AB 574: Prior authorization: physical therapy.

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 sets forth specified prior authorization limitations for health care service plans and health insurers.

This bill would prohibit a health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2027, that provides coverage for physical therapy from imposing prior authorization for the initial 12 physical therapy treatment visits for a new condition. The bill would authorize prior authorization for physical therapy for a recurring condition, as specified. The bill would require a physical therapy provider to verify an enrollee’s or an insured’s coverage and disclose their share of the cost of care, as specified. The bill would require a physical therapy provider to obtain separate written consent for costs that may not be covered by the enrollee’s or insured’s plan contract or policy, that includes a written estimate of the cost of care for which the enrollee or insured is responsible if coverage is denied or otherwise not applicable. With respect to health care service plans, the bill would specify that its provisions do not apply to Medi-Cal managed care plan contracts. Because a willful violation of this provision 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 3

“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. January 22, 2026Consideration of Governor's veto stricken from file.
2. October 6, 2025Consideration of Governor's veto pending.
3. October 6, 2025Vetoed by Governor.
4. September 9, 2025Enrolled and presented to the Governor at 3 p.m.
5. September 3, 2025Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 76. Noes 1. Page 2859.).
6. September 2, 2025In Assembly. Concurrence in Senate amendments pending.
7. September 2, 2025Read third time. Passed. Ordered to the Assembly. (Ayes 39. Noes 0. Page 2388.).
8. July 1, 2025Read second time. Ordered to third reading.
9. June 30, 2025From committee: Be ordered to second reading pursuant to Senate Rule 28.8.
10. June 16, 2025Read second time and amended. Re-referred to Com. on APPR.
11. June 13, 2025From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 7. Noes 0.) (June 11).
12. May 21, 2025Referred to Com. on HEALTH.