Relating to the licensure of artificial intelligence augmented and autonomous service providers, and including penalties

The bill requires the director of the department of inspections, appeals, and licensing to appoint an executive director for the board, whose salary shall be set by the governor, with the approval of the senate and consistent with the pay plan for exempt positions in the executive branch of government. The executive director may employ such staff as necessary to carry out the duties of the board and take those actions that are reasonably necessary to carry out and enforce the laws and rules administered by the board, except as otherwise provided by law or rules of the board. The bill requires the board to adopt rules to set fees to offset administration of the bill. _____ review activities of licensees that may constitute research on humans; authorize and develop frameworks for practice agreements; conduct or contract for algorithmic safety and bias audits; and issue a state provider identifier for insurance billing. The bill allows the board to adopt rules related to licensing and professional standards. The bill prohibits the board from adopting a rule that materially restricts the practice of AAASPs or imposes a material barrier to entry to the AAASP market unless the board approves the rule by at least a two-thirds vote and publishes written findings that the restriction is supported by substantial evidence of a patient-safety risk and is the least restrictive means to address that risk. The bill requires the board to meet at least quarterly and at such additional times as necessary to carry out its duties. A meeting of the board may be called by the executive director, by the chair who shall be elected annually by the board, or upon written request of a majority of board members. Meetings of the board are subject to open meeting and public records requirements. The bill allows the board to receive complaints, conduct investigations, and issue discipline against licensees. The bill allows a licensee to contest discipline as a contested case proceeding. The bill requires a person to obtain an AAASP license to provide services using a fully autonomous AI in any circumstance, or an advisory or supervised autonomous AI in certain circumstances listed in the bill. _____ analyzes patient-specific data to generate options, potential diagnoses, risk stratification, or therapeutic suggestions to a licensed health care provider or user, where such output is intended to inform but not substitute for independent clinical judgment, and where the provider or user is expected to review, contextualize, and determine whether and how to act upon the suggestion for each patient encounter. The bill does not require a license for the provision of services using an informational AI, defined in the bill as an artificial intelligence that provides aggregated data, literature, or administrative information to a user but does not suggest a specific clinical action. The bill creates multiples classes of AAASP license, each of which shall include a modifier based on the level of autonomy employed by the artificial intelligence operated by the licensee. The bill requires an AAASP providing services that are analogous to services provided by licensed health professionals using an artificial intelligence that has not received federal clearance to obtain a class A license. For an AAASP using an artificial intelligence that has received federal clearance the bill requires a class B license. For clinical AI services providing nondiagnostic therapy, coaching, or monitoring, and which do not independently establish a diagnosis, the bill requires an AAASP to receive a class C license. The bill also establishes four levels of autonomy modifiers for AAASP licenses, including a level for AAASPs that are not required to obtain a license but voluntarily choose to do so. The bill allows an AAASP with the highest or second-highest level of autonomy modifier to issue clinical orders, and orders for prescription drugs other than controlled substances. The bill requires the board to review an application for a license for completeness within days of receipt of the application. _____ from denying an application on the basis that the application is incomplete. The bill requires the board to issue a final decision on a license application within days of receipt of a complete application unless the board ethicist determines that an applicant’s proposed data collection constitutes human subjects research requiring full review by the state centralized institutional review board or an external institutional review board. If the board fails to issue a decision on an application within the time period required by the bill, the bill requires the board to issue a provisional license upon submission by the applicant of a sworn attestation under penalty of perjury that the applicant has satisfied all minimum insurance, bonding, safety, reporting, and compliance requirements for provisional licensure. The bill also includes provisions for licensure by reciprocity. The bill requires an AAASP with the highest or second-highest level of autonomy modifier to make disclosures and receive informed consent from patients prior to providing services. The bill also imposes a professional duty of loyalty on an AAASP with the highest or second-highest level of autonomy modifier that requires the AAASP to prioritize the patient’s overall welfare, which includes the optimization of clinical outcomes, financial efficiency, care coordination, and patient convenience. The bill prohibits the interface through which an artificial intelligence interacts with a patient from presenting paid commercial content, advertisements, sponsored results, or third-party marketing