Healthcare

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 establishes the Independent Medical Review System within each department, under which an enrollee or insured may seek review if a health care service has been denied, modified, or delayed by a health care service plan or health insurer and the enrollee or insured has previously filed a grievance that remains unresolved after 30 days. This bill would require a health care service plan or health insurer to annually report to the appropriate department the total number of claims processed by the health care service plan or health insurer for the prior year and its number of treatment denials or modifications, separated and disaggregated as specified, commencing on or before June 1, 2026. The bill would require the departments to compare the number of a health care service plan's or health insurer's treatment denials and modifications to (1) the number of successful independent medical review overturns of the plan's or insurer's treatment denials or modifications and (2) the number of treatment denials or modifications reversed by a plan or insurer after an independent medical review for the denial or modification is requested, filed, or applied for. For a health care service plan or health insurer with 10 or more independent medical reviews in a given year, the bill would make the health care service plan or health insurer liable for an administrative penalty, as specified, if more than 50% of the independent medical reviews filed with a health care service plan or health insurer result in an overturning or reversal of a treatment denial or modification in any one individual category of specified general types of care. The bill would make a health care service plan or health insurer liable for additional administrative penalties for each independent medical review resulting in an additional overturned or reversed denial or modification in excess of that threshold. The bill would require the departments to annually include data, analysis, and conclusions relating to these provisions in specified reports. 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. Existing law creates the Managed Care Administrative Fines and Penalties Fund in the State Treasury for the deposit of fines and administrative penalties collected pursuant to provisions licensing and regulating health care service plans. This bill would create the Managed Care Independent Medical Review Administrative Penalties Subaccount in the Managed Care Administrative Fines and Penalties Fund for the receipt and deposit of moneys generated from the administrative penalties described above with respect to health care service plans. The bill would create the Health Insurance Independent Medical Review Administrative Penalties Fund in the State Treasury for the receipt and deposit of moneys generated from the administrative penalties described above with respect to health insurers. The bill would authorize the moneys in the Managed Care Independent Medical Review Administrative Penalties Subaccount and Health Insurance Independent Medical Review Administrative Penalties Fund to be expended, as specified, upon appropriation by the Legislature. This bill would declare that its provisions are severable. 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 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's requirements a crime. Existing law sets forth specified coverage requirements for plan contracts. This bill, the Obesity Care Access Act, would require an individual or group health care service plan contract or health insurance policy that provides coverage for outpatient prescription drug benefits and is issued, amended, or renewed on or after January 1, 2026, to include coverage for bariatric surgery and at least one antiobesity medication approved by the United States Food and Drug Administration. Because a willful violation of these provisions 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.

This measure would designate the week of May 24, 2026, to May 30, 2026, inclusive, as California OB-GYN Week to recognize the essential contributions of obstetricians and gynecologists (OB-GYNs) to the health care system and the critical role they play in delivering comprehensive, preventive, and primary care services, and to encourage the continued recognition and support of OB-GYNs to ensure access to high-quality, equitable health care for all Californians.

This measure, in order to support ongoing public education and to encourage vaccination, screening, and linkage to care, would declare June 2026 as Hepatitis B Awareness Month in California in alignment with national and global awareness activities, and encourage state agencies, local health jurisdictions, community-based organizations, health care providers, and other stakeholders to observe this month with appropriate educational and outreach activities focused on hepatitis B prevention, testing, treatment, and health equity.

Existing law requires the State Department of Education, on or before January 1, 2024, to develop a plan to expand mental health instruction in California public schools. This bill would require the department, on or before January 1, 2028, to develop a plan to expand digital wellness instruction in California public schools, as provided.

This California state resolution urges federal immigration agencies to prioritize and expedite the processing of Deferred Action for Childhood Arrivals renewals, work authorization documents, and H-1B visas. It cites significant delays in application processing that have caused income instability and job losses for over 140,000 Californians participating in the DACA program. The resolution specifically highlights the impact on essential workers in education and health care, arguing that timely processing is necessary to protect community economic stability and workforce availability.

The electors of a county may propose an ordinance to the county board of supervisors by submitting an initiative petition containing signatures by registered voters in the county in an amount equal to 10% of the number of votes cast within the county for all candidates for Governor at the preceding gubernatorial election. If the county elections official certifies that an initiative petition has been signed by at least that number of voters, the county board of supervisors is required to either adopt the ordinance or submit it to the voters at the next statewide election occurring not less than 88 days later. This bill would require any Fresno County initiative petition that has been certified as sufficient by the Fresno County Registrar of Voters on or before July 8, 2026, to be submitted, without alteration, to the voters at the November 3, 2026, statewide general election. This bill would make legislative findings and declarations as to the necessity of a special statute for the County of Fresno. This bill would declare that it is to take effect immediately as an urgency statute.

This bill is a House Resolution that formally recognizes the value of "food as medicine" in improving public health and reducing healthcare costs in California. It highlights how providing medically tailored meals, produce prescriptions, and other nutrition services helps prevent and manage diet-related conditions, particularly for communities of color. The text cites evidence that these programs lower emergency room visits and hospitalizations while noting that they are currently optional under existing state healthcare initiatives. By documenting these successes and the role of local providers, the resolution aims to encourage broader adoption of these services to support patient health and economic stability.

This House resolution honors California veterans and urges the federal government to speed up the processing of disability claims. It highlights that long wait times for these benefits can cause financial hardship and delay access to necessary medical care. The bill calls on Congress and the Department of Veterans Affairs to reduce backlogs by improving staffing, increasing administrative efficiency, and modernizing their claims systems. Ultimately, it is a formal request for federal action rather than a law that changes state rules or allocates new funds.

Existing law requires the State Department of Education to identify an evidence-based online training program that a county office of education, school district, state special school, or charter school that serves pupils in grades 7 to 12, inclusive, can use to train school staff and pupils as part of their policy on pupil suicide prevention. Existing law requires the department, subject to an appropriation for these purposes, to provide a grant to a county office of education to acquire a training program identified by the department and disseminate that training program at no cost to specified educational entities, as specified. This bill would revise and recast these provisions by (1) deleting the requirement to provide the above-described grant, (2) deleting the requirement of the department to identify the above-described evidence-based online training program, (3) instead requiring the Behavioral Health Services Oversight and Accountability Commission to develop an online training program to train school staff, pupils who are 13 years of age or older, and parents, guardians, or caregivers of pupils as part of the policy on pupil suicide prevention adopted by county offices of education, school districts, state special schools, and charter schools that serve pupils in kindergarten or in any of grades 1 to 12, inclusive, as specified. The bill would require those educational entities that elect to conduct suicide risk screenings to report, on or before June 30, 2027, and June 30 annually thereafter, the number of pupils screened, and which screening instruments were used, for the reporting year, to the department, as provided, and would require the department to compile and post statewide aggregate data on these screenings on its internet website, as provided. This bill would declare that it is to take effect immediately as an urgency statute.