Communicable diseases: hepatitis C.
Vote required
Majority
Fiscal committee
No
Appropriation
No
Current location
Passed
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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 prohibits health care service plans and health insurers in California from requiring prior authorization or step therapy for direct-acting antiviral drugs used to treat hepatitis C. It mandates that clinical criteria align with established medical guidelines from organizations like the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America, and restricts the types of tests or information requested during the prior authorization process. The bill also addresses reimbursement requirements to avoid impacting local agencies.
Key provisions
- Prohibits prior authorization for direct-acting antiviral drugs for hepatitis C treatment by health care service plans and health insurers.
- Requires clinical criteria for hepatitis C treatment to align with established medical guidelines.
- Restricts the types of tests and information requested during prior authorization.
- Specifies that coverage of therapeutically equivalent drugs without prior authorization is permitted if at least one equivalent version is covered.
- Prohibits requests for liver biopsies, genotype testing, sobriety requirements, and fibrosis staging thresholds.
- Addresses reimbursement to avoid state-mandated local program costs.
Who is affected
- Health care service plans
- Health insurers
- Patients with hepatitis C
- Healthcare providers
- California residents
Bill text
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Sponsors
Official sponsors from legislative records.
1 on record
Primary sponsor
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