CaliforniaProviders can request faster drug dose changes for some patients
People with certain ongoing cancer or serious chronic condition treatments may have their provider request a dose change, with a written answer due within 72 hours.
What it does
For certain ongoing cancer or serious chronic condition drugs, a treating provider may request a dose or frequency change without prior approval. Plans and insurers must answer within 72 hours and approve requests that meet the rules.
Argument forPatients with serious chronic conditions or cancer may get needed dose changes sooner when their provider requests them, without prior approval or later review.
Argument againstPlans may still delay some needed changes because the process excludes opioids, controlled drugs, certain off-label uses, and requests after two dose adjustments.
More detail
A treating provider may request a dose or frequency change without prior approval or later utilization review; the plan or insurer must answer in writing within 72 hours and approve qualifying requests. This applies to enrollees in covered health plans and insured people whose treating provider contracts with the plan or insurer. The request must show that the drug was previously covered for a serious chronic condition or cancer treatment and is still prescribed for that condition or treatment. The drug cannot be an opioid or scheduled controlled substance, and the dose cannot already have been adjusted more than twice without prior approval. Different, unapproved uses qualify only if they also meet the conditions in the cited health code section. This rule does not apply to Medi-Cal managed care plans contracting with the state health department. The plan or insurer must respond within 72 hours after receiving the request.
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Where it stands
- Introduced
- Passed Senate
- Passed Assembly
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- Sep 27Chaptered by Secretary of State. Chapter 663, Statutes of 2026.Latest
- Sep 27Approved by the Governor Gavin Newsom.Became Law
- Aug 30Enrolled and presented to the Governor at 6 p.m.To Governor
- Aug 25Assembly amendments concurred in. (Ayes 40. Noes 0. Page 5740.) Ordered to engrossing and enrolling.Major
- Vote recorded Unfinished Business SB964 Smallwood-Cuevas Concurrence. Result: pass.Upper
- Aug 24In Senate. Concurrence in Assembly amendments pending.
- Vote recorded SB 964 Smallwood-Cuevas Senate Third Reading By Arambula. Result: pass.Lower
- Aug 24Read third time. Passed. (Ayes 77. Noes 0. Page 6390.) Ordered to the Senate.Passed Assembly
- Aug 17Ordered to third reading.Minor
- Aug 17Read third time and amended.Major
- Aug 13Read second time. Ordered to third reading.Minor
- Vote recorded Do pass. Result: pass.Lower
- Aug 13From committee: Do pass. (Ayes 15. Noes 0.) (August 13).Minor
- Aug 13Assembly Rule 63 suspended.
- Jun 24June 24 set for first hearing. Placed on suspense file.
- Jun 10From committee: Do pass and re-refer to Com. on APPR. (Ayes 15. Noes 0.) (June 9). Re-referred to Com. on APPR.Minor
- Jun 9
- Vote recorded Do pass and be re-referred to the Committee on [Appropriations]. Result: pass.Lower
- May 26Referred to Com. on HEALTH.Minor
- May 20In Assembly. Read first time. Held at Desk.Minor
- May 19Read third time. Passed. (Ayes 39. Noes 0. Page 4357.) Ordered to the Assembly.Passed Senate
- Vote recorded 3rd Reading SB964 Smallwood-Cuevas. Result: pass.Upper
- May 18Read second time. Ordered to third reading.Minor
- May 14Read second time and amended. Ordered to second reading.Major
- Vote recorded Do pass as amended. Result: pass.Upper
- May 14From committee: Do pass as amended. (Ayes 7. Noes 0. Page 4259.) (May 14).Major
- May 8Set for hearing May 14.
- Apr 13April 13 hearing: Placed on APPR. suspense file.
- Vote recorded Placed on suspense file. Result: pass.Upper
- Apr 10Set for hearing April 13.
- Apr 6Read second time and amended. Re-referred to Com. on APPR.Major
- Mar 26From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 11. Noes 0. Page 3689.) (March 25).Major
- Mar 25
- Vote recorded Do pass as amended, but first amend, and re-refer to the Committee on [Appropriations]. Result: pass.Upper
- Mar 9Set for hearing March 25.
- Feb 11Referred to Com. on HEALTH.Minor
- Feb 4From printer. May be acted upon on or after March 6.
- Feb 3Introduced. Read first time. To Com. on RLS. for assignment. To print.Introduced
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