California Assembly Bill AB2613

California 2025-2026 Regular Session

• Introduced: 2/20/26
• Refer: 3/19/26
• Report Pass: 3/19/26
• Refer: 3/23/26
• Report Pass: 4/23/26
• Refer: 4/28/26

Caption

Health care service plans: provider contract termination: notice.

Impact

The bill introduces critical changes to existing laws governing health care service plans, particularly regarding how enrollees are informed and treated during provider changes. By mandating automatic reinstatement to previous providers without requiring a request from the enrollee, the law aims to enhance patient security and continuity of care. The ability for affected patients to receive out-of-network care at in-network cost sharing if their previous provider is no longer contracted ensures that patients do not lose access to needed care due to administrative oversights.

Summary

Assembly Bill 2613, introduced by Assembly Member Sharp-Collins, focuses on how health care service plans manage provider network transitions and contract terminations. This legislation amends the Health and Safety Code to require health care service plans to automatically reinstate enrollees to their previously assigned primary care providers if a transition is delayed or fails within 120 days. It mandates notification procedures that include alerts via both mail and electronic means, emphasizing communication to patients about changes in their care provider arrangements.

Sentiment

Discussion around AB 2613 reflects a generally positive sentiment among advocates who favor strong patient rights and consistent access to care. Supporters highlight the importance of this legislation in reducing confusion and ensuring that patients can maintain relationships with their health care providers. However, there are concerns from some opposition groups regarding the potential administrative burden it may impose on health care plans and how effectively they will manage these additional requirements.

Contention

Key points of contention include the implications of increased notification obligations on health care providers and the potential for operational challenges in complying with automatic reinstatement protocols. Critics argue that while the intentions are noble, the enforcement of these provisions could complicate contract management and lead to unintended consequences, such as delays in actual provider transitions. The balance between patient protection and the operational realities of health care service plans remains a complex area of discussion with varying stakeholder perspectives.