CaliforniaHealth care coverage: prior authorizations.
What it does
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law provides that a health care service plan or a health insurer that authorizes a specific type of treatment by a health care provider shall not rescind or modify this authorization after the provider renders the health care service in good faith and pursuant to the authorization.
More detail
This bill would require an approved prior authorization for a health care service requested by an in-network provider to remain valid for at least one year from the date of approval, or the period requested by the treating provider if less than one year. Because a violation of the bill by a health care service plan would be a crime, the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Where do you stand?
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Where it stands
- Introduced
- Passed Assembly
- Passed Senate
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- Sep 20Vetoed by Governor Gavin Newsom.Latest
- Sep 3Enrolled and presented to the Governor at 4 p.m.To Governor
- Aug 26Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 64. Noes 4. Page 6560.).Major
- Vote recorded AB 539 Schiavo Concurrence in Senate Amendments. Result: pass.Lower
- Aug 25In Assembly. Concurrence in Senate amendments pending.
- Vote recorded 3rd Reading AB539 Schiavo By Weber Pierson. Result: pass.Upper
- Aug 25Read third time. Passed. Ordered to the Assembly. (Ayes 31. Noes 0.).Passed Senate
- Aug 24Read second time. Ordered to third reading.Minor
- Aug 21Read third time and amended. Ordered to second reading.Major
- Aug 13Read second time. Ordered to third reading.Minor
- Vote recorded Do pass. Result: pass.Upper
- Aug 13From committee: Do pass. (Ayes 5. Noes 0.) (August 13).Minor
- Aug 3In committee: Referred to APPR. suspense file.Minor
- Vote recorded Placed on suspense file. Result: pass.Upper
- Jul 2Read second time and amended. Re-referred to Com. on APPR.Major
- Jul 2From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 8. Noes 0.) (July 1).Major
- Jul 1
- Vote recorded Do pass as amended, but first amend, and re-refer to the Committee on [Appropriations]. Result: pass.Upper
- 2025
- Jun 23In committee: Set, second hearing. Hearing canceled at the request of author.
- Jun 18In committee: Set, first hearing. Hearing canceled at the request of author.
- May 21Referred to Com. on HEALTH.Minor
- May 13In Senate. Read first time. To Com. on RLS. for assignment.Minor
- May 12Read third time. Passed. Ordered to the Senate. (Ayes 64. Noes 2. Page 1518.)Passed Assembly
- Vote recorded AB 539 Schiavo Assembly Third Reading. Result: pass.Lower
- May 8Read second time. Ordered to third reading.Minor
- May 7From committee: Do pass. (Ayes 11. Noes 0.) (May 7).Minor
- Vote recorded Do pass. Result: pass.Lower
- Apr 29Re-referred to Com. on APPR.Minor
- Apr 28Read second time and amended.Major
- Apr 24From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 12. Noes 0.) (April 22).Major
- Apr 22
- Vote recorded Do pass as amended and be re-referred to the Committee on [Appropriations]. Result: pass.Lower
- Feb 24Referred to Com. on HEALTH.Minor
- Feb 12From printer. May be heard in committee March 14.
- Feb 11Read first time. To print.Introduced