Bill > AB539

This bill amends existing California health care regulations to strengthen patient protections by requiring that prior authorizations for health care services remain valid for at least one year from the date of approval, or throughout the entire course of prescribed treatment if that treatment is less than one year long. The bill applies to both health care service plans and health insurers, preventing them from rescinding or modifying a treatment authorization after a health care provider has already rendered services in good faith. Prior to this bill, there was no clear requirement for how long a prior authorization would remain valid, which could potentially leave patients and providers vulnerable to sudden changes in coverage. The legislation maintains existing provisions that prohibit plans and insurers from rescinding authorizations for reasons such as contract modifications or eligibility recalculations. Importantly, the bill does not expand or alter the underlying benefits available to patients, but rather ensures more stability and predictability in the prior authorization process. The bill also includes a provision stating that no state reimbursement is required for implementing these changes, as they relate to potential changes in legal infractions.

Budget and Finance, Health and Social Services

https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202520260AB539