Bill > AB1970

This bill prohibits health care service plans and health insurance policies issued, amended, or renewed on or after January 1, 2027, from using "step therapy" as a requirement before covering prescription drugs for mental health or substance use disorders. Step therapy is a practice where a patient must try a less expensive drug first before their insurance will cover a prescribed, potentially more effective, medication. This prohibition will not apply if the U.S. Food and Drug Administration (FDA) labeling for a drug indicates that a prior medication must be taken. The bill also clarifies that this change does not affect Medi-Cal managed care plans unless federal approvals are obtained, and it does not apply to specialized dental or vision plans, or Medicare supplement contracts.

https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202520260AB1970