Utah Authorizes AI-Based Prescription Renewals
Utah has issued a policy through the Utah Department of Commerce and its Office of Artificial Intelligence Policy, authorizing a pilot program that allows an artificial intelligence (AI) system to autonomously renew certain prescription medications under state oversight. While limited in scope, this policy action represents a significant regulatory development and raises important questions for pharmacies and providers operating across state lines.
Key Elements of the Utah Policy
- Utah has authorized an AI system to evaluate patient responses and renew existing prescriptions without real-time human clinician involvement.
- The authority applies only to prescription renewals, not initial prescribing.
- The policy was issued by a state executive agency as part of a defined pilot program, with articulated oversight and evaluation parameters.
Why This Matters Outside Utah
Most state pharmacy and medical practice acts assume prescriptions are issued by licensed human practitioners pursuant to statute or board rule. State laws require practitioners to obtain and maintain licensure, with the assumption that humans will hold these licenses. Advances in AI have prompted some states to create legislation to protect practitioners and ensure that licenses stay attached to humans. For example, effective January 1, 2026, Oregon expressly prohibits a “nonhuman entity” from using a nursing title, e.g., APRN.
Utah’s policy-based approach creates uncertainty for non-Utah pharmacies that may receive or transfer AI-generated prescriptions into states that have not expressly addressed AI involvement in prescribing or renewals.
Questions for the Industry
- Validity Across State Lines: How should pharmacies evaluate a prescription renewal generated by AI pursuant to Utah policy when dispensing in another state? Is such a prescription valid, invalid, or legally ambiguous in states that have not recognized AI prescribing authority?
- Prescriber Definitions and Scope: Do existing statutory definitions of “prescriber” or “practitioner” exclude AI absent express legislative authorization? Will some states respond by enacting laws or rules requiring prescriptions to be issued only by live, licensed humans?
- Pharmacy Dispensing and Transfers: How does pharmacist corresponding responsibility apply when the renewal decision is made by AI? Can AI-renewed prescriptions be transferred across state lines, and should receiving pharmacies treat them differently?
- Records and Transparency: How will prescription records reflect that a renewal was issued by AI pursuant to departmental policy? Will pharmacies be able to readily identify AI involvement for compliance, audit, or enforcement purposes?
Looking Ahead
Utah’s policy-driven pilot is likely to prompt broader regulatory discussions. Other states may explore similar executive or departmental actions, while some may move to restrict or prohibit AI involvement absent legislative authorization.
Critically, Utah’s approach appears to conflict with recent federal executive orders aimed at preventing state-level differences in AI regulation. In December 2025, the White House issued an Executive Order directing federal agencies to identify and eliminate state laws or policies that obstruct the development of a uniform national AI framework, signaling a preference for centralized federal standards rather than state-by-state experimentation.
This tension is further underscored by emerging federal legislation. Representative David Schweikert has introduced the Healthy Technology Act of 2025, which would expressly authorize AI systems, subject to defined federal guardrails, to prescribe FDA-approved medications. If enacted, this legislation would shift authority over AI-enabled prescribing from state policy experiments to a federally standardized model, potentially preempting or displacing state executive programs like Utah’s pilot.
Of note, the Health Technology Act requires the technology to be authorized by state law to prescribe the drug involved. As such, it appears that at least for now, there is still an appetite to permit states to have some say in how AI functions within their borders.
Taken together, these developments raise a fundamental question for regulated healthcare stakeholders: whether AI-enabled prescribing and renewal authority will ultimately be determined through state-level policy initiatives or consolidated under a uniform federal regime. Until that question is resolved, pharmacies and providers operating nationally face heightened compliance risk when relying on prescriptions generated pursuant to state-specific AI authorizations.
We are actively tracking developments and will provide updates as additional guidance, legislation, or enforcement positions emerge.
