States split on regulating AI in medicine

As artificial intelligence takes on increasingly sophisticated roles in health care, hospitals should prepare for different states to impose different rules on how the technology can be used, a leading health AI expert has warned.

“Folks need to honestly be prepared for a patchwork set of regulatory frameworks that are going to be the reality over the next one to two years,” Brian Anderson, CEO of the Coalition for Health AI, said at Newsweek’s AI Health Summit in New York.

Federal laws and agencies regulate some uses of medical AI, but there is no comprehensive federal framework, leaving states to develop their own rules.

With more than 280 AI bills affecting health care introduced in state legislatures in the first half of 2026, according to Manatt Health, the push for state-level regulation is already well underway. “That train has left the station,” Anderson said.

By the end of July, 33 had been signed into law across 22 states, with the regulatory landscape continuing to evolve.

Amid that uncertainty, Anderson said hospitals will need ways to monitor AI as they begin using more autonomous, or “agentic,” systems.

“The health systems we’re talking to right now are deeply concerned about the use of agents in high-risk use cases,” he said.

As AI systems move closer to performing tasks traditionally carried out by clinicians, Anderson said regulators face difficult questions about how well the technology must perform before it is trusted in higher-risk settings.

“Is a 95 percent accuracy in a sepsis algorithm that’s being tested in a particular state good enough? What about 80 percent? What about 70 percent?” he asked. “We don’t know the answer to these questions.”

Utah is already testing one approach involving Doctronic, whose AI technology can assist with renewals of existing prescriptions. The pilot remains in an initial phase in which a licensed medical practitioner authorizes every request.

The experiment addresses a common access problem: patients may struggle to see a clinician simply to renew medication, particularly in areas facing provider shortages. Unlike a refill, a prescription renewal generally requires authorization from a licensed prescriber, and pharmacists typically cannot provide one themselves.

But in April, the Utah Medical Licensing Board recommended that the Doctronic program be suspended pending further discussion, arguing that prescription renewals require clinical reassessment and raising patient-safety concerns.

Anderson said even medication renewals – which he described as a relatively low-risk use of the technology – can carry risks.

“A patient’s blood levels or their lab values for whatever could be particularly elevated or of concern, and that might warrant a provider adjusting the medications or stopping a medication altogether,” he said. “So it’s not without risk.”

Anderson said other states are looking at similar approaches, but differing rules could create problems for health systems and technology companies operating nationally.

“If you have 50 different regulatory frameworks and 50 different hoops that you need to jump through,” Anderson said, technology companies may decide smaller states are simply “not worth it.”

CHAI is working with states and other groups to encourage greater consistency.

“They recognize if you have a patchwork of this, things are going to slow down,” Anderson said.

Anderson said he hopes a broader federal framework will eventually make the system easier to navigate.

“My hope certainly is that at the federal level, there is some overarching set of frameworks and regulatory guidance that’s given,” he said.