CaliforniaHealth plans would face a 30-day deadline for rare-disease drug requests
For a specialist’s request for the only approved drug for a rare disease, a health plan or insurer would have 30 days to decide whether to cover it.
What it does
For certain rare-disease drugs, health plans and insurers must decide on coverage within 30 days. If they do not decide or a dispute remains, they must approve the request.
Argument forPeople with rare diseases might get a needed treatment sooner because plans and insurers must approve it if they miss the 30-day deadline.
Argument againstPlans and insurers might have to approve a drug before resolving a dispute, which could make it harder to correct a mistaken request.
More detail
Health plans and insurers must decide whether to approve coverage before a patient can get certain prescription drugs. This covers health care service plans and health insurers, for a disease affecting fewer than 200,000 people in the United States. The requested drug must be FDA-approved to treat that disease. This applies only when a specialist with expertise in the disease says the drug is medically necessary and it is the only FDA-approved treatment for that rare disease. A plan must immediately approve the request if it has not decided by the deadline or a dispute is still ongoing then. The plan rule does not apply to Medi-Cal managed care contracts. The rule applies to plan contracts and insurance policies issued, changed, or renewed on or after January 1, 2027. The 30 days begin when a provider or staff member sends the request to the plan, insurer, or its delegate.
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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 27Chaptered by Secretary of State - Chapter 557, Statutes of 2026.Latest
- Sep 27Approved by the Governor Gavin Newsom.Became Law
- Sep 10Enrolled and presented to the Governor at 3 p.m.To Governor
- Aug 31
- Vote recorded AB 1887 Zbur Concurrence in Senate Amendments. Result: pass.Lower
- Aug 30Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 78. Noes 0. Page 6932.).Major
- Vote recorded 3rd Reading AB1887 Zbur et al. By Blakespear. Result: pass.Upper
- Aug 30In Assembly. Concurrence in Senate amendments pending.
- Aug 30Read third time. Passed. Ordered to the Assembly. (Ayes 40. 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 17Read second time. Ordered to third reading.Minor
- Aug 13Read second time and amended. Ordered returned to second reading.Major
- Vote recorded Do pass as amended. Result: pass.Upper
- Aug 13From committee: Amend, and do pass as amended. (Ayes 7. Noes 0.) (August 13).Major
- 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 10. 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
- Jun 10Referred to Com. on HEALTH.Minor
- May 28In Senate. Read first time. To Com. on RLS. for assignment.Minor
- Vote recorded AB 1887 Zbur Assembly Third Reading. Result: pass.Lower
- May 27Read third time. Passed. Ordered to the Senate. (Ayes 77. Noes 0. Page 5487.)Passed Assembly
- May 20Read third time and amended. Ordered to third reading. (Page 5167.)Major
- May 18Read second time. Ordered to third reading.Minor
- May 14From committee: Do pass. (Ayes 14. Noes 0.) (May 14).Minor
- Vote recorded Do pass. Result: pass.Lower
- May 14Joint Rule 62(a), file notice suspended. (Page 5030.)
- May 13In committee: Set, first hearing. Referred to APPR. suspense file.Minor
- 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
- Apr 6Re-referred to Com. on HEALTH.Minor
- Mar 26From 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 13From printer. May be heard in committee March 15.
- Feb 12Read first time. To print.Introduced
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