Utah's Office of Artificial Intelligence Policy is doubling down on its AI-in-healthcare experiment, approving three new pilots that could eventually allow AI systems to prescribe and refill medications without a clinician ever reviewing them. The pilots involve Nolla Health (an acne app that assesses skin from photos and prescribes topical medications), August AI (AI-driven prescription renewals for chronic conditions), and Expect Fitness (virtual pelvic floor therapy for women). All three will start with physician oversight, but later phases could significantly reduce — or eliminate — human review.

The moves are part of Utah's AI sandbox, established by state law in 2024, which allows private companies to test AI tools under a supervised regulatory framework. But the program has drawn sharp criticism: the state's medical licensing board asked regulators to suspend an earlier AI prescribing pilot from Doctronic, citing lack of transparency and patient safety risks. Legal experts have also flagged murky accountability when AI-driven prescribing errors cause harm.

Key Takeaways:

• Pilots begin with mandatory physician review but can advance to post-hoc or no review with regulator approval
• Utah's medical board previously asked for a similar pilot to be suspended — regulators refused
• A Stanford law professor flagged unresolved liability questions around AI prescribing errors in JAMA Health Forum
• Master agreements with University of Utah Health and Intermountain Health set the stage for future pilots

Why it matters: Utah is testing a model that could reshape how prescriptions are written across the U.S. — with or without a doctor in the loop. How these pilots perform, and who is held responsible when things go wrong, could set a national precedent for AI's role in clinical care.