AB 539: Health care coverage: prior authorizations.

Official summary

Legislative Counsel’s Digest (official, as of the latest version). Written by nonpartisan legislative staff; reproduced verbatim.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law provides that a health care service plan or a health insurer that authorizes a specific type of treatment by a health care provider shall not rescind or modify this authorization after the provider renders the health care service in good faith and pursuant to the authorization.

This bill would require an approved prior authorization for a health care service requested by an in-network provider to remain valid for at least one year from the date of approval, or the period requested by the treating provider if less than one year. Because a violation of the bill by a health care service plan would be a crime, the bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

Sponsors

Sponsors by party (alphabetical): Democratic 1

“Support” is shown only as formal sponsorship recorded by the legislature. Roll-call votes are available on the official bill page.

Recent official actions

1. September 20, 2026Vetoed by Governor.
2. September 3, 2026Enrolled and presented to the Governor at 4 p.m.
3. August 26, 2026Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 64. Noes 4. Page 6560.).
4. August 25, 2026In Assembly. Concurrence in Senate amendments pending.
5. August 25, 2026Read third time. Passed. Ordered to the Assembly. (Ayes 31. Noes 0.).
6. August 24, 2026Read second time. Ordered to third reading.
7. August 21, 2026Read third time and amended. Ordered to second reading.
8. August 13, 2026Read second time. Ordered to third reading.
9. August 13, 2026From committee: Do pass. (Ayes 5. Noes 0.) (August 13).
10. August 3, 2026In committee: Referred to APPR. suspense file.
11. July 2, 2026Read second time and amended. Re-referred to Com. on APPR.
12. July 2, 2026From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 8. Noes 0.) (July 1).