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 bill designates June 2026 as Men's Mental Health Month to raise awareness about mental health issues affecting men. The measure is a formal proclamation that does not change laws or allocate funding, but rather encourages public recognition of the topic. Once passed, it serves as an official declaration without imposing new requirements on individuals or organizations.

This measure would declare the month of June 2026 as Alzheimer's Disease and Brain Awareness Month, and would urge all Californians to commemorate the month of June 2026 as Alzheimer's Disease and Brain Awareness Month.

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.

Senate Resolution 122 formally recognizes November 2026 as Pancreatic Cancer Awareness Month in California. This non-binding resolution highlights the severity of the disease, noting its high mortality rate and lack of early detection methods, while also pointing out that current federal funding for pancreatic cancer research is low compared to other areas. The bill urges all Californians to take action to end pancreatic cancer and calls for increased awareness and support for research efforts. It does not change any laws or allocate state funds but serves to draw public attention to the issue.

This Senate Resolution officially designates September 2026 as Ovarian Cancer Awareness Month in California. The bill aims to highlight the severity of the disease and encourage women to seek early medical attention for symptoms like bloating and pelvic pain. It does not change laws or allocate funding but serves to raise public awareness and support for those affected by ovarian cancer.

Senate Resolution 126 declares September 2026 as Childhood Cancer Awareness Month in California, aiming to highlight the impact of pediatric cancer on families and the state's medical resources. The resolution encourages individuals, businesses, and organizations to participate in awareness activities and support affected families throughout the year. It also expresses gratitude to healthcare providers and parents while reaffirming the Senate's commitment to finding cures and less toxic treatments for children with cancer.