On Sep. 11, CAL LEG passed bill for outpatient drug benefit offerings.
CAL LEG passed bill AB 1842 re opioid-related or substance abuse treatment coverage.
Adds Health and Safety Code (HSC) section CAL LEG 2-1-1342.75 (health care service plans) and adds Insurance Code (INS) CAL INS 2-1-10123.1935 (contract provisions).
Bill Provisions
Group or individual health service plan or insurer offering an outpatient prescription drug benefit must offer at least 1 FDA-approved medication in each of four categories.
Medication to reverse opioid overdose including naloxone product or opioid antagonist.
And fourth, to treat substance use disorder including daily oral buprenorphine product.
Plan/insurer must offer without prior authorization, step therapy, or utilization review.
Not prohibited from selecting an AB-rated generic equivalent, biosimilar, or interchangeable biological product defined as by 42 USC 262(i)(2), 42 USC 262(i)(3).
No reimbursement required; lack of reimbursement does not violate CAL Constitution.
Legislative History
On Jan. 16, 2024, bill introduced in Assembly; on Apr. 29, 2024, bill passed Assembly.
On Apr. 29, 2024, bill introduced in Senate; on Aug. 28, 2024, bill passed in Senate.
On Aug. 29, 2024, bill concurred in Assembly with Senate amendments, sent to enroll.
On Sep. 3, 2024, bill enrolled; on Sep. 11, 2024, bill was presented to the governor.
Effectiveness
No effective date specified; generally effective Jan. 1 after enactment, on Jan. 1, 2025.
Sep. 27, 2024 CAL LEG Governor Approval
On Sep. 27, 2024, CAL LEG governor approved bill AB 1842 and assigned Ch. 633.
Regulators
CAL LEG
Entity Types
Ins
Reference
Ch. 633, 9/27/2024; Bill, AB1842, 9/11/2024; Citation: CAL INS 2-1-10123; CAL LEG 2-1-1342; 42 USC 262;
