Can AI Prescribe Medication in California?

With the rise of autonomous agents, a common question from tech-forward clinics is: "Can our AI refill prescriptions?" The technology is certainly capable of checking a database and authorizing a refill. But is it legal?

The Hard Line: No Independent Prescribing

In California, prescribing medication is the practice of medicine. Only licensed individuals (MDs, DOs, NPs, PAs) can prescribe. An algorithm cannot hold a medical license. Therefore, an AI cannot independently authorize a prescription. This is reinforced by the Business and Professions Code Section 2052.

The Gray Area: "Standing Orders" and AI

Some clinics attempt to use "standing orders" or protocols to allow AI to process refills. For example, "If patient has taken Lisinopril for 5 years and BP is stable, authorize refill."

Warning: The Medical Board of California has signaled that automating this decision without human review is risky. If the AI misses a nuance (e.g., a recent lab result showing kidney strain) and refills the drug, the supervising physician is 100% liable.

The Compliant Workflow: "Draft & Approve"

The only safe way to use AI for prescriptions in 2026 is the "Draft & Approve" model:

1. AI Analysis: The AI reviews the request, checks the chart, and drafts the prescription order.
2. Human Queue: The draft goes into a queue for the provider.
3. Human Action: The provider reviews the summary and clicks "Sign & Send."

This keeps the "Human in the Loop" (HITL), satisfying both AB 3030 and medical licensing requirements. The AI acts as a scribe, not a doctor.