Amended IN Senate May 20, 2024 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 1842Introduced by Assembly Member Reyes(Coauthor: Assembly Member Arambula)January 16, 2024An act to add Section 1342.75 to the Health and Safety Code, and to add Section 10123.1935 to the Insurance Code, relating to health care coverage. LEGISLATIVE COUNSEL'S DIGESTAB 1842, as amended, Reyes. Health care coverage: Medication-assisted treatment.Existing law, the KnoxKeene 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 also provides for the regulation of health insurers by the Department of Insurance. Existing law authorizes health care service plans and health insurers that cover prescription drugs to utilize reasonable medical management practices, including prior authorization and step therapy, consistent with applicable law. This bill would prohibit a medical service plan and a health insurer from subjecting a naloxone product or another opioid antagonist approved by the United States Food and Drug Administration, or a buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder, to prior authorization or step therapy. 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.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.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YES Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 1342.75 is added to the Health and Safety Code, to read:1342.75. Notwithstanding any other law, a health care service plan shall not subject any either of the following to prior authorization or step therapy:(a) A naloxone product or another opioid antagonist approved by the United States Food and Drug Administration.(b) A buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder.SEC. 2. Section 10123.1935 is added to the Insurance Code, to read:10123.1935. Notwithstanding any other law, a health insurer shall not subject any either of the following to prior authorization or step therapy:(a) A naloxone product or another opioid antagonist approved by the United States Food and Drug Administration.(b) A buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder.SEC. 3. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
Amended IN Senate May 20, 2024 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 1842Introduced by Assembly Member Reyes(Coauthor: Assembly Member Arambula)January 16, 2024An act to add Section 1342.75 to the Health and Safety Code, and to add Section 10123.1935 to the Insurance Code, relating to health care coverage. LEGISLATIVE COUNSEL'S DIGESTAB 1842, as amended, Reyes. Health care coverage: Medication-assisted treatment.Existing law, the KnoxKeene 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 also provides for the regulation of health insurers by the Department of Insurance. Existing law authorizes health care service plans and health insurers that cover prescription drugs to utilize reasonable medical management practices, including prior authorization and step therapy, consistent with applicable law. This bill would prohibit a medical service plan and a health insurer from subjecting a naloxone product or another opioid antagonist approved by the United States Food and Drug Administration, or a buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder, to prior authorization or step therapy. 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.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.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YES
Amended IN Senate May 20, 2024
Amended IN Senate May 20, 2024
CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION
Assembly Bill
No. 1842
Introduced by Assembly Member Reyes(Coauthor: Assembly Member Arambula)January 16, 2024
Introduced by Assembly Member Reyes(Coauthor: Assembly Member Arambula)
January 16, 2024
An act to add Section 1342.75 to the Health and Safety Code, and to add Section 10123.1935 to the Insurance Code, relating to health care coverage.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AB 1842, as amended, Reyes. Health care coverage: Medication-assisted treatment.
Existing law, the KnoxKeene 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 also provides for the regulation of health insurers by the Department of Insurance. Existing law authorizes health care service plans and health insurers that cover prescription drugs to utilize reasonable medical management practices, including prior authorization and step therapy, consistent with applicable law. This bill would prohibit a medical service plan and a health insurer from subjecting a naloxone product or another opioid antagonist approved by the United States Food and Drug Administration, or a buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder, to prior authorization or step therapy. 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.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 KnoxKeene 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 also provides for the regulation of health insurers by the Department of Insurance. Existing law authorizes health care service plans and health insurers that cover prescription drugs to utilize reasonable medical management practices, including prior authorization and step therapy, consistent with applicable law.
This bill would prohibit a medical service plan and a health insurer from subjecting a naloxone product or another opioid antagonist approved by the United States Food and Drug Administration, or a buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder, to prior authorization or step therapy. 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.
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.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. Section 1342.75 is added to the Health and Safety Code, to read:1342.75. Notwithstanding any other law, a health care service plan shall not subject any either of the following to prior authorization or step therapy:(a) A naloxone product or another opioid antagonist approved by the United States Food and Drug Administration.(b) A buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder.SEC. 2. Section 10123.1935 is added to the Insurance Code, to read:10123.1935. Notwithstanding any other law, a health insurer shall not subject any either of the following to prior authorization or step therapy:(a) A naloxone product or another opioid antagonist approved by the United States Food and Drug Administration.(b) A buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder.SEC. 3. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. Section 1342.75 is added to the Health and Safety Code, to read:1342.75. Notwithstanding any other law, a health care service plan shall not subject any either of the following to prior authorization or step therapy:(a) A naloxone product or another opioid antagonist approved by the United States Food and Drug Administration.(b) A buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder.
SECTION 1. Section 1342.75 is added to the Health and Safety Code, to read:
### SECTION 1.
1342.75. Notwithstanding any other law, a health care service plan shall not subject any either of the following to prior authorization or step therapy:(a) A naloxone product or another opioid antagonist approved by the United States Food and Drug Administration.(b) A buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder.
1342.75. Notwithstanding any other law, a health care service plan shall not subject any either of the following to prior authorization or step therapy:(a) A naloxone product or another opioid antagonist approved by the United States Food and Drug Administration.(b) A buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder.
1342.75. Notwithstanding any other law, a health care service plan shall not subject any either of the following to prior authorization or step therapy:(a) A naloxone product or another opioid antagonist approved by the United States Food and Drug Administration.(b) A buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder.
1342.75. Notwithstanding any other law, a health care service plan shall not subject any either of the following to prior authorization or step therapy:
(a) A naloxone product or another opioid antagonist approved by the United States Food and Drug Administration.
(b) A buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder.
SEC. 2. Section 10123.1935 is added to the Insurance Code, to read:10123.1935. Notwithstanding any other law, a health insurer shall not subject any either of the following to prior authorization or step therapy:(a) A naloxone product or another opioid antagonist approved by the United States Food and Drug Administration.(b) A buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder.
SEC. 2. Section 10123.1935 is added to the Insurance Code, to read:
### SEC. 2.
10123.1935. Notwithstanding any other law, a health insurer shall not subject any either of the following to prior authorization or step therapy:(a) A naloxone product or another opioid antagonist approved by the United States Food and Drug Administration.(b) A buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder.
10123.1935. Notwithstanding any other law, a health insurer shall not subject any either of the following to prior authorization or step therapy:(a) A naloxone product or another opioid antagonist approved by the United States Food and Drug Administration.(b) A buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder.
10123.1935. Notwithstanding any other law, a health insurer shall not subject any either of the following to prior authorization or step therapy:(a) A naloxone product or another opioid antagonist approved by the United States Food and Drug Administration.(b) A buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder.
10123.1935. Notwithstanding any other law, a health insurer shall not subject any either of the following to prior authorization or step therapy:
(a) A naloxone product or another opioid antagonist approved by the United States Food and Drug Administration.
(b) A buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder.
SEC. 3. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
SEC. 3. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
SEC. 3. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
### SEC. 3.