CaliforniaHealth care coverage: mental health or substance use disorders.
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 also provides for the regulation of health insurers by the Department of Insurance. Existing law authorizes health care service plans and health insurers that cover prescription drugs to utilize reasonable medical management practices, including prior authorization and step therapy, consistent with applicable law.
More detail
This bill would prohibit a health care service plan contract or a health insurance policy that is issued, amended, or renewed on or after January 1, 2027, from imposing step therapy as a prerequisite to authorizing coverage of any prescription drug used for the treatment of a serious mental illness or substance use disorder, as those terms are defined, except as specified. The bill would specify that the prohibition on step therapy does not apply when the United States Food and Drug Administration-labeled indications and usage of a drug indicate that some prior medication must be taken. Because a willful violation of this provision 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
- Aug 13In committee: Held under submission.Latest
- Aug 3In committee: Referred to APPR. suspense file.Minor
- Vote recorded Placed on suspense file. Result: pass.Upper
- Jun 29Read second time and amended. Re-referred to Com. on APPR.Major
- Jun 25From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 9. Noes 0.) (June 24).Major
- Jun 24
- Vote recorded Do pass as amended, but first amend, and re-refer to the Committee on [Appropriations]. Result: pass.Upper
- Jun 15In committee: Set, first hearing. Hearing canceled at the request of author.
- May 27Referred to Com. on HEALTH.Minor
- May 18In Senate. Read first time. To Com. on RLS. for assignment.Minor
- Vote recorded AB 1970 Harabedian Assembly Third Reading. Result: pass.Lower
- May 18Read third time. Passed. Ordered to the Senate. (Ayes 69. Noes 0. Page 5133.)Passed Assembly
- May 14Read second time. Ordered to third reading.Minor
- May 13From committee: Do pass. (Ayes 14. Noes 0.) (May 13).Minor
- Vote recorded Do pass. Result: pass.Lower
- Apr 22From committee: Do pass and re-refer to Com. on APPR. (Ayes 15. Noes 0.) (April 21). Re-referred to Com. on APPR.Minor
- Apr 22Coauthors revised.
- Apr 21
- Vote recorded Do pass and be re-referred to the Committee on [Appropriations]. Result: pass.Lower
- Mar 25Re-referred to Com. on HEALTH.Minor
- Mar 24From committee chair, with author's amendments: Amend, and re-refer to Com. on HEALTH. Read second time and amended.Major
- Mar 2Referred to Com. on HEALTH.Minor
- Feb 14From printer. May be heard in committee March 16.
- Feb 13Read first time. To print.Introduced