AB-539
Health & Public Health

Health care coverage: prior authorizations.

Engrossed
CA
2025-2026 Regular Session
0
0
Track

Key Takeaways

  • Requires health insurers to maintain prior authorizations for at least one year after approval.
  • Prohibits insurers from rescinding approved treatments after services are provided in good faith.
  • Establishes criminal penalties for health plans that violate these authorization requirements.

Summary

Assembly Member Schiavo's health care coverage legislation establishes new duration requirements for prior authorizations issued by California health plans and insurers, mandating that approvals remain valid for at least one year or throughout the prescribed course of treatment if shorter.

The measure builds upon existing state law, which already prohibits health plans and insurers from rescinding or modifying treatment authorizations after services have been provided in good faith. Under the proposed changes, prior authorizations would need to maintain their validity for a minimum 12-month period from the approval date, unless the authorized treatment is expected to conclude sooner. The requirements would apply equally to health care service plans regulated by the Department of Managed Health Care and health insurers overseen by the Department of Insurance.

The bill designates violations by health care service plans as criminal offenses under state law, making it a state-mandated local program. However, the measure specifies that no state reimbursement will be required for local agencies or school districts, as any costs would stem from changes to crime definitions under the California Constitution.

Key Dates

Next Step
Referred to the Senate Standing Committee on Health
Next Step
Senate Committee
Referred to the Senate Standing Committee on Health
Hearing has not been scheduled yet
Vote on Assembly Floor
Assembly Floor
Vote on Assembly Floor
AB 539 Schiavo Assembly Third Reading
Assembly Appropriations Hearing
Assembly Committee
Assembly Appropriations Hearing
Do pass
Assembly Health Hearing
Assembly Committee
Assembly Health Hearing
Do pass as amended and be re-referred to the Committee on [Appropriations]
Introduced
Assembly Floor
Introduced
Read first time. To print.

Contacts

Profile
Shannon GroveR
Senator
Committee Member
Not Contacted
Not Contacted
Profile
Scott WienerD
Senator
Committee Member
Not Contacted
Not Contacted
Profile
Tim GraysonD
Senator
Committee Member
Not Contacted
Not Contacted
Profile
Monique LimonD
Senator
Committee Member
Not Contacted
Not Contacted
Profile
Maria DurazoD
Senator
Committee Member
Not Contacted
Not Contacted
0 of 13 row(s) selected.
Page 1 of 3
Select All Legislators
Profile
Shannon GroveR
Senator
Committee Member
Profile
Scott WienerD
Senator
Committee Member
Profile
Tim GraysonD
Senator
Committee Member
Profile
Monique LimonD
Senator
Committee Member
Profile
Maria DurazoD
Senator
Committee Member
Profile
Susan RubioD
Senator
Committee Member
Profile
Lena GonzalezD
Senator
Committee Member
Profile
Akilah Weber PiersonD
Senator
Committee Member
Profile
Pilar SchiavoD
Assemblymember
Bill Author
Profile
Caroline MenjivarD
Senator
Committee Member
Profile
Steve PadillaD
Senator
Committee Member
Profile
Laura RichardsonD
Senator
Committee Member
Profile
Suzette ValladaresR
Senator
Committee Member

Get Involved

Act Now!

Email the authors or create an email template to send to all relevant legislators.

Introduced By

Pilar Schiavo
Pilar SchiavoD
California State Assembly Member
40% progression
Bill has passed all readings in its first house and is ready to move to the other house (5/12/2025)

Latest Voting History

May 12, 2025
PASS
Assembly Floor
Vote on Assembly Floor
AyesNoesNVRTotalResult
6421379PASS

Key Takeaways

  • Requires health insurers to maintain prior authorizations for at least one year after approval.
  • Prohibits insurers from rescinding approved treatments after services are provided in good faith.
  • Establishes criminal penalties for health plans that violate these authorization requirements.

Get Involved

Act Now!

Email the authors or create an email template to send to all relevant legislators.

Introduced By

Pilar Schiavo
Pilar SchiavoD
California State Assembly Member

Summary

Assembly Member Schiavo's health care coverage legislation establishes new duration requirements for prior authorizations issued by California health plans and insurers, mandating that approvals remain valid for at least one year or throughout the prescribed course of treatment if shorter.

The measure builds upon existing state law, which already prohibits health plans and insurers from rescinding or modifying treatment authorizations after services have been provided in good faith. Under the proposed changes, prior authorizations would need to maintain their validity for a minimum 12-month period from the approval date, unless the authorized treatment is expected to conclude sooner. The requirements would apply equally to health care service plans regulated by the Department of Managed Health Care and health insurers overseen by the Department of Insurance.

The bill designates violations by health care service plans as criminal offenses under state law, making it a state-mandated local program. However, the measure specifies that no state reimbursement will be required for local agencies or school districts, as any costs would stem from changes to crime definitions under the California Constitution.

40% progression
Bill has passed all readings in its first house and is ready to move to the other house (5/12/2025)

Key Dates

Next Step
Referred to the Senate Standing Committee on Health
Next Step
Senate Committee
Referred to the Senate Standing Committee on Health
Hearing has not been scheduled yet
Vote on Assembly Floor
Assembly Floor
Vote on Assembly Floor
AB 539 Schiavo Assembly Third Reading
Assembly Appropriations Hearing
Assembly Committee
Assembly Appropriations Hearing
Do pass
Assembly Health Hearing
Assembly Committee
Assembly Health Hearing
Do pass as amended and be re-referred to the Committee on [Appropriations]
Introduced
Assembly Floor
Introduced
Read first time. To print.

Latest Voting History

May 12, 2025
PASS
Assembly Floor
Vote on Assembly Floor
AyesNoesNVRTotalResult
6421379PASS

Contacts

Profile
Shannon GroveR
Senator
Committee Member
Not Contacted
Not Contacted
Profile
Scott WienerD
Senator
Committee Member
Not Contacted
Not Contacted
Profile
Tim GraysonD
Senator
Committee Member
Not Contacted
Not Contacted
Profile
Monique LimonD
Senator
Committee Member
Not Contacted
Not Contacted
Profile
Maria DurazoD
Senator
Committee Member
Not Contacted
Not Contacted
0 of 13 row(s) selected.
Page 1 of 3
Select All Legislators
Profile
Shannon GroveR
Senator
Committee Member
Profile
Scott WienerD
Senator
Committee Member
Profile
Tim GraysonD
Senator
Committee Member
Profile
Monique LimonD
Senator
Committee Member
Profile
Maria DurazoD
Senator
Committee Member
Profile
Susan RubioD
Senator
Committee Member
Profile
Lena GonzalezD
Senator
Committee Member
Profile
Akilah Weber PiersonD
Senator
Committee Member
Profile
Pilar SchiavoD
Assemblymember
Bill Author
Profile
Caroline MenjivarD
Senator
Committee Member
Profile
Steve PadillaD
Senator
Committee Member
Profile
Laura RichardsonD
Senator
Committee Member
Profile
Suzette ValladaresR
Senator
Committee Member