Drug formularies.
Vote required
Majority
Fiscal committee
No
Appropriation
No
Current location
Appropriations
Take action
Record your position on this measure.
Create an account to record your position, submit testimony, or contact your legislator.
Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Assembly
- Passed Senate
- To Governor
- Became Law
Overview
This bill, AB 2000, aims to regulate how health care service plans and health insurers manage prescription drug formularies. It prohibits these plans from making significant changes to their formularies during a plan year without specific justification and providing notice to enrollees and providers. The bill also establishes a faster process for obtaining authorization for non-formulary medications and requires plans to report formulary changes to the state’s Department of Managed Health Care and Department of Insurance, with potential penalties for non-compliance. Furthermore, it clarifies the definition of ‘expeditious process’ for non-formulary drug approvals.
Key provisions
- Prohibits significant formulary changes during a plan year without specific justification.
- Requires 90-day notice to enrollees and providers before formulary changes.
- Establishes a 72-hour approval timeframe for nonurgent nonformulary drug requests.
- Authorizes transitional coverage for 90 days if a formulary change requires a switch to a different drug.
- Mandates reporting of formulary changes to the Department of Managed Health Care and Department of Insurance within 30 days.
- Defines ‘expeditious process’ for nonformulary drug authorization.
- Authorizes the departments to investigate and impose penalties for noncompliance.
- Clarifies the definition of ‘formulary’.
Who is affected
- Health care service plans
- Health insurers
- Enrollees in health plans
Bill text
Read the latest version inline or switch to a previous version.
Text extraction is in progress. View the official source.
Sponsors
Official sponsors from legislative records.
1 on record
Primary sponsor
Arguments
Reasons offered for and against this legislation.
Arguments in favor
No arguments in favor have been submitted.
Submit yoursArguments opposed
No arguments opposed have been submitted.
Submit yours