Mark González
- Democratic
- Assemblymember
- District 54
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 health insurers by the Department of Insurance. Existing law sets forth specified prior authorization limitations for health care service plans and health insurers. This bill would prohibit a health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2027, that provides coverage for physical therapy from imposing prior authorization for the initial 12 physical therapy treatment visits for a new condition. The bill would authorize prior authorization for physical therapy for a recurring condition, as specified. The bill would require a physical therapy provider to verify an enrollee's or an insured's coverage and disclose their share of the cost of care, as specified. The bill would require a physical therapy provider to obtain separate written consent for costs that may not be covered by the enrollee's or insured's plan contract or policy, that includes a written estimate of the cost of care for which the enrollee or insured is responsible if coverage is denied or otherwise not applicable. With respect to health care service plans, the bill would specify that its provisions do not apply to Medi-Cal managed care plan contracts. Because a willful violation of this provision by a health care service plan would be a crime, the 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.
Consideration of Governor's veto pending.
Vetoed by Governor.
Enrolled and presented to the Governor at 3 p.m.
Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 76. Noes 1. Page 2859.).
Read third time. Passed. Ordered to the Assembly. (Ayes 39. Noes 0. Page 2388.).
In Assembly. Concurrence in Senate amendments pending.
Read second time. Ordered to third reading.
From committee: Be ordered to second reading pursuant to Senate Rule 28.8.
Read second time and amended. Re-referred to Com. on APPR.
From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 7. Noes 0.) (June 11).
In Senate. Read first time. To Com. on RLS. for assignment.
Read third time. Passed. Ordered to the Senate. (Ayes 73. Noes 1. Page 1511.)
Read second time. Ordered to third reading.
From committee: Do pass. (Ayes 14. Noes 0.) (April 30).
From committee: Do pass and re-refer to Com. on APPR. (Ayes 16. Noes 0.) (April 22). Re-referred to Com. on APPR.
From committee chair, with author's amendments: Amend, and re-refer to Com. on HEALTH. Read second time and amended.
From printer. May be heard in committee March 15.
Read first time. To print.
| Bill Text Versions | Format |
|---|---|
| AB574 | HTML |
| 02/12/25 - Introduced | |
| 03/10/25 - Amended Assembly | |
| 06/16/25 - Amended Senate | |
| 09/05/25 - Enrolled |
| Document | Format |
|---|---|
| 04/18/25- Assembly Health | |
| 04/28/25- Assembly Appropriations | |
| 05/02/25- ASSEMBLY FLOOR ANALYSIS | |
| 06/10/25- Senate Health | |
| 07/01/25- Sen. Floor Analyses | |
| 09/02/25- ASSEMBLY FLOOR ANALYSIS | |
| 10/23/25- ASSEMBLY FLOOR ANALYSIS |
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