Health care coverage: antisteering.
Vote required
Majority
Fiscal committee
No
Appropriation
No
Current location
Appropriations
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Assembly
- Passed Senate
- To Governor
- Became Law
Overview
This bill, AB 577, aims to prevent health care service plans and insurance companies from steering patients towards specific pharmacies or providers for prescription drugs. It prohibits practices like requiring patients to use a retail pharmacy when a different in-network option is clinically appropriate, or imposing restrictions on which providers can administer medications. The bill also mandates that healthcare providers obtain patient consent and provide cost estimates before administering injected or infused medications, ensuring transparency and patient choice. It addresses both health service plans and insurance companies.
Key provisions
- Prohibits requiring patients to use a specific retail pharmacy for oral medications.
- Prevents health plans from dictating which in-network provider can administer injected or infused medications.
- Requires healthcare providers to obtain patient consent before administering medications.
- Mandates disclosure of cost-sharing amounts to patients before medication administration.
- Outlaws discriminatory practices against in-network physicians related to dispensing prescription oral medications.
- Addresses pharmacy benefit manager practices related to prescription drug coverage.
- Requires health insurers to follow the same restrictions as health service plans.
- Defines ‘pharmacy benefit manager’ for clarity.
Who is affected
- Health care service plans
- Health insurers
Bill text
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Sponsors
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1 on record
Primary sponsor
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