Two prior authorization reform bills have passed the California legislature and are headed to Gov. Gavin Newsom’s desk.
The California Medical Association, which supported the legislation, said in a Sept. 11 news release the bills “aim to dramatically streamline the system, ensuring timely access to care for patients.”
If signed by Mr. Newsom, Assembly Bill 512 would:
- Require payers to answer electronic prior authorization requests within three business days for standard requests and within 24 hours for urgent care.
- Require payers to answer non-electronic requests within five business days for standard reviews and within 48 hours for urgent requests.
If signed, Senate Bill 306 would:
- Allow the California Department of Managed Health Care to waive prior authorizations for services or prescriptions that payers approve at least 90% of the time.
- Require payers to report prior authorization data.
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