---
type: source
title: "California AB 489 (2025): Prohibiting AI Misrepresentations About Healthcare Licenses — Second Wave of State Clinical AI Regulation"
author: "Hintze Law / Medical Board of California"
url: https://hintzelaw.com/blog/2025/10/23/california-prohibits-ai-misrepresentations-about-health-care-licenses
date: 2025-10-23
domain: health
secondary_domains: [ai-alignment]
format: legal-analysis
status: processed
processed_by: vida
processed_date: 2026-04-03
priority: medium
tags: [California, AB-3030, AB-489, clinical-AI, disclosure, regulation, state-legislation, federal-model, belief-5]
extraction_model: "anthropic/claude-sonnet-4.5"
---

## Content

Analysis of California AB 489, signed October 11, 2025, effective January 1, 2026. The second major California AI healthcare law, following AB 3030 (effective January 1, 2025).

**AB 3030 (effective January 1, 2025) — the first wave:**
- Requires health facilities, clinics, and physician's offices to notify patients when using generative AI to communicate "patient clinical information"
- Disclosure requirement: each AI-generated patient communication must include notice of AI use AND instructions on how to contact a human healthcare provider
- Exemption: communications read and reviewed by a licensed human provider
- Scope: outpatient communications, patient portal messages, clinical information delivery

**AB 489 (effective January 1, 2026) — the second wave:**
- Prohibits AI from misrepresenting itself as a licensed healthcare provider
- Addresses a gap in AB 3030: AB 3030 required disclosure of AI use in communications; AB 489 prohibits AI claiming to BE a licensed clinician
- Relevant for: diagnostic chatbots, virtual assistants, AI-powered triage tools that present as clinical professionals

**State regulatory landscape (as of 2025-2026):**
- California: both AB 3030 (disclosure) and AB 489 (misrepresentation prohibition) now in force
- Colorado: similar disclosure requirements enacted
- Utah: similar disclosure requirements enacted
- No federal equivalent: FDA's January 2026 CDS guidance contains NO disclosure requirements for AI clinical tools — the federal regulatory track is entirely absent on this dimension

**The federal-state gap:**
California's AB 3030/AB 489 framework represents a disclosure and anti-misrepresentation model. The FDA's January 2026 CDS guidance expanded enforcement discretion WITHOUT adding disclosure requirements. The state regulatory innovation is operating in the exact space that federal regulation vacated.

**No federal replication imminent:**
The search found no federal legislation in Congress following California's AB 3030 model. The regulatory innovation is state-level; federal adoption is not on the near-term legislative horizon in 2026.

## Agent Notes
**Why this matters:** The California AB 3030/AB 489 sequence shows state-level clinical AI regulation evolving in the space vacated by federal deregulation. This is the US domestic equivalent of the EU AI Act rollback story — while the EU weakened safety requirements, US states are creating new consumer protection requirements. But states have limited reach: they cannot regulate the AI models themselves (only deployment in their jurisdictions) and cannot mandate post-market surveillance or bias evaluation. AB 3030/AB 489 are important but insufficient relative to the failure modes documented in Sessions 8-18.
**What surprised me:** The absence of any federal legislation following California's model. In prior regulatory cycles (HIPAA, ACA), California often led with state law that then influenced federal legislation. That pattern is not occurring in clinical AI — the federal government is moving opposite to California on this issue.
**What I expected but didn't find:** Evidence that AB 3030's January 2025 effective date has produced compliance reporting or enforcement actions that document the scale of AI use in patient communications. Early implementation data would help establish the baseline.
**KB connections:** FDA January 2026 CDS guidance (federal deregulation companion); Session 18 regulatory capture pattern; EU AI Act rollback; Lords inquiry (adoption-focused).
**Extraction hints:**
- "California AB 3030 (January 2025) and AB 489 (January 2026) establish a state-level disclosure and anti-misrepresentation framework for clinical AI, filling a regulatory gap that the FDA's January 2026 CDS guidance enforcement discretion expansion explicitly left vacant — with no federal legislative follow-through as of 2026"
**Context:** Hintze Law is a privacy/AI regulatory law firm. Medical Board of California published the GenAI notification requirements. Orrick and ArentFox Schiff analyses confirm scope of both laws. Colorado and Utah have similar but distinct approaches.

## Curator Notes
PRIMARY CONNECTION: FDA January 2026 CDS guidance; Session 18 regulatory capture pattern; EU AI Act rollback
WHY ARCHIVED: Documents the state-federal regulatory divergence on clinical AI. California building disclosure protections WHILE federal government expands enforcement discretion. This divergence is a structural claim candidate.
EXTRACTION HINT: The "state-federal regulatory divergence" claim is extractable: California and 2 other states creating clinical AI disclosure requirements while FDA expands enforcement discretion — divergent regulatory trajectories creating inconsistent patient protections depending on state of residence.
