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"Our patients sign a consent form at intake, so the AI scribe is covered." If you run a practice and have heard that sentence from a vendor rep, an office manager or yourself, check it against one new state law. Louisiana's Act 649 has been in force for 81 days, and it asks for something a signed form cannot give: a spoken notice, at the visit, before the recording starts.

What Louisiana actually requires

Act 649 (House Bill 475 of the 2026 Regular Session) took effect on 1 August 2026, according to summaries from the insurer LAMMICO and from law firms read for this article in October 2026. It adds R.S. 37:22.1. The core duty, as those summaries describe it, is that a licensed healthcare professional must verbally disclose the use of a recording device, software or service before recording any part of an appointment or treatment that will be transcribed by artificial intelligence.

Two words carry the weight. "Verbally" rules out a line buried in paperwork. "Before" rules out telling the patient after the session that a note was drafted with AI. One summary adds that the law reaches telehealth as well as in-person visits.

It is also a disclosure law, not a consent law. The bill was first drafted to require patient consent and an opt-out, and the enacted version moved to disclosure only. One summary reads the final text as allowing a clinician to record after disclosing even if the patient objects, while the clinician remains free to decline to record. Treat that reading as a point to confirm with your board, not as a safe harbor.

So what for you: if your compliance plan for AI scribing is a checkbox on the new-patient form, it addresses a different question from the one Louisiana asked.

The kernel of truth in the intake-form habit

Dismissing the form would be a mistake. Written consent at intake is still a sound habit. It records that the patient was told about the tool, it sets expectations before the first visit, and it may do work under other laws, such as state recording-consent rules, that sit alongside this one. Our earlier Q&As on state AI scribe consent laws and wiretap risk cover that side.

The myth is the step from "we have a form" to "we are covered". A form answers whether the patient agreed once. Act 649 asks whether the patient heard, at this visit, that this recording would be transcribed by AI. Those are different facts, and in a licensing complaint only one of them can be shown from the note.

So what for you: keep the form, and stop treating it as the compliance step.

Who the law reaches, and what we could not confirm

The summaries say the Act applies to professionals licensed under Title 37 of the Louisiana code. One lists nursing, dental health, mental health, physical therapy, social work and rehabilitation services among them. We read that list in a truncated snippet and did not read the enrolled definition of "healthcare professional," so we cannot tell you that your specific license is inside it.

That matters most if you run more than one site. A group with locations in several states, or a telehealth service seeing patients who live in Louisiana, needs to find out which of its clinicians hold a Louisiana license and treat Louisiana patients. Ask your state board and your professional liability carrier directly, and get the answer in writing.

So what for you: the question to settle this week is whether any of your licensed staff are inside Act 649, not whether the law is a good idea.

How it differs from California's rule

If you have read about California AB 3030, the contrast is useful. According to law-firm and policy summaries, AB 3030 has applied since 1 January 2025 to health facilities, clinics, physician offices and group practices. It requires a disclaimer, plus instructions for reaching a human, on generative AI messages to patients about clinical information. A message that a licensed provider has read and reviewed is exempt, and the summaries say the statute sets no specific penalties and relies on each licensing board's existing discipline.

The two laws target different moments. California governs what the AI sends out. Louisiana governs what the AI listens to. A practice that uses an AI scribe in the room and an AI tool for patient messages can meet both rules and still have only one script written. Neither rule is the HIPAA business associate agreement question, which we cover in our piece on why a HIPAA-compliant badge does not make a scribe safe.

So what for you: list every place AI touches a patient interaction, then match each one to the rule that governs it.

A disclosure routine that works at every site

The evidence points toward a short, standard routine. Commentators on the Act recommend standardized scripts, documentation of the disclosure and a non-AI fallback for when a patient does not want the tool. Those are sensible and cheap, and they work the same way in every state.

Here is a version you can adapt with your own counsel:

• Say it aloud, before the record button. One sentence, for example: "I use an AI tool that records and transcribes our visit to draft my notes. I review everything it writes."
• Log it. Add a field or template line to the note, "AI recording disclosed verbally," so the fact can be shown later.
• Keep a fallback. If a patient says no, write the note the old way and record that choice in the chart.
• Use one script across sites. A shared script and one note field remove the variation between clinicians, which is where most compliance gaps start.
• Check the vendor setting. Confirm the tool cannot start recording before the clinician has made the disclosure.

If you would rather have an independent read on where AI touches patients across your sites and which rules apply to each, the AI Opportunity and Growth Assessment maps that to your own workflows, and you can start with a free 20-minute discovery call.

So what for you: a one-sentence script and a note field cost nothing and turn a legal duty into a habit your whole team can repeat.

Frequently asked questions

Does Louisiana require patient consent for an AI scribe? No. Act 649 (HB 475), in force since 1 August 2026, requires a licensed healthcare professional to disclose verbally, before recording, that a device, software or service will record and transcribe the appointment with AI. Summaries say the final version dropped the earlier consent and opt-out requirement.

Does a consent form signed at intake satisfy Louisiana's AI recording law? The statute asks for a verbal disclosure before any part of an appointment or treatment is recorded for AI transcription, so a form signed weeks earlier is a weak fit. The safe reading is a spoken notice at every recorded visit, with a line in the note recording that it was given.

What happens if a clinician does not make the disclosure? Summaries of Act 649 say a violation can lead to discipline by the clinician's licensing board. They also say the clinician is immune from civil liability absent gross negligence or willful misconduct. Confirm the details with your board and your professional liability carrier.

Does California have a similar rule for AI in patient care? California AB 3030, in force since 1 January 2025, covers a different task. It requires a disclaimer and instructions for reaching a human on generative AI messages to patients about clinical information from clinics, physician offices and group practices, unless a licensed provider reviewed the message.

Sources: LAMMICO, "This Encounter is Being Recorded: Louisiana Act 649," 2026; law-firm summaries of Louisiana Act 649 (HB 475, 2026 Regular Session) from AGG and Phelps, and a legislative tracker entry for HB 475, all read in October 2026; summaries of California AB 3030 from law-firm and policy publications, read in October 2026. We read these secondary summaries and did not retrieve the official Louisiana or California statute pages, so confirm the exact text, the definition of covered professionals and your own obligations with your licensing board, your counsel and your professional liability carrier before relying on this. This article is general information, not legal advice.

Related: State AI scribe consent laws · AI scribe wiretap risk · The HIPAA-compliant badge myth