Utah approves AI pilot to issue initial acne prescriptions with staged physician review

Utah's Office of Artificial Intelligence Policy approved three new healthcare AI pilots, Healthcare Dive reported on 6 October 2026, including one in which an AI system issues initial acne prescriptions and later sends them without prior physician review ¹². Nolla Health, the developer of that system, said on 5 October that it is the first organisation in the US to receive regulatory approval for AI to issue initial prescriptions ².

What Utah approved

Nolla Health's pilot covers adults in Utah with mild-to-moderate acne, who can be prescribed initial medications and refills from a short list of topical drugs ¹. The company describes three stages of oversight ²:

• stage one, the first 100 patients: a licensed physician reviews and approves every AI-generated prescription before it is sent ²;

• stage two, the first 500 patients: the AI issues prescriptions autonomously and a physician reviews them retroactively each day ²;

• stage three: a physician retroactively reviews a sample of prescriptions once a week ².

If the AI cannot confidently select a treatment, the patient is directed to a licensed physician ². Nolla Health says clinicians agree with its treatment recommendations in over 96% of real-world cases, a figure from the company itself ². The service costs $4.99 a month ².

The other two pilots come from August AI, whose system will renew prescriptions for people with chronic conditions, and Expect Fitness, which will offer virtual pelvic floor therapy for women ¹. In all three pilots the companies need written approval from regulators before moving into later phases that could include less human oversight ¹.

Zach Boyd, director of the Office of Artificial Intelligence Policy, said the office ensures "that public health and patient safety remain paramount" ². Nolla Health said it met the Utah Medical Board ahead of launch so that the board's feedback was reflected in the final programme ².

What it means for the market

Utah's AI sandbox, the Artificial Intelligence Learning Laboratory, was set up by state law in 2024 ¹. Companies sign an agreement with the state that defines boundaries, safeguards and reporting requirements, so vendors can test AI-based tools in a supervised environment before they are scaled ¹. The new pilots extend that route from prescription renewals, first tested by Doctronic, to initial prescribing ¹².

The programme is also widening on the buyer side. Last month the office signed master agreements with University of Utah Health and Intermountain Health, which set the terms under which it can later approve pilots at those health systems ¹. Nolla Health says its app has been downloaded by more than 175,000 people across 44 states ².

Caveats

The programme remains contested. Utah's medical licensing board asked for the Doctronic pilot to be suspended, saying it had not been told before launch, and doctors raised concerns about the lack of human clinical judgement ¹. Regulators refused to pause it ¹. Michelle Mello, a professor of law and health policy at Stanford University, argued in a JAMA Health Forum commentary that Doctronic's contract is unclear about who bears responsibility for AI prescribing errors that injure patients ¹.

The accounts of timing differ. Healthcare Dive reported on 6 October that none of the pilots had yet launched, while Nolla Health said on 5 October that its system was available that day to Utah residents aged 18 and over ¹². The clinical performance figures come from the company and have not been independently reported ². Each company still needs written approval from regulators before any move to reduced human oversight ¹.