California 2011-2012 Regular Session Status: Enacted

SB 866 — Health care coverage: prescription drugs.

Last action — Chaptered by Secretary of State. Chapter 648, Statutes of 2011.

  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed Senate
  4. ✓
    Passed Assembly
  5. ✓
    To Executive
  6. 6
    Enacted

This bill has been enacted into law. Introduced February 18, 2011. Enacted.

Prognosis

Likely to advance 70% · moderate confidence

Where this bill stands today.

Odds of enactment

High

How often bills like it became law.

  • Enacted

    Current position in the legislative process.

  • 1 sponsor

    1 primary, 0 co-sponsors signed on.

  • Cleared a recorded vote

    Passed 8 recorded votes so far.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

Summary

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the 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. Commonly referred to as utilization review, existing law governs the procedures that apply to every health care service plan and health insurer that prospectively, retrospectively, or concurrently reviews and approves, modifies, delays, or denies, based on medical necessity, requests by providers prior to, retrospectively, or concurrent with, the provision of health care services to enrollees or insureds, as specified. Existing law also imposes various requirements and restrictions on health care service plans and health insurers, including, among other things, a prohibition on health care service plans and health insurers that provide prescription drug benefits from excluding or limiting coverage for a drug on the basis that the drug is prescribed for a use that is different from the use for which the drug has been approved for marketing by the federal Food and Drug Administration. Existing law also requires a health care service plan that provides prescription drug benefits to maintain an expeditious process by which prescribing providers, as described, may obtain authorization for a medically necessary nonformulary prescription drug, according to certain procedures. This bill would require the Department of Managed Health Care and the Department of Insurance to, on or before July 1, 2012, develop a prior authorization form for use by every health care service plan and health insurer that provides prescription drug benefits, except as specified. On and after January 1, 2013, or 6 months after the form is developed, whichever is later, the bill would require every prescribing provider, as defined, when requesting prior authorization for prescription drug benefits, to submit the prior authorization form to the health care service plan or health insurer, and would require those plans and insurers to utilize and accept those prior authorization forms for prescription drug benefits. Except as specified, upon a failure by the plan or insurer to accept the prior authorization form or to respond to a prescribing provider within 2 business days, the bill would deem the prior authorization request as granted. Because a willful violation of the bill's provisions relative to health care service plans 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.

Bill Text

Action History

  1. Chaptered by Secretary of State. Chapter 648, Statutes of 2011.

  2. Approved by the Governor.

  3. Enrolled and presented to the Governor at 10:30 a.m.

  4. Assembly amendments concurred in. (Ayes 28. Noes 11. Page 2452.) Ordered to engrossing and enrolling.

  5. In Senate. Concurrence in Assembly amendments pending.

  6. Read third time. Passed. (Ayes 57. Noes 21. Page 3045.) Ordered to the Senate.

  7. Read second time. Ordered to third reading.

  8. Read second time and amended. Ordered to second reading.

  9. From committee: Do pass as amended. (Ayes 12. Noes 5.) (August 25).

  10. Set, first hearing. Referred to APPR. suspense file.

  11. Read second time and amended. Re-referred to Com. on APPR.

  12. From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 15. Noes 0.) (June 21).

  13. Referred to Com. on HEALTH.

  14. In Assembly. Read first time. Held at Desk.

  15. Read third time. Passed. (Ayes 27. Noes 10. Page 1265.) Ordered to the Assembly.

  16. Read second time and amended. Ordered to third reading.

  17. From committee: Do pass as amended. (Ayes 6. Noes 2. Page 1123.) (May 26).

  18. Set for hearing May 26.

  19. Placed on APPR. suspense file.

  20. Set for hearing May 2.

  21. From committee: Do pass and re-refer to Com. on APPR. (Ayes 7. Noes 0. Page 676.) (April 13). Re-referred to Com. on APPR.

  22. From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.

  23. Set for hearing April 13.

  24. Referred to Com. on HEALTH.

  25. From printer. May be acted upon on or after March 21.

  26. Introduced. Read first time. To Com. on RLS. for assignment. To print.

Sponsors

  • Hernandez · Primary

Sponsorship breakdown

Export CSV (upgrade) →

1 sponsors · 0 co-sponsors · 121 not signed on · 5 voted No

Sponsors (1)

  • Hernandez

Co-sponsors (0)

None.

Not signed on (121)

121 members have not signed on to this bill.

Show all 121 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

Unfinished Business SB866 Hernandez Concurrence

Passed 28 Yea · 11 Nay · 1 Other
Party YeaNayPresentNot Voting
Unaffiliated 251101
Republican 1000
Democratic 2000
Total 281101
% of votes cast 70%28%0%3%
How each member voted (40)
Member Party Vote
Yee — Yea
Hancock — Yea
Lowenthal — Yea
De León — Yea
Huff — Nay
Negrete McLeod — Yea
Rubio — Yea
Corbett — Yea
Alquist — Yea
Blakeslee — Yea
Leno — Yea
Lieu — Yea
Pavley — Yea
Simitian — Yea
Steinberg — Yea
Vargas — Yea
Wolk — Yea
Wright — Yea
Runner — Nay
Cannella — Nay
Dutton — Nay
Walters — Nay
Anderson — Yea
Harman — Nay
Hernandez — Yea
Kehoe — Yea
Liu — Yea
Price — Yea
Wyland — Yea
Emmerson — Nay
Correa — Yea
Evans — Not Voting
DeSaulnier — Yea
Fuller — Nay
Beth Gaines — Nay
Bill Berryhill — Nay
La Malfa — Nay
Calderon, Lisa Democratic Yea
Padilla, Stephen C. Democratic Yea
Strickland, Tony Republican Yea

Official roll call →

SB 866 Hernandez Senate Third Reading By PAN

Passed 57 Yea · 21 Nay · 2 Other
Party YeaNayPresentNot Voting
Republican 0200
Unaffiliated 561902
Democratic 1000
Total 572102
% of votes cast 71%26%0%3%
How each member voted (80)
Member Party Vote
Halderman — Yea
Carter — Yea
Fuentes — Yea
Gatto — Yea
Hill — Yea
Fong — Yea
Allen — Yea
Hueso — Yea
Huffman — Yea
Butler — Yea
Portantino — Yea
John A. Pérez — Yea
Mitchell — Yea
Fletcher — Yea
Cedillo — Yea
Davis — Yea
Ma — Yea
Perea — Yea
Skinner — Yea
Swanson — Yea
Williams — Yea
Galgiani — Yea
Gordon — Yea
Hall — Yea
Hayashi — Yea
Chesbro — Yea
Nestande — Yea
Torres — Yea
Bonilla — Yea
Yamada — Yea
Lara — Yea
Mendoza — Yea
Campos — Yea
Atkins — Yea
Logue — Nay
Cook — Nay
Olsen — Nay
Solorio — Yea
Wagner — Nay
Gorell — Not Voting
Hagman — Nay
Harkey — Nay
Conway — Nay
Jeffries — Nay
Donnelly — Nay
Miller — Nay
Morrell — Nay
Nielsen — Nay
Norby — Nay
Silva — Nay
Achadjian — Nay
Alejo — Yea
Ammiano — Yea
Beall — Yea
Block — Yea
Blumenfield — Yea
Bradford — Yea
Brownley — Yea
Buchanan — Yea
Huber — Yea
Knight — Nay
Mansoor — Not Voting
Monning — Yea
Pan — Yea
Smyth — Yea
Valadao — Nay
Wieckowski — Yea
Eng — Yea
Feuer — Yea
Dickinson — Yea
Furutani — Yea
Garrick — Nay
Beth Gaines — Nay
Bill Berryhill — Yea
Bonnie Lowenthal — Yea
Roger Hernández — Yea
V. Manuel Pérez — Yea
Calderon, Lisa Democratic Yea
Grove, Shannon Republican Nay
Jones, Brian W. Republican Nay

Official roll call →

Do pass as amended.

Passed 12 Yea · 5 Nay
Party YeaNayPresentNot Voting
Unaffiliated 11500
Democratic 1000
Total 12500
% of votes cast 71%29%0%0%
How each member voted (17)
Member Party Vote
Hall — Yea
Campos — Yea
Gatto — Yea
Hill — Yea
Mitchell — Yea
Davis — Yea
Donnelly — Nay
Norby — Nay
Wagner — Nay
Blumenfield — Yea
Bradford — Yea
Harkey — Nay
Lara — Yea
Nielsen — Nay
Solorio — Yea
Fuentes — Yea
Calderon, Lisa Democratic Yea

Official roll call →

Do pass as amended and be re-referred to the Committee on Appropriations.

Passed 15 Yea · 0 Nay · 4 Other
Party YeaNayPresentNot Voting
Unaffiliated 15004
Total 15004
% of votes cast 79%0%0%21%
How each member voted (19)
Member Party Vote
Mitchell — Yea
Bonilla — Yea
Atkins — Yea
Gordon — Yea
Logue — Not Voting
Monning — Yea
Nestande — Yea
Pan — Yea
Silva — Not Voting
Ammiano — Yea
Hayashi — Yea
Mansoor — Not Voting
Smyth — Yea
Williams — Yea
Eng — Yea
Garrick — Not Voting
Bonnie Lowenthal — Yea
Roger Hernández — Yea
V. Manuel Pérez — Yea

Official roll call →

3rd Reading

Passed 27 Yea · 10 Nay · 3 Other
Party YeaNayPresentNot Voting
Unaffiliated 241003
Republican 1000
Democratic 2000
Total 271003
% of votes cast 68%25%0%8%
How each member voted (40)
Member Party Vote
Yee — Yea
Wyland — Nay
Lowenthal — Yea
De León — Yea
Negrete McLeod — Yea
Rubio — Yea
Evans — Yea
Cannella — Not Voting
Fuller — Nay
Runner — Not Voting
Hancock — Yea
Harman — Nay
Hernandez — Yea
Kehoe — Yea
Anderson — Yea
Corbett — Yea
Correa — Yea
Dutton — Nay
Leno — Yea
Lieu — Yea
Pavley — Yea
Simitian — Yea
Vargas — Yea
Walters — Nay
Wright — Yea
Alquist — Yea
Blakeslee — Nay
Huff — Not Voting
Liu — Yea
Price — Yea
Steinberg — Yea
Wolk — Yea
Emmerson — Nay
DeSaulnier — Yea
Beth Gaines — Nay
Bill Berryhill — Nay
La Malfa — Nay
Calderon, Lisa Democratic Yea
Padilla, Stephen C. Democratic Yea
Strickland, Tony Republican Yea

Official roll call →

Do pass as amended.

Passed 6 Yea · 2 Nay · 1 Other
Party YeaNayPresentNot Voting
Unaffiliated 6201
Total 6201
% of votes cast 67%22%0%11%
How each member voted (9)
Member Party Vote
Runner — Nay
Emmerson — Not Voting
Kehoe — Yea
Lieu — Yea
Pavley — Yea
Price — Yea
Steinberg — Yea
Walters — Nay
Alquist — Yea

Official roll call →

Placed on Appropriations Suspense file.

Passed 9 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 9000
Total 9000
% of votes cast 100%0%0%0%
How each member voted (9)
Member Party Vote
Runner — Yea
Price — Yea
Alquist — Yea
Kehoe — Yea
Lieu — Yea
Pavley — Yea
Steinberg — Yea
Walters — Yea
Emmerson — Yea

Official roll call →

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does SB 866 do?
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the 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. Commonly referred to as utilization review, existing law governs the procedures that apply to every health care service plan and health insurer that prospectively, retrospectively, or concurrently reviews and approves, modifies, delays, or denies, based on medical necessity, requests by providers prior to, retrospectively, or concurrent with, the provision of health care services to enrollees or insureds, as specified. Existing law also imposes various requirements and restrictions on health care service plans and health insurers, including, among other things, a prohibition on health care service plans and health insurers that provide prescription drug benefits from excluding or limiting coverage for a drug on the basis that the drug is prescribed for a use that is different from the use for which the drug has been approved for marketing by the federal Food and Drug Administration. Existing law also requires a health care service plan that provides prescription drug benefits to maintain an expeditious process by which prescribing providers, as described, may obtain authorization for a medically necessary nonformulary prescription drug, according to certain procedures. This bill would require the Department of Managed Health Care and the Department of Insurance to, on or before July 1, 2012, develop a prior authorization form for use by every health care service plan and health insurer that provides prescription drug benefits, except as specified. On and after January 1, 2013, or 6 months after the form is developed, whichever is later, the bill would require every prescribing provider, as defined, when requesting prior authorization for prescription drug benefits, to submit the prior authorization form to the health care service plan or health insurer, and would require those plans and insurers to utilize and accept those prior authorization forms for prescription drug benefits. Except as specified, upon a failure by the plan or insurer to accept the prior authorization form or to respond to a prescribing provider within 2 business days, the bill would deem the prior authorization request as granted. Because a willful violation of the bill's provisions relative to health care service plans 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.
Who sponsors SB 866?
SB 866 is sponsored by Hernandez.
What is the current status of SB 866?
This bill has been enacted into law. Introduced February 18, 2011. Enacted.
Where can I track SB 866?
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