summary
Introduced
01/23/2025
01/23/2025
In Committee
06/24/2025
06/24/2025
Crossed Over
03/20/2025
03/20/2025
Passed
Dead
Introduced Session
2025-2026 Regular Session
Bill Summary
An act to amend Sections 1276.4, 1276.66, 1280.15, 1280.19, 1342.2, 1374.55, 1385.002, 1385.004, 1385.006, 1417.2, 1418.22, 120956, 120960, 127672, 127672.9, 127825, and 150900 of, to amend the heading of Article 6.1 (commencing with Section 1385.001) of Chapter 2.2 of Division 2 of, to amend and repeal Sections 1265.9 and 1385.005 of, to add Sections 1356.3, 1385.008, 1385.009, 1385.0010, 1385.0011, 1385.0012, 1385.0013, 1385.0014, 1385.0015, 1385.0016, 1385.0017, 1385.0018, 1385.0019, 1385.0020, 1385.0021, 1385.0022, 1385.0023, 1385.0024, 1385.0025, 1385.026, and 127673.05 to, and to repeal and add Sections 1385.001 and 127697 of, the Health and Safety Code, to amend Section 10119.6 of, and to add Section 10125.2 to, the Insurance Code, to amend Section 1026 of the Penal Code, and to amend Sections 5961.2, 14006, 14006.01, 14006.15, 14006.2, 14006.5, 14006.6, 14007.5, 14007.65, 14007.8, 14015, 14126.033, 14132, 14132.36, 14132.171, 14165.57, 14184.200, 14197.7, and 14199.128 of, to amend and repeal Sections 14000, 14005.11, 14005.20, 14005.40, 14005.401, 14006.3, 14006.4, 14007.9, 14009.6, 14009.7, 14011, 14013.3, 14051, 14051.5, 14105.33, 14126.024, 14133.85, 14148.5, and 14166.17 of, to amend, repeal, and add Sections 14005.62, 14105.436, and 14132.100 of, to add Sections 14107.115 and 14132.994 to, to repeal Section 14006.1 of, to repeal Chapter 16.5 (commencing with Section 18998) of Part 6 of Division 9 of, and to repeal and add Section 14105.38 of, the Welfare and Institutions Code, and to amend Section 83 of Chapter 40 of the Statutes of 2024, relating to health, and making an appropriation therefor, to take effect immediately, bill related to the budget.
AI Summary
This bill is a comprehensive health omnibus trailer bill that makes numerous changes to California's healthcare system, with significant modifications across various programs and services. Here are the key provisions:
1. Pharmacy Benefit Manager (PBM) Regulation:
- Establishes a new licensure process for PBMs starting January 1, 2027
- Requires PBMs to obtain a license from the Department of Managed Health Care
- Imposes reporting requirements and creates new funds to oversee PBM activities
2. Medi-Cal Eligibility Changes:
- Beginning January 1, 2026, individuals 19-59 years old without satisfactory immigration status will:
- Be limited to emergency and pregnancy-related services
- Be required to pay a $30 monthly premium
- Lose dental coverage
3. Resource Limit for Medi-Cal:
- Implements a resource limit of $130,000 for a single person and $65,000 for each additional household member (up to 10 members)
4. COVID-19 Coverage:
- Modifies requirements for Medi-Cal managed care plans' coverage of COVID-19 screening, testing, immunizations, and therapeutics
5. Community Health Worker Services:
- Establishes community health worker services as a covered Medi-Cal benefit
- Defines community health workers and their role in healthcare delivery
6. Pharmacy and Drug-Related Provisions:
- Changes rebate requirements for pharmaceutical manufacturers
- Modifies drug pricing and reporting requirements
7. Other Notable Changes:
- Adjustments to hospice services coverage
- Modifications to cognitive health assessments
- Changes to AIDS Drug Assistance Program funding and services
The bill aims to improve healthcare access, regulate pharmacy benefit managers, and make various technical adjustments to California's health programs, with many provisions taking effect on January 1, 2026.
Committee Categories
Budget and Finance
Sponsors (0)
No sponsors listed
Other Sponsors (1)
Budget and Fiscal Review (S)
Last Action
From committee with author's amendments. Read second time and amended. Re-referred to Com. on BUDGET. (on 06/24/2025)
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