Bill > AB951

This bill addresses health care coverage for individuals with pervasive developmental disorder or autism by prohibiting health care service plans and health insurance policies issued, amended, or renewed on or after January 1, 2026, from requiring patients previously diagnosed with these conditions to undergo a rediagnosis to maintain behavioral health treatment coverage. The bill defines "rediagnosis" as a subsequent diagnostic procedure to confirm an existing disorder and clarifies that while health plans cannot mandate rediagnosis, treating providers may still reevaluate patients or prescribe a rediagnosis at their discretion. Health plans must continue existing treatments while waiting for any potential rediagnosis and cannot delay or discontinue care. The legislation also specifies detailed requirements for behavioral health treatment, including the qualifications of service providers (such as certified behavior analysts or licensed medical professionals), the need for treatment plans with measurable goals, and the types of services covered. The bill applies to most health care service plans and insurance policies, with exceptions for specialized plans that do not cover mental health services or Medi-Cal programs. By preventing unnecessary repeated diagnoses, the bill aims to reduce administrative barriers and ensure continuous care for individuals with autism and pervasive developmental disorders.

Budget and Finance, Health and Social Services

https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202520260AB951