Legislation Tracker

Requires pharmacy benefit managers (PBMs) to exercise fiduciary duty in its contracts with health care service plans; to wholly remit rebates, discounts, and other remuneration to these plans; to report affiliated entities and group purchasing organizations; and to refrain from spread pricing.

AB 910 was substantially amended and no longer pertains to Pharmacy Benefit Manager practices.

Sets a copayment of one cent for Medi-Cal expansion adults affected by recent federal law and restores the period of retroactive coverage to three months

States the legislature’s intent to reduce individual burden to enrollees while conforming California law with new federal 6-month redetermination and work/community engagement requirements for Medicaid

Requires health plans to reinstate enrollees automatically to their original primary care provider when a planned provider network change—that causes enrollees to be reassigned to a new provider—is later reversed, delayed, or cancelled within 120 days

Treats debt charged to “medical credit cards” similarly to other medical debt related to the use of medical services, products, or devices by prohibiting its inclusion in consumer credit reports and their use as a negative factor in issuing credit decisions

Permits the treating provider of a patient under a health plan or insurer to adjust the dose or frequency of a drug up to two times without prior authorization to serve patient medical needs

State-matching funds saved from decreased Medi-Cal enrollment due to new federal law will be used to establish the California Health Access Fund to be administered by the Department of Health Care Services

Requires a health plan or insurer to count towards the patient’s cost sharing amounts paid by the patient and those given by drug manufacturers as copay assistance

Requires the California Health and Human Services Agency to identify employers with 50 or more employees who have workers enrolled in Medi-Cal and to report annually the cost of Medi-Cal benefits provided to those employees and their dependents

Reverses the state freeze on Medi-Cal enrollment of undocumented persons aged 19 and older, while retaining new state law levying a $30 monthly premium and dental service restrictions

Prevents a health plan or insurer from requiring prior authorization for direct-acting hepatitis C treatment drugs that are medically necessary

Stops a public school serving grades 7 to 12 from preventing access to condoms at school-based health centers and also bans retail outlets from refusing to provide over-the-counter contraception based on age.

Requires a health plan or insurer that already covers injectable HIV pre-exposure prophylaxis (PrEP) to also cover it under the outpatient prescription drug benefit

Authorizes a $23 billion bond issue to finance the California Foundation for Science and Health Research Fund to provide grants and loans for various organizations engaged in scientific research and development, including biomedical, behavioral health, and climate research