2026 New Law Alert: California
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Last year, numerous pieces of legislation impacting physicians were signed into law in California. The following new health laws are particularly relevant to physician practices and medical professional liability.
This alert is based in part on information obtained from the California Medical Association. All laws are effective January 1, 2026, unless otherwise noted.
Advanced practice providers:
Updates and clarifies various statutory provisions governing physician assistants (PAs), supervising physicians, and podiatrists. These changes impact administrative processes, modify licensing, renewal, and application fees for PAs and podiatrists, and align licensing processes and terminology between the associated professional licensing agencies.
The key provision on AB 1501 that impact PAs is the expansion of the allowable supervision ratio from 4 PAs to 8 PAs per supervising physician in all care settings. Previously, California had restricted PA supervision to a 1:4 ratio and in 2024 expanded the allowable ratio to 1:8 (under AB 1070), but this was restricted to in-home health evaluations that did not involve direct care or medication administration.
Another important provision of AB 1501 is the requirement for the Physician Assistant Board (PAB) to review and update PA practice agreement structures, potentially reducing administrative burden.
MIEC Note: We recommend that physicians, medical practices, and/or MSOs review their onboarding and supervision workflows for physician assistants and make any necessary changes to comply; physician assistants and supervising physicians should continue to monitor the PAB for any updates to practice agreements or other supervision requirements.
Clarifies (but does not expand) the scope of services that can be provided by a certified registered nurse anesthetist (CRNA) pursuant to an order from a physician, dentist, or podiatrist. It defines “anesthesia services” as preoperative, intraoperative, and postoperative care and pain management for patients receiving anesthesia under a qualified provider’s order; the selection and administration of medications pursuant to that order; and the provision of emergency, critical-care, and resuscitation services. The law further clarifies that a patient-specific order for anesthesia services authorizes the CRNA to select, initiate, and implement the anesthesia modality, and to modify or discontinue it, as clinically indicated.
AB 583 (Effective July 1, 2026)
Authorizes nurse practitioners (NPs) to complete and attest to death and fetal death certificates, determine and record causes of death, and amend vital records in situations in which the NP was the last medical provider to attend to the deceased patient. The law also includes NPs among the professionals who are required to notify the coroner of deaths that occur under specific circumstances.
Artificial intelligence:
Importantly, this law adds a provision to the Civil Code that prevents any defendant who “developed, modified, or used” an artificial intelligence (AI) technology from asserting a defense in a civil action that argues that the AI “autonomously caused the harm.” Other defenses relating to causation, foreseeability, and comparative fault still apply.
MIEC Note: In a medical malpractice case, this law may hinder the defense of a physician whose patient was harmed by the failure of AI technology. When using AI in documentation or to assist with treatment, physicians should not rely exclusively on AI output or recommendations without regularly and carefully reviewing all information for accuracy and completeness.
Regulates the use of AI in healthcare settings, specifically the use of AI chatbots that simulate interactions with licensed healthcare providers. The law includes various prohibitions to prevent the appearance of AI-generated content as possessing clinical expertise or coming from a healthcare provider, unless those systems are directly supported by a licensed clinician.
Privacy and confidentiality:
Strengthens privacy protections for reproductive health data and restricts the use of digital tracking around sensitive medical facilities. Specifically, it prohibits the use of geofencing technology around health care facilities to identify, track, or target individuals who receive care at the facility. It also prohibits certain uses of personal information or research records, with the goal of preventing harassment of patients seeking reproductive care.
Strengthens the protections of immigrants in healthcare settings by amending the Confidentiality of Medical Information Act (CMIA) to include birthplace and immigration status as protected health information (PHI), prohibiting healthcare settings from facilitating immigration enforcement unless otherwise required by law, and requiring healthcare facilities to restrict access to nonpublic areas for immigration enforcement purposes.
Prohibits health care providers, state agencies, courts, and the Controlled Substance Utilization Review and Evaluation System (CURES) from complying with out-of-state subpoenas or investigations that target legally protected gender-affirming care.
Enhances the governance, transparency, and accountability of the California Data Exchange Framework (DxF) for mandatory health data sharing. New entities are required to execute the Data Sharing Agreement by 7/1/26. For more information on requirements, see the HCAI Fact Sheet.
Corporate practice of medicine:
Prohibits a private equity group or hedge fund that is involved as either an investor or owner of a medical or dental practice, from interfering with the professional judgment of the physicians or dentists in that practice. As such, this law prevents these entities from directing specified actions, including hiring practices, billing procedures, patient treatment hours, and selection of medical equipment. The law also prohibits any contractual clauses that apply to the above actions and/or that impose non-compete or non-disparagement requirements on physicians.
Drug prescribing/dispensing:
Authorizes physicians in the Emergency Department (ED), upon discharge, to dispense unused portions of non-controlled medications directly to patients who received a portion of the medication during their ED visit. This prevents patients from having to immediately visit a pharmacy following discharge from the ED. Additionally, this law exempts certain automated unit dose systems (AUDS) in hospitals from specific licensure requirements, so they may be used for this purpose.
Accelerates the approval process for clinical research involving Schedule I and II controlled substances, particularly psychedelics like ibogaine, MDMA, and psilocybin, to explore new treatments for PTSD, traumatic brain injury, and addiction.
Preventive care:
Authorizes the California Department of Public Health (CDPH) to maintain its own standards in determining which preventive care services are covered by insurers. Mandates that health plans and insurers cover preventive care services, including vaccinations, as recommended by the CDPH, Advisory Committee on Immunization Practices (ACIP), and other federal bodies (USPSTF) as of January 1, 2025. The law requires coverage under the 2025 guidelines in light of the recent updates to CDC guidelines, and it continues to apply if federal agencies, such the CDC, downgrade or remove recommendations in the future. Additionally, the law provides liability protection for health care providers who administer immunizations in compliance with CDPH guidelines.
Medical practice and ethics:
AB 849 (Effective January 1, 2027)
Requires health care providers to notify patients that for sensitive examinations involving an ultrasound performed by a sonographer, a trained medical chaperone will be available upon request. Practices and facilities that offer sensitive examinations involving the genitalia, breasts, rectum, or groin, must inform patients in writing (via text, email, or written notice) that they have a right to have a chaperone present during those examinations. The presence of the chaperone must be documented in the patient’s chart.
This law allows trained medical personnel, including another sonographer, to serve as the chaperone, and practices must educate staff on proper chaperone techniques, including observation, intervention against inappropriate behavior, and patient privacy.
If a medical chaperone is not available, the practice may work with a patient to find an acceptable alternative. The health care provider may either delay the examination until a chaperone is available, or they may decline to perform the examination without a chaperone. The patient may also decline to involve a chaperone.
MIEC Note: Medical practices and facilities that offer ultrasonography services should review and, if necessary, update their chaperone policy to include the above requirements. Develop written notice for patients as to the availability of chaperones, standard documentation regarding chaperones, and train both clinical and non-clinical staff in chaperone techniques.
Repeals the sunsetting of the End of Life Option Act, which has been in effect since 2016 and was set to expire in 2026. This law, which is now permanent, allows the prescription of an aid in dying medication to a patient with a terminal illness that will allow them to self-administer the medication to end their life.
MIEC note: The End of Life Option Act allows the prescription of medication to aid in ending the life of a patient who has been diagnosed with a terminal illness, provided that the patient has capacity for making medical decisions and self-administers the medication.
More information can be found here: https://endoflifeoptionact.ucsf.edu/about-end-life-option-act/end-life-option-act