Healthcare

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 establishes the Independent Medical Review System within each department, under which an enrollee or insured may seek review if a health care service has been denied, modified, or delayed by a health care service plan or health insurer and the enrollee or insured has previously filed a grievance that remains unresolved after 30 days. This bill would require a health care service plan or health insurer to annually report to the appropriate department the total number of claims processed by the health care service plan or health insurer for the prior year and its number of treatment denials or modifications, separated and disaggregated as specified, commencing on or before June 1, 2026. The bill would require the departments to compare the number of a health care service plan's or health insurer's treatment denials and modifications to (1) the number of successful independent medical review overturns of the plan's or insurer's treatment denials or modifications and (2) the number of treatment denials or modifications reversed by a plan or insurer after an independent medical review for the denial or modification is requested, filed, or applied for. For a health care service plan or health insurer with 10 or more independent medical reviews in a given year, the bill would make the health care service plan or health insurer liable for an administrative penalty, as specified, if more than 50% of the independent medical reviews filed with a health care service plan or health insurer result in an overturning or reversal of a treatment denial or modification in any one individual category of specified general types of care. The bill would make a health care service plan or health insurer liable for additional administrative penalties for each independent medical review resulting in an additional overturned or reversed denial or modification in excess of that threshold. The bill would require the departments to annually include data, analysis, and conclusions relating to these provisions in specified reports. Because a willful violation of these provisions by a health care service plan would be a crime, this bill would impose a state-mandated local program. Existing law creates the Managed Care Administrative Fines and Penalties Fund in the State Treasury for the deposit of fines and administrative penalties collected pursuant to provisions licensing and regulating health care service plans. This bill would create the Managed Care Independent Medical Review Administrative Penalties Subaccount in the Managed Care Administrative Fines and Penalties Fund for the receipt and deposit of moneys generated from the administrative penalties described above with respect to health care service plans. The bill would create the Health Insurance Independent Medical Review Administrative Penalties Fund in the State Treasury for the receipt and deposit of moneys generated from the administrative penalties described above with respect to health insurers. The bill would authorize the moneys in the Managed Care Independent Medical Review Administrative Penalties Subaccount and Health Insurance Independent Medical Review Administrative Penalties Fund to be expended, as specified, upon appropriation by the Legislature. This bill would declare that its provisions are severable. 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.

Existing law, the Lanterman Developmental Disabilities Services Act, requires the State Department of Developmental Services to contract with regional centers for the provision of services and supports for persons with developmental disabilities and their families. Existing law, until July 1, 2026, creates the Advisory Council on Improving Interactions between People with Intellectual and Development Disabilities and Law Enforcement, under the Department of Justice, to, among other things, evaluate existing training for peace officers specific to interactions between law enforcement and individuals with intellectual and developmental disabilities. Existing law requires the council to submit a report including recommendations to the Legislature for improving outcomes of interactions with both individuals who have an intellectual or developmental disability and mental health conditions, as specified. This bill would require the State Department of Developmental Services to conduct a statewide evaluation of safety training services provided by regional centers, as specified. The bill would require the department, by July 1, 2028, to submit a report to the Legislature summarizing its findings and recommendations and would require the recommendations to address specified topics, including, among others, recommendations for establishing standardized, statewide protocols for responding to crises involving individuals with intellectual or developmental disabilities. The bill would state the intent of the Legislature to consider, upon receipt and consideration of that report, providing funding to the department for the purpose of developing, implementing, and sustaining safety training services statewide.

This measure would designate the week of May 24, 2026, to May 30, 2026, inclusive, as California OB-GYN Week to recognize the essential contributions of obstetricians and gynecologists (OB-GYNs) to the health care system and the critical role they play in delivering comprehensive, preventive, and primary care services, and to encourage the continued recognition and support of OB-GYNs to ensure access to high-quality, equitable health care for all Californians.

This measure, in order to support ongoing public education and to encourage vaccination, screening, and linkage to care, would declare June 2026 as Hepatitis B Awareness Month in California in alignment with national and global awareness activities, and encourage state agencies, local health jurisdictions, community-based organizations, health care providers, and other stakeholders to observe this month with appropriate educational and outreach activities focused on hepatitis B prevention, testing, treatment, and health equity.

Existing law requires the State Department of Education, on or before January 1, 2024, to develop a plan to expand mental health instruction in California public schools. This bill would require the department, on or before January 1, 2028, to develop a plan to expand digital wellness instruction in California public schools, as provided.

This bill is a House Resolution that formally recognizes the value of "food as medicine" in improving public health and reducing healthcare costs in California. It highlights how providing medically tailored meals, produce prescriptions, and other nutrition services helps prevent and manage diet-related conditions, particularly for communities of color. The text cites evidence that these programs lower emergency room visits and hospitalizations while noting that they are currently optional under existing state healthcare initiatives. By documenting these successes and the role of local providers, the resolution aims to encourage broader adoption of these services to support patient health and economic stability.

This House resolution honors California veterans and urges the federal government to speed up the processing of disability claims. It highlights that long wait times for these benefits can cause financial hardship and delay access to necessary medical care. The bill calls on Congress and the Department of Veterans Affairs to reduce backlogs by improving staffing, increasing administrative efficiency, and modernizing their claims systems. Ultimately, it is a formal request for federal action rather than a law that changes state rules or allocates new funds.

Existing law requires the State Department of Education to identify an evidence-based online training program that a county office of education, school district, state special school, or charter school that serves pupils in grades 7 to 12, inclusive, can use to train school staff and pupils as part of their policy on pupil suicide prevention. Existing law requires the department, subject to an appropriation for these purposes, to provide a grant to a county office of education to acquire a training program identified by the department and disseminate that training program at no cost to specified educational entities, as specified. This bill would revise and recast these provisions by (1) deleting the requirement to provide the above-described grant, (2) deleting the requirement of the department to identify the above-described evidence-based online training program, (3) instead requiring the Behavioral Health Services Oversight and Accountability Commission to develop an online training program to train school staff, pupils who are 13 years of age or older, and parents, guardians, or caregivers of pupils as part of the policy on pupil suicide prevention adopted by county offices of education, school districts, state special schools, and charter schools that serve pupils in kindergarten or in any of grades 1 to 12, inclusive, as specified. The bill would require those educational entities that elect to conduct suicide risk screenings to report, on or before June 30, 2027, and June 30 annually thereafter, the number of pupils screened, and which screening instruments were used, for the reporting year, to the department, as provided, and would require the department to compile and post statewide aggregate data on these screenings on its internet website, as provided. This bill would declare that it is to take effect immediately as an urgency statute.

Existing law, the Pharmacy Law, provides for the licensure and regulation of pharmacists by the California State Board of Pharmacy. Existing law authorizes a pharmacist to, among other things, perform certain procedures or functions and furnish specified drugs. Existing law authorizes the refilling of a prescription for a dangerous drug without the authorization of the prescriber if the prescriber is unavailable to authorize the refill and, in the pharmacist's professional judgment, failure to refill the prescription might interrupt the patient's ongoing care and have a significant adverse effect on the patient's well-being. Existing law requires a pharmacist to notify the prescriber, as specified, of any prescription refilled without their authorization. This bill would only require a pharmacist to provide that notification if a prescriber is identified.

Existing law, the Health Care Decisions Law, provides for the creation, form, and revocation of advance health care directives, and authorizes an adult having capacity to give an individual health care instruction. Under existing law, the advance health care directive of a patient in a skilled nursing facility is not effective unless a patient advocate or ombudsman signs the advance directive as a witness and declares that they are serving as a witness pursuant to this requirement. Existing law authorizes a witness who is a patient advocate or ombudsman to rely on the representations of the administrators or staff of the skilled nursing facility, or of family members, as convincing evidence of the identity of the patient, as specified. This bill would delete a patient advocate from the above-described witness duties, thus requiring that an ombudsman witness the advance health care directive of a patient in a skilled nursing facility.