AB 280 (Aguiar-Curry, D-Davis)
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Placed on the Assembly Appropriations Committee suspense file on April 23.
AB 280 would require a plan or insurer to annually verify and delete inaccurate listings from its provider directories and would require a provider directory to be 60% accurate on July 1, 2026, with increasing percentage accuracy benchmarks required to be met each year until the directories are 95% accurate by July 1, 2029. The bill would subject a plan or insurer to administrative penalties for failure to meet the prescribed benchmarks. The bill would require a plan or insurer to provide coverage for all covered health care services provided to an enrollee or insured who reasonably relied on inaccurate, incomplete, or misleading information contained in a provider directory and to reimburse the provider the out-of-network amount for those services.
AB 371 (Haney, D-San Francisco)
Support
Passed the Assembly Health Committee on April 22. To be heard in the Assembly Appropriations Committee.
AB 371 would implement additional network adequacy standards — including time and distance standards and requirements — for specified plans and insurers that cover dental services. The plans and insurers would be required to offer dental appointments subject to the regulatory geographic accessibility standards of the Department of Managed Health Care (DMHC) or the Department of Insurance (DOI). The bill would also require that DMHC or DOI review an entire dental provider network’s adequacy.
AB 384 (Connolly, D-San Rafael)
Support
Passed the Assembly Health Committee on April 22. To be heard in the Assembly Appropriations Committee.
AB 384 would prohibit health care service plans, including Medi-Cal managed care plans, from requiring prior authorization for mental health and substance use disorder patients.
AB 510 (Addis, D-San Luis Obispo)
Support
Passed the Assembly Health Committee on April 22. To be heard in the Assembly Appropriations Committee.
AB 510 would require that any appeal or grievance for a health plan’s denial or modification of a service based on medical necessity be reviewed by a licensed physician, or a licensed health care professional under specified circumstances, within two business days — or within a timely fashion appropriate for the nature of the insured’s condition if the insured faces imminent or serious threat to their health. Additionally, if the plan failed to meet the deadline, the bill would deem the prior authorization request approved.
AB 512 (Harabedian, D-Pasadena)
Support
Passed the Assembly Health Committee on April 22. To be heard in the Assembly Appropriations Committee.
AB 512 would shorten the timeline for prior authorization requests — from within five business days to no more than 48 hours for standard requests or from 72 hours to 24 hours for urgent requests — from when the plan or insurer received the reasonably necessary information it requests to make the determination.
AB 539 (Schiavo, D-Santa Clarita)
Support
Passed the Assembly Health Committee on April 22. To be heard in the Assembly Appropriations Committee.
AB 539 would require that a health care service plan’s or health insurer’s prior authorization for a health care service remain valid for a period of at least one year from the approval date.
AB 669 (Haney, D-San Francisco)
Support
Passed the Assembly Health Committee on April 22. To be heard in the Assembly Appropriations Committee.
AB 669 would require health plans, starting in 2027, to cover all in-network substance use disorder treatments without prior authorization, including medically necessary prescription drugs; outpatient services; and the first 28 days of inpatient, intensive outpatient, or partial hospitalization treatments. For inpatient treatments that last longer than 28 days, the bill specifies a concurrent review and appeal process. For intensive outpatient and partial hospitalization treatments that last longer than 28 days, the bill specifies a retrospective review process.
AB 682 (Ortega, D-Hayward)
Support
Passed the Assembly Health Committee on April 29. To be heard in the Assembly Appropriations Committee.
AB 682 would mandate that health plans collect and publicly report health insurance claims denial information. The information collected and reported would include the number of claims processed, adjudicated, denied, or partially denied.
SB 32 (Weber Pierson, D-San Diego)
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Introduced on Dec. 2. April 30 hearing in the Senate Health Committee.
SB 32 would require the Department of Health Care Services, Department of Managed Health Care, and Department of Insurance to develop and adopt, by July 1, 2027, time or distance accessibility standards for hospitals with perinatal units, which health plans would be required to meet. The bill would require that the perinatal unit time or distance standards not be longer than Medi-Cal managed care plans. SB 32 would also require that the departments consult with stakeholders in developing the standards, and it would allow for alternative access standards. These provisions would become inoperative on July 1, 2033, and be repealed on Jan. 1, 2034.
SB 306 (Becker, D-Menlo Park)
Support
Passed the Senate Health Committee on April 23. To be heard in the Senate Appropriations Committee.
SB 306 would prohibit a health care plan, health insurer, or an entity with which the plan or insurer contracts for prior authorization from imposing prior authorizations on a covered health care service for certain conditions for one year — including if, in the prior year, the plan approved 90% or more of the same requests for a covered service.