Health care coverage: antisteering.

Assembly Member Wilson's anti-steering legislation aims to prevent health plans, insurers, and pharmacy benefit managers from restricting how patients receive prescription medications. The measure, which would take effect January 2026, prohibits these entities from requiring patients to use specific pharmacies or self-administer medications when providers determine alternative methods are medically necessary.

The bill establishes several key protections for medication access and administration. Health plans and insurers cannot mandate the use of mail-order or retail pharmacies when providers recommend alternatives, nor can they impose higher cost-sharing for medications administered in network physician offices versus mail-order settings. The legislation also prevents discrimination against physicians who dispense medications, prohibiting contract terms that discourage dispensing or retaliation against providers who exercise these rights.

Under the new requirements, healthcare providers must obtain patient consent and provide cost estimates before administering medications in a manner different from what the insurer initially directed. The provisions apply to both injected and infused medications administered in physician offices, clinics, and infusion centers, though hospital outpatient facilities are excluded. The measure maintains existing federal and state compliance requirements, including DEA registration for controlled substances.