee's medical history, clinical circumstances, and relevant demographic data rather than broad group data. AI tools must be reviewed for accuracy, AI policies are subject to audit by the Insurance Commissioner, and carriers must report the share of denials aided by AI.
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In effect
Maryland HB 1563 (AI-denial reporting)
Maryland · Effective June 1, 2026 · 2026 Md. Laws ch. 165 (HB 1563); Md. Code, Ins. 15-10A-06
Among other emergency-room and post-acute care provisions, this law expands the quarterly report that carriers must submit to the Maryland Insurance Commissioner. The report must include the number of adverse decisions and whether an artificial intelligence, algorithm, or other software tool was used in making them. The Commissioner may use this information as a basis for examining the carrier.
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In effect
Delaware AI Medical-Titles Ban (no AI 'doctors')
Delaware · Effective April 23, 2026 · Del. H.B. 191, 153rd Gen. Assemb. (2025-2026), 85 Del. Laws c. 250 (amending 24 Del. C.)
This law makes clear that artificial intelligence and other nonhuman entities cannot be licensed or certified to practice medicine or nursing in Delaware. It bars AI agents from being licensed as a physician, physician assistant, professional nurse, advanced practice nurse, or practical nurse, and from using the professional titles or abbreviations tied to those roles, such as 'Dr.,' 'MD,' 'RN,' 'APRN,' or 'PA.' The intent is to prevent AI tools from misrepresenting themselves as licensed human clinicians, while still allowing AI to be used as a support tool by licensed professionals.
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In effect
California SB 243 (companion chatbots: AI disclosure + suicide-safety protocol)
California · Effective January 1, 2026 · Cal. Bus. & Prof. Code 22601 et seq. (SB 243, 2025)
This law sets safety rules for companion chatbots — AI systems designed to hold human-like, ongoing conversations that meet a user's social needs. Operators must tell users they are interacting with AI whenever a reasonable person might be fooled into thinking it is human, and must maintain a protocol for detecting and responding to signs of suicidal thoughts or self-harm, including pointing users to crisis resources. It adds extra protections for minors, such as disclosure, periodic break reminders, and measures to prevent sexually explicit content. Users harmed by violations can sue.
- 14 more
- AI Companion Safeguards Law · New York · In effect
- TX SB 1188 (AI in Health Records) · Texas · In effect
- TX SB 815 (No AI-Only Insurance Denials) · Texas · In effect
- Nevada AB 406 (therapists barred from using AI in care) · Nevada · In effect
- Nevada AB 406 (AI can't pose as a therapist) · Nevada · In effect
- Utah S.B. 226 (must disclose you're talking to AI on request; AI use no excuse) · Utah · In effect
- HB 452 (Mental Health Chatbots) · Utah · In effect
- California AB 3030 (GenAI patient messages must carry an AI disclaimer) · California · In effect
- Texas v. Pieces Technologies · TX · In effect
- Utah AI Policy Act · Utah · In effect
- My Health My Data Act · Washington · In effect
- Va. Code 32.1-127 (rules for patient voice assistants in care facilities) · Virginia · In effect
- Colorado AI Act (repealed) · Colorado · Repealed / replaced
- PA HB 2787 ban on AI for school mental health services · Pennsylvania · Proposed / pending
County healthcare AI rules (1)
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In effect
Los Angeles County prohibition on data centers in unincorporated areas (2026)
Los Angeles County, CA · Effective September 17, 2026 · Los Angeles County, Cal. — Department of Regional Planning memorandum prohibiting large-scale AI data center development in unincorporated areas, September 17, 2026, pending zoning code amendment
Los Angeles County's planning director ordered an IMMEDIATE PROHIBITION on the development of large-scale data centers that power artificial intelligence across the county's UNINCORPORATED AREAS. Department of Regional Planning Director AMY BODEK issued the directive in a memorandum on Thursday, September 17, 2026, saying it is intended to serve as INTERIM GUIDANCE FOR PLANNING STAFF while the county moves toward codifying the prohibition in its zoning code. This is the largest jurisdiction to act in this dataset. Los Angeles County is the most populous county in the United States, and its unincorporated areas alone hold more people than many states. The path here is worth following because it is not a moratorium. Board Chair and First District Supervisor HILDA SOLIS introduced a motion in April 2026 addressing public health and environmental concerns about data centers, and THE BOARD OF SUPERVISORS APPROVED IT UNANIMOUSLY. The county's report back on that motion identified ZONING CHANGES THAT WOULD PROHIBIT THESE FACILITIES — not pause them. The planning director's memorandum holds the line in the meantime; Solis says she intends to bring further actions before the Board to implement the Regional Planning and Public Health departments' recommendations and amend the zoning code. Solis gave two reasons. The first is local and specific: 'I introduced it in response to concerns raised by San Gabriel Valley residents who were understandably concerned about the effects of data centers in their communities, concerns that have since been reflected nationwide.' The second is not local at all: 'The need for such a ban has only been further underscored by alarming developments from the AI sector on CATASTROPHIC IMPACTS THE TECHNOLOGY MAY HAVE ON HUMANITY.' That is the second American local government in this dataset, after Gary, Indiana, to put AI existential risk on the record as a reason for a land-use restriction — and unlike Gary it is paired with an ordinary public-health and environmental record.
City / local healthcare AI rules (1)
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Proposed / pending
DC SDAA (B24-0558)
Washington, DC · B24-0558 (DC Council, 2021; reintroduced)
DC's Stop Discrimination by Algorithms Act would bar algorithmic decision-making that discriminates in housing, employment, education, credit, healthcare, insurance. Mandates annual bias audits, consumer notice, disclosure; private right of action with civil penalties up to $10,000 per violation. Pending across DC Council sessions since 2021.