California 2013-2014 Regular Session Status: Passed Assembly

AB 889 — Health care coverage: prescription drugs.

Last action — From Senate committee without further action.

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

This bill died with 2013-2014 Regular Session. It reached “Passed Assembly” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Summary

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 that act a crime. Existing law also 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, providing 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, requiring 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. Existing law also requires every health care service plan that provides prescription drug benefits that maintains one or more drug formularies to provide to members of the public, upon request, a copy of the most current list of prescription drugs on the formulary. This bill would authorize health care service plans and health insurers to require step therapy, as defined, when more than one drug is appropriate for the treatment of a medical condition, subject to specified requirements. The bill would require a plan or insurer that requires step therapy to have an expeditious process in place to authorize exceptions to step therapy when medically necessary and to conform effectively and efficiently with continuity of care requirements. The bill would require the duration of any step therapy or fail first protocol to be consistent with up-to-date peer-reviewed, scientific, medical and pharmaceutical evidence, and would, except under certain conditions, prohibit a health care service plan or health insurer from requiring that a patient try and fail on more than 2 medications before allowing the patient access to other medication prescribed by the prescribing provider, as specified. The bill, with regard to an enrollee or insured changing plans or policies, would prohibit a new plan or insurer from requiring the enrollee or insured to repeat step therapy when that person is already being treated for a medical condition by a prescription drug, as specified. The bill would specify that these provisions would not apply to accident-only, specified disease, hospital indemnity, Medicare supplement, dental-only, or vision-only contracts or policies. Because a willful violation of these requirements with respect 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. From Senate committee without further action.

  2. In committee: Held under submission.

  3. In committee: Placed on APPR. suspense file.

  4. From committee: Do pass and re-refer to Com. on APPR. (Ayes 7. Noes 2.) (June 26). Re-referred to Com. on APPR.

  5. Referred to Com. on HEALTH.

  6. In Senate. Read first time. To Com. on RLS. for assignment.

  7. Read third time. Passed. Ordered to the Senate. (Ayes 59. Noes 17. Page 1691.)

  8. Read second time. Ordered to third reading.

  9. From committee: Do pass. (Ayes 13. Noes 4.) (May 24).

  10. In committee: Set, first hearing. Referred to APPR. suspense file.

  11. Re-referred to Com. on APPR.

  12. Read second time and amended.

  13. From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 15. Noes 4.) (April 30).

  14. Re-referred to Com. on HEALTH.

  15. From committee chair, with author's amendments: Amend, and re-refer to Com. on HEALTH. Read second time and amended.

  16. Re-referred to Com. on HEALTH.

  17. From committee chair, with author's amendments: Amend, and re-refer to Com. on HEALTH. Read second time and amended.

  18. Referred to Com. on HEALTH.

  19. Read first time.

  20. From printer. May be heard in committee March 26.

  21. Introduced. To print.

Sponsors

  • Frazier · Primary

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 121 not signed on · 4 voted No

Sponsors (1)

  • Frazier

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

AB 889 FRAZIER Assembly Third Reading

Passed 59 Yea · 17 Nay · 3 Other
Party YeaNayPresentNot Voting
Unaffiliated 511403
Democratic 7000
Republican 1300
Total 591703
% of votes cast 75%22%0%4%
How each member voted (79)
Member Party Vote
Achadjian — Nay
Alejo — Yea
Ammiano — Yea
Bigelow — Nay
Blumenfield — Yea
Bradford — Yea
Brown — Yea
Buchanan — Yea
Harkey — Nay
Logue — Nay
Maienschein — Yea
Mansoor — Nay
Melendez — Nay
Nazarian — Yea
Wagner — Nay
Williams — Yea
Chávez — Nay
Stone — Yea
Lowenthal — Yea
Gray — Yea
Atkins — Yea
Skinner — Yea
Waldron — Yea
Mitchell — Yea
Gomez — Yea
Gordon — Yea
Bonilla — Yea
Linder — Yea
Bloom — Yea
Medina — Yea
Olsen — Yea
Quirk — Yea
Gonzalez — Yea
Hagman — Nay
Jones-Sawyer — Yea
Levine — Yea
Bocanegra — Yea
Morrell — Nay
John A. Pérez — Yea
Salas — Yea
Mullin — Yea
Nestande — Yea
Pan — Yea
Campos — Yea
Chau — Yea
Chesbro — Yea
Cooley — Yea
Dickinson — Yea
Eggman — Yea
Perea — Yea
Rendon — Yea
Ting — Yea
Weber — Yea
Wieckowski — Yea
Conway — Nay
Wilk — Nay
Holden — Not Voting
Daly — Not Voting
Donnelly — Nay
Fox — Yea
Frazier — Yea
Gatto — Yea
Yamada — Yea
Gorell — Not Voting
Hall — Yea
Beth Gaines — Nay
Roger Hernández — Yea
V. Manuel Pérez — Yea
Allen, Benjamin Democratic Yea
Bonta, Mia Democratic Yea
Calderon, Lisa Democratic Yea
Fong, Mike Democratic Yea
Garcia, Robert Democratic Yea
Muratsuchi, Al Democratic Yea
Quirk-Silva, Sharon Democratic Yea
Dahle, Megan Republican Nay
Grove, Shannon Republican Nay
Jones, Brian W. Republican Yea
Patterson, Joe Republican Nay

Official roll call →

Do pass.

Passed 13 Yea · 4 Nay
Party YeaNayPresentNot Voting
Unaffiliated 12400
Democratic 1000
Total 13400
% of votes cast 76%24%0%0%
How each member voted (17)
Member Party Vote
Bigelow — Nay
Bradford — Yea
Linder — Yea
Weber — Yea
Bocanegra — Yea
Campos — Yea
Gatto — Yea
Gomez — Yea
Hall — Yea
Harkey — Nay
Donnelly — Nay
Ammiano — Yea
Eggman — Yea
Pan — Yea
Quirk — Yea
Wagner — Nay
Calderon, Lisa Democratic Yea

Official roll call →

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

Passed 15 Yea · 4 Nay
Party YeaNayPresentNot Voting
Unaffiliated 14400
Democratic 1000
Total 15400
% of votes cast 79%21%0%0%
How each member voted (19)
Member Party Vote
Ammiano — Yea
Maienschein — Yea
Mansoor — Nay
Wilk — Nay
Chesbro — Yea
Bonilla — Yea
Mitchell — Yea
Lowenthal — Yea
Logue — Nay
Atkins — Yea
Nazarian — Yea
Nestande — Yea
Pan — Yea
Wagner — Nay
Wieckowski — Yea
Gomez — Yea
Roger Hernández — Yea
V. Manuel Pérez — Yea
Bonta, Mia Democratic Yea

Official roll call →

Subjects

healthcare health-insurance
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Frequently asked questions

What does AB 889 do?
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 that act a crime. Existing law also 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, providing 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, requiring 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. Existing law also requires every health care service plan that provides prescription drug benefits that maintains one or more drug formularies to provide to members of the public, upon request, a copy of the most current list of prescription drugs on the formulary. This bill would authorize health care service plans and health insurers to require step therapy, as defined, when more than one drug is appropriate for the treatment of a medical condition, subject to specified requirements. The bill would require a plan or insurer that requires step therapy to have an expeditious process in place to authorize exceptions to step therapy when medically necessary and to conform effectively and efficiently with continuity of care requirements. The bill would require the duration of any step therapy or fail first protocol to be consistent with up-to-date peer-reviewed, scientific, medical and pharmaceutical evidence, and would, except under certain conditions, prohibit a health care service plan or health insurer from requiring that a patient try and fail on more than 2 medications before allowing the patient access to other medication prescribed by the prescribing provider, as specified. The bill, with regard to an enrollee or insured changing plans or policies, would prohibit a new plan or insurer from requiring the enrollee or insured to repeat step therapy when that person is already being treated for a medical condition by a prescription drug, as specified. The bill would specify that these provisions would not apply to accident-only, specified disease, hospital indemnity, Medicare supplement, dental-only, or vision-only contracts or policies. Because a willful violation of these requirements with respect 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 AB 889?
AB 889 is sponsored by Frazier.
What is the current status of AB 889?
This bill died with 2013-2014 Regular Session. It reached “Passed Assembly” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track AB 889?
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