What applies to a physician in Utah

Applies to: The Office of Artificial Intelligence Policy and participants in its AI learning laboratory; until SB 226 repealed Section 13-2-12 effective May 7, 2025, also persons using generative AI in consumer transactions and people providing the services of occupations licensed or certified by the Department of Commerce, including health professions

Bound licensed health professionals, physicians included, to disclose generative AI use, and persons using it in consumer transactions to disclose it when asked; SB 226 replaced those duties in 2025.

Applies to: Individuals providing the services of an occupation licensed or certified by the Department of Commerce, including physicians and other health professionals, and suppliers using generative AI in consumer transactions

Binds those providing licensed Commerce Department occupations, physicians included, to disclose high-risk generative AI use, and suppliers in consumer transactions, practices and hospitals among them, on request.

Applies to: Licensed mental health therapists in Utah, a term the letter defines to include physicians engaged in the practice of mental health therapy (guidance)

Non-binding guidance addressed to licensed mental health therapists, a term it defines to include physicians engaged in mental health therapy; it asks nothing of practices or hospitals.

Applies to: HIPAA covered entities and business associates that use tracking technologies on websites or mobile apps

HHS guidance for HIPAA covered entities: tracking technologies on patient portals and apps may not send PHI to vendors without a business associate agreement or patient authorization.

Applies to: Covered entities under Section 1557 that use patient care decision support tools

OCR guidance on 45 CFR 92.210 for Section 1557 covered entities, such as practices and hospitals; it changes no coverage, payment or licensure decision reaching physicians.

Applies to: Covered entities under Section 1557 of the Affordable Care Act: health programs and activities receiving HHS federal financial assistance, HHS-administered programs and ACA Exchanges

Binds Section 1557 covered entities, such as practices and hospitals receiving HHS funds, on decision support tools; it changes no coverage, payment or licensure decision reaching physicians.

Applies to: Suppliers of mental health chatbots used by Utah users

Binds suppliers of mental health chatbots, defined by Utah's consumer sales act with no provider exemption, so a practice or hospital that offers one to patients is covered.

Applies to: HIPAA covered entities and the vendors that handle PHI for them

HHS guidance for HIPAA covered entities: a vendor's AI chatbot handling PHI on a patient portal is a business associate, so the practice or hospital needs a business associate agreement first.

Applies to: HIPAA covered entities and business associates

Proposed rule binding HIPAA covered entities and business associates: asset inventory, network map, ePHI encryption and multifactor authentication, with ePHI in AI training data protected.

Applies to: Anyone who makes an AI chatbot publicly available to consumers

Would bind anyone who makes an AI chatbot publicly available to consumers, which reaches a practice's or hospital's patient-facing chatbot.

Applies to: Medicare Advantage organizations

Binds Medicare Advantage plans only: medical necessity decisions rest on the enrollee's own circumstances, and a qualified professional reviews adverse decisions before issue.

Applies to: Medicare Advantage organizations and Medicare-Medicaid Plans

Applies to Medicare Advantage organizations and Medicare-Medicaid Plans only: AI alone may not deny an admission, downgrade to observation or end post-acute care, and decisions rest on the patient's own circumstances.

Applies to: Physicians and other practitioners billing the Medicare physician fee schedule

Fee schedule codes G0552 to G0554 let clinicians bill for FDA-cleared digital mental health treatment devices; a payment option, not a duty.

Applies to: Medicare Advantage organizations, state Medicaid and CHIP fee-for-service programs, Medicaid managed care plans, CHIP managed care entities and qualified health plan issuers on the federally facilitated Exchanges

Binds MA, Medicaid, CHIP and Exchange payers only: prior authorization deadlines, specific denial reasons and a prior authorization API; no AI rule, listed for prior authorization.

Applies to: Medicare Part B-enrolled organizations that join the model, other than suppliers of durable medical equipment, prosthetics, orthotics and supplies and laboratory suppliers; their Original Medicare patients; and clinicians who co-manage those patients

Voluntary CMS model: participating organizations and co-managing clinicians gain new billing options; no duty unless an organization joins.

Applies to: Health insurers subject to Utah's preauthorization statute, Section 31A-22-650

Binds insurers only: AI use in authorization review must be disclosed to network providers, and medical necessity denials need a reviewer's independent medical judgment.

Applies to: Physicians and other practitioners paid under the Medicare physician fee schedule

Proposed fee schedule pricing for 10 software analysis codes, paid to whoever bills the fee schedule; a payment change, not a duty.

Applies to: Medicare Advantage organizations; CMS and ONC for a report to Congress

Would bind Medicare Advantage plans only: electronic prior authorization and annual reports on requests approved or denied with AI or other decision technology.