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California bills · 2025-2026 Regular Session

California AB 2499

Health care coverage: claims payments.

  1. Introduced
  2. In committee
  3. Passed House
  4. Passed Senate
  5. To Governor
  6. Became law

Sponsors

Summary

Official abstract published by the California legislature· 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 the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan or health insurer to reimburse a complete claim or a portion thereof within 30 calendar days after receipt of the claim, or, if a claim or portion thereof does not meet the criteria for a complete claim or the criteria for coverage under the plan or insurance contract, to notify the claimant in writing that the claim or portion thereof is contested or denied as soon as practicable, but no later than 30 calendar days after receipt of the claim by the plan or insurer. This bill would, commencing May 26, 2028, require a plan or insurer to accept electronic medical records and supporting documentation necessary to process a claim through a standard electronic submission method, as specified, and would prohibit a plan or insurer from denying, pending, or delaying a claim solely because the plan's or insurer's systems are unable to accept documentation that otherwise meets the plan's or insurer's requirements. The bill would specify that if a state or federal standard is adopted that is specific to file size, number, or other capacity requirements for claims-related supporting documentation submissions, that standard would apply. Because a willful violation of these provisions by a health care service plan 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.

Text versions

Roll-call votes

State vote data last updated Oct 15, 2026, 8:06 AM.

DateVoteResultYour legislators
Aug 27, 2026
House		AB 2499 Gipson Concurrence in Senate AmendmentspassSet your home in California to see
Aug 27, 2026
House		With recommendation: That Senate amendments be concurred in.passSet your home in California to see
Aug 25, 2026
Senate		3rd Reading AB2499 Gipson By Weber PiersonpassSet your home in California to see
Jul 1, 2026
Senate		Do pass as amended, but first amend, and re-refer to the Committee on [Appropriations]passSet your home in California to see
May 28, 2026
House		AB 2499 Gipson Assembly Third ReadingpassSet your home in California to see
May 14, 2026
House		Do pass as amended.passSet your home in California to see
Apr 22, 2026
House		Do pass and be re-referred to the Committee on [Appropriations]passSet your home in California to see
Mar 24, 2026
House		Do pass and be re-referred to the Committee on [Labor and Employment]passSet your home in California to see

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