Health care coverage: prior authorizations.

Assembly Member Schiavo's health care coverage proposal establishes a one-year minimum validity period for prior authorizations issued by California health plans and insurers, marking a shift from the current system where authorization periods can vary.

The measure builds upon existing state law that prevents health plans and insurers from rescinding or modifying treatment authorizations after services are rendered in good faith. Under the new provisions, once a health plan or insurer approves a prior authorization for medical care, that approval must remain valid for at least 12 months from the date issued. The requirements apply equally to entities regulated under both the Knox-Keene Health Care Service Plan Act and the Insurance Code.

The bill maintains current criminal penalties for health plans that violate these requirements, while specifying that local agencies and school districts will not receive state reimbursement for any costs related to enforcement. This classification of violations as crimes creates a state-mandated local program, though the bill indicates implementation should not impose direct costs on local jurisdictions.