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<ns0:Id>20250AB__257599INT</ns0:Id>
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<ns0:Action>
<ns0:ActionText>INTRODUCED</ns0:ActionText>
<ns0:ActionDate>2026-02-20</ns0:ActionDate>
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<ns0:SessionYear>2025</ns0:SessionYear>
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<ns0:AuthorText authorType="LEAD_AUTHOR">Introduced by Assembly Member Ortega</ns0:AuthorText>
<ns0:Authors>
<ns0:Legislator>
<ns0:Contribution>LEAD_AUTHOR</ns0:Contribution>
<ns0:House>ASSEMBLY</ns0:House>
<ns0:Name>Ortega</ns0:Name>
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<ns0:Title> An act to add Section 1714.48 to the Civil Code, to add Section 1339.76 to the Health and Safety Code, and to add Article 2.7 (commencing with Section 2820) to Chapter 2 of Division 3 of the Labor Code, relating to health care services. </ns0:Title>
<ns0:RelatingClause>health care services</ns0:RelatingClause>
<ns0:GeneralSubject>
<ns0:Subject>Health care services: artificial intelligence.</ns0:Subject>
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<html:p>
(1)
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Existing law provides for the licensure and regulation of health facilities and clinics by the State Department of Public Health. Existing law generally makes a violation of these provisions a crime. Existing law, the Medical Practice Act, establishes the Medical Board of California for the licensing, regulation, and discipline of physicians and surgeons. Existing law requires a health facility, clinic, physician’s office, or office of a group practice that uses generative artificial intelligence to generate written or verbal patient communications pertaining to patient clinical information, as defined, to ensure that those communications include both a disclaimer that indicates to the patient that a communication was generated by generative artificial intelligence, as specified, and clear instructions describing how a patient may contact a human health care
provider, employee, or other appropriate person.
</html:p>
<html:p>This bill would require a health facility, clinic, physician’s office, or office of a group practice that uses or deploys a covered tool, as defined, for patient care to disclose required information to any licensed health care professional or other person using a covered tool or viewing outputs from a covered tool. The bill would require, among other things, the disclosure to include a notice that a worker providing direct patient care is permitted to override the output of a covered tool if, in the judgment of the worker acting in their scope of practice, an override is appropriate for the patient, or as necessary to comply with applicable law, including civil rights law. The bill would specify the required time and manner the disclosure is to be provided pursuant to these provisions. By placing new requirements on health facilities and clinics, this bill would expand the scope of a crime and would impose a
state-mandated local program.</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Existing law charges the Labor Commissioner with enforcement of various labor laws, including investigation of employee complaints.
</html:p>
<html:p>This bill would declare it is the policy of the state that a worker providing direct patient care be free to use their professional judgment to make assessments and decisions within their scope of practice as appropriate for their patients and that it is public policy of the state that a worker should not be penalized for relying in good faith on technology that the licensed health care professional’s employer has selected or approved for their use in patient care. The bill would prohibit an employer from using or deploying technology to replace or eliminate a worker’s use of professional judgment in patient care and would prohibit an employer from retaliating or discriminating against a worker providing patient care, as specified. The
bill would authorize a worker who is subject to retaliation or discrimination in violation of these provisions to file a complaint with the Labor Commissioner against an employer. </html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
Existing law provides that everyone is responsible not only for the result of their willful acts, but also for an injury occasioned to another by their want of ordinary care or skill in the management of their property or person. Existing law prohibits a defendant who developed, modified, or used artificial intelligence, as defined, from asserting a defense that the artificial intelligence autonomously caused the harm to the plaintiff.
</html:p>
<html:p>This bill would prohibit a defendant who developed, modified, or used artificial intelligence, as defined, that is alleged to have harmed the plaintiff from asserting a defense that the failure of a licensed health care professional or other health care worker to override an output of the
artificial intelligence or clinical decision support system is a superseding cause severing the defendant’s liability for the alleged harm. </html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
</html:p>
<html:p>This bill would provide that no reimbursement is required by this act for a specified reason.</html:p>
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<ns0:Preamble>The people of the State of California do enact as follows:</ns0:Preamble>
<ns0:BillSection id="id_5D250BD9-B7A9-46C3-B0B1-574339261C77">
<ns0:Num>SECTION 1.</ns0:Num>
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Section 1714.48 is added to the
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, to read:
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<ns0:Num>1714.48.</ns0:Num>
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<html:p>
(a)
<html:span class="EnSpace"/>
For purposes of this section, the following definitions shall apply:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
“Artificial intelligence” means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.
</html:p>
<html:p>
(2)
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“Clinical decision support system” means a computerized system or tool that does both of the following:
</html:p>
<html:p>
(A)
<html:span class="EnSpace"/>
Supports decisionmaking related to patient care based on algorithms, or models, based in clinical practice guidelines or that derive relationships from training data,
including algorithms or models that are developed using unsupervised learning models.
</html:p>
<html:p>
(B)
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Produces an output that results in a prediction, classification, recommendation, evaluation, or analysis.
</html:p>
<html:p>
(b)
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In an action against a defendant who developed, modified, selected, or deployed artificial intelligence that is alleged to have caused harm to the plaintiff, it shall not be a defense, and the defendant may not assert, that the failure of a licensed health care professional or other health care worker to override an output of the artificial intelligence or clinical decision support system is a superseding cause severing the defendant’s liability for the alleged harm.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
This section does not limit or preclude a defendant from presenting either of the following:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
Any other affirmative defense, including evidence relevant to causation or foreseeability.
</html:p>
<html:p>
(2)
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Other evidence relevant to the comparative fault of any other person or entity.
</html:p>
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<ns0:Num>SEC. 2.</ns0:Num>
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Section 1339.76 is added to the
<ns0:DocName>Health and Safety Code</ns0:DocName>
, to read:
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<ns0:LawSection id="id_1E5FF34D-8100-4BB8-954A-454484937C80">
<ns0:Num>1339.76.</ns0:Num>
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<html:p>
(a)
<html:span class="EnSpace"/>
A health facility, clinic, physician’s office, or office of a group practice that uses or deploys a covered tool for patient care shall disclose required information, described in subdivision (b), to any licensed health care professional or other person using a covered tool or viewing outputs from a covered tool.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
Required information under subdivision (a) shall include all of the following:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
Details on the covered tool, including developer, funding source, any foundation model used, and description of output.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Intended use of the covered tool, including intended patient population, intended users, and
intended decisionmaking role.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
Cautioned out-of-scope use of the covered tool, including known risks and limitations.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
List of the inputs into the covered tool.
</html:p>
<html:p>
(5)
<html:span class="EnSpace"/>
Description of how the covered tool generates outputs.
</html:p>
<html:p>
(6)
<html:span class="EnSpace"/>
Development details of the covered tool, including, but not limited to, all of the following:
</html:p>
<html:p>
(A)
<html:span class="EnSpace"/>
Description of the training set or clinical research underlying recommendations, including demographic representativeness and known biases based on protected characteristics.
</html:p>
<html:p>
(B)
<html:span class="EnSpace"/>
Description of the relevance of training data to deployed setting.
</html:p>
<html:p>
(C)
<html:span class="EnSpace"/>
Process used to ensure fairness in development of the intervention.
</html:p>
<html:p>
(7)
<html:span class="EnSpace"/>
Description of the validation process.
</html:p>
<html:p>
(8)
<html:span class="EnSpace"/>
Qualitative measures of performance.
</html:p>
<html:p>
(9)
<html:span class="EnSpace"/>
Description of ongoing maintenance of intervention implementation and use.
</html:p>
<html:p>
(10)
<html:span class="EnSpace"/>
Description of updates and continued validation or fairness assessment process.
</html:p>
<html:p>
(11)
<html:span class="EnSpace"/>
Notice that health care entities and developers are liable for harm that results from the use of artificial intelligence in patient care.
</html:p>
<html:p>
(12)
<html:span class="EnSpace"/>
Notice that a worker providing direct patient care is permitted to override the output of a covered tool if, in the judgment of the worker acting in
their scope of practice, such an override is appropriate for the patient, or as necessary to comply with applicable law, including civil rights law.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
A disclosure made pursuant to this section shall be provided at the time the licensed health care professional or other person uses the covered tool or views any recommendation or output generated by the covered tool.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
The disclosure shall be provided in plain language to, and linked in the health record of, any patient whose care was affected by the output of the covered tool or whose health information was used as an input to the covered tool.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
The disclosure shall be provided with ample time for the licensed health care professional or other person to review and make reasoned decisions based on their professional judgment on whether
and how to use the covered tool.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
A violation of this section by a licensed health facility is subject to the enforcement mechanisms described in Article 4 (commencing with Section 1290) of Chapter 2.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
A violation of this section by a licensed clinic is subject to the enforcement mechanisms described in Article 4 (commencing with Section 1235) of Chapter 1.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
A violation of this section by a physician is subject to the jurisdiction of the Medical Board of California or the Osteopathic Medical Board of California, as appropriate.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
A violation of this section constitutes “unfair competition” as defined in Section 17200 of the Business and Professions Code and is punishable as prescribed in Chapter 5 (commencing with
Section 17200) of Part 2 of Division 7 of the Business and Professions Code.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
For purposes of this section, the following definitions shall apply:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
“Artificial intelligence” means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
“Clinic” has the same meaning as defined in Section 1200.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
“Clinical decision support system” means a computerized system or tool that does both of the following:
</html:p>
<html:p>
(A)
<html:span class="EnSpace"/>
Supports decisionmaking related to patient care based on algorithms, or models, based in clinical
practice guidelines or that derive relationships from training data, including such algorithms or models that are developed using unsupervised learning models.
</html:p>
<html:p>
(B)
<html:span class="EnSpace"/>
Produces an output that results in a prediction, classification, recommendation, evaluation, or analysis.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
“Covered tool” means artificial intelligence or a clinical decision support system.
</html:p>
<html:p>
(5)
<html:span class="EnSpace"/>
“Health facility” has the same meaning as defined in Section 1250.
</html:p>
<html:p>
(6)
<html:span class="EnSpace"/>
“Office of a group practice” has the same meaning as defined in Section 1339.75.
</html:p>
<html:p>
(7)
<html:span class="EnSpace"/>
“Patient clinical information” has the same meaning as defined in Section 1339.75.
</html:p>
<html:p>
(8)
<html:span class="EnSpace"/>
“Physician’s office” has the
same meaning as defined in Section 1339.75.
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<ns0:Num>SEC. 3.</ns0:Num>
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Article 2.7 (commencing with Section 2820) is added to Chapter 2 of Division 3 of the
<ns0:DocName>Labor Code</ns0:DocName>
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<ns0:LawHeading type="ARTICLE" id="id_40C8FCE6-20E9-4DB4-84B3-03B6352799E4">
<ns0:Num>2.7.</ns0:Num>
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<ns0:LawHeadingText>Health Information Technology: Worker Rights</ns0:LawHeadingText>
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<ns0:Num>2820.</ns0:Num>
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<html:p>For the purposes of this article, the following definitions shall apply:</html:p>
<html:p>
(a)
<html:span class="EnSpace"/>
“Artificial intelligence” means an engineered or machine-based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
“Clinical decision support system” means a computerized system or tool that does both of the following:
</html:p>
<html:p>
(A)
<html:span class="EnSpace"/>
Supports decisionmaking related to patient care based on algorithms, or models, based in clinical practice guidelines or that derive relationships from training data, including such
algorithms or models that are developed using unsupervised learning models.
</html:p>
<html:p>
(B)
<html:span class="EnSpace"/>
Produces an output that results in a prediction, classification, recommendation, evaluation, or analysis.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
“Technology” means scientific hardware or software, including artificial intelligence and clinical decision support systems, used to achieve a medical or nursing care objective at a health facility.
</html:p>
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<ns0:LawSection id="id_89A2B68C-C174-4ACD-BCDD-B544BC13A7E4">
<ns0:Num>2821.</ns0:Num>
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<html:p>
(a)
<html:span class="EnSpace"/>
It is the public policy of the State of California that a worker providing direct patient care be free to use their professional judgment to make assessments and decisions within their scope of practice as appropriate for their patients.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
It is the public policy of the State of California that a worker providing direct patient care should not be penalized for relying in good faith on technology that the licensed health care professional’s employer has selected or approved for their use in patient care.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
An employer shall not use or deploy technology to replace or limit a worker’s use of professional judgment in patient care.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
An employer shall not retaliate or discriminate against a worker providing direct patient care based on both of the following:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
The worker’s override of, or request to override, the output of technology if, in the judgment of the worker acting in their scope of practice, such an override is appropriate for the patient, or as necessary to comply with applicable law, including civil rights law.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
The worker’s compliance with the output of technology if the technology was provided or approved by the worker’s employer for patient care.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
A worker who is subject to retaliation or discrimination in violation of this article has the right under this article to file a complaint with the Labor Commissioner against an employer who retaliates or discriminates
against the worker.
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<ns0:Num>SEC. 4.</ns0:Num>
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<html:p>
No reimbursement is required by this act pursuant to Section 6 of Article XIII
<html:span class="ThinSpace"/>
B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII
<html:span class="ThinSpace"/>
B of the California Constitution.
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