Josh Becker
- Democratic
- Senator
- District 13
Author
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 disability insurers by the Department of Insurance. Existing law generally authorizes a health care service plan or disability insurer to use prior authorization and other utilization review or utilization management functions, under which a licensed physician or a licensed health care professional who is competent to evaluate specific clinical issues may approve, modify, delay, or deny requests for health care services based on medical necessity. Existing law requires a health care service plan or disability insurer, including those plans or insurers that delegate utilization review or utilization management functions to medical groups, independent practice associations, or to other contracting providers, to comply with specified requirements and limitations on their utilization review or utilization management functions. Existing law authorizes the Director of the Department of Managed Health Care or the Insurance Commissioner to assess an administrative penalty to a health care service plan or disability insurer, as applicable, for failure to comply with those requirements. This bill would require a health care service plan or disability insurer, including a specialized health care service plan or specialized health insurer, that uses an artificial intelligence, algorithm, or other software tool for the purpose of utilization review or utilization management functions, or that contracts with or otherwise works through an entity that uses that type of tool, to ensure compliance with specified requirements, including that the artificial intelligence, algorithm, or other software tool bases its determination on specified information and is fairly and equitably applied, as specified. 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.
Chaptered by Secretary of State. Chapter 879, Statutes of 2024.
Approved by the Governor.
Enrolled and presented to the Governor at 3 p.m.
Assembly amendments concurred in. (Ayes 40. Noes 0. Page 5770.) Ordered to engrossing and enrolling.
Read third time. Passed. (Ayes 76. Noes 0. Page 7004.) Ordered to the Senate.
In Senate. Concurrence in Assembly amendments pending.
Ordered to third reading.
Read third time and amended.
Read third time and amended.
Ordered to third reading.
Read second time. Ordered to third reading.
From committee: Do pass. (Ayes 14. Noes 0.) (August 15).
August 7 set for first hearing. Placed on suspense file.
From committee: Do pass as amended and re-refer to Com. on APPR. with recommendation: To consent calendar. (Ayes 11. Noes 0.) (July 2).
Read second time and amended. Re-referred to Com. on APPR.
Read second time and amended. Re-referred to Com. on P. & C.P.
From committee: Do pass as amended and re-refer to Com. on P. & C.P. (Ayes 16. Noes 0.) (June 18).
From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.
In Assembly. Read first time. Held at Desk.
Read third time. Passed. (Ayes 37. Noes 0. Page 4179.) Ordered to the Assembly.
Ordered to special consent calendar.
Read second time. Ordered to third reading.
From committee: Do pass. (Ayes 7. Noes 0. Page 3972.) (May 16).
Set for hearing May 16.
April 22 hearing: Placed on APPR suspense file.
Set for hearing April 22.
Read second time and amended. Re-referred to Com. on APPR.
From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 11. Noes 0. Page 3561.) (April 10).
From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.
Set for hearing April 10.
April 3 set for second hearing canceled at the request of author.
Set for hearing April 3.
March 20 set for first hearing canceled at the request of author.
Set for hearing March 20.
From printer. May be acted upon on or after March 15.
Introduced. Read first time. To Com. on RLS. for assignment. To print.
| Bill Text Versions | Format |
|---|---|
| SB1120 | HTML |
| 02/13/24 - Introduced | |
| 04/01/24 - Amended Senate | |
| 04/15/24 - Amended Senate | |
| 06/10/24 - Amended Assembly | |
| 06/20/24 - Amended Assembly | |
| 07/08/24 - Amended Assembly | |
| 08/22/24 - Amended Assembly | |
| 08/23/24 - Amended Assembly | |
| 09/05/24 - Enrolled | |
| 09/28/24 - Chaptered |
| Document | Format |
|---|---|
| 04/08/24- Senate Health | |
| 04/19/24- Senate Appropriations | |
| 05/17/24- Sen. Floor Analyses | |
| 06/14/24- Assembly Health | |
| 06/29/24- Assembly Privacy and Consumer Protection | |
| 08/05/24- Assembly Appropriations | |
| 08/19/24- ASSEMBLY FLOOR ANALYSIS | |
| 08/23/24- ASSEMBLY FLOOR ANALYSIS | |
| 08/30/24- Sen. Floor Analyses |
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