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California bills · 2025-2026 Regular Session

California SB 964

Prescription drug coverage: dose adjustments.

  1. Introduced
  2. In committee
  3. Passed Senate
  4. Passed House
  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 generally authorizes a health care service plan or health insurer to use utilization review, under which a licensed physician or a licensed health care professional who is competent to evaluate specific clinical issues may approve, modify, delay, or deny requests for health care services based on medical necessity. Existing law also prohibits a health care service plan that covers prescription drug benefits from limiting or excluding coverage for a drug that was previously approved for coverage if an enrollee continues to be prescribed that drug, as specified. This bill would authorize an enrollee's or insured's treating contracting provider to submit a written request to a health care service plan or health insurer requesting the authority to adjust the dose or frequency of a drug to meet the specific medical needs of the enrollee or insured without prior authorization or subsequent utilization management. The bill would require the plan or insurer to issue a written response within 72 hours and to authorize the request if specified conditions are established in the request. 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 16, 2026, 12:24 AM.

DateVoteResultYour legislators
Aug 25, 2026
Senate		Unfinished Business SB964 Smallwood-Cuevas ConcurrencepassSet your home in California to see
Aug 24, 2026
House		SB 964 Smallwood-Cuevas Senate Third Reading By ArambulapassSet your home in California to see
Aug 13, 2026
House		Do pass.passSet your home in California to see
Jun 9, 2026
House		Do pass and be re-referred to the Committee on [Appropriations]passSet your home in California to see
May 19, 2026
Senate		3rd Reading SB964 Smallwood-CuevaspassSet your home in California to see
May 14, 2026
Senate		Do pass as amendedpassSet your home in California to see
Apr 13, 2026
Senate		Placed on suspense filepassSet your home in California to see
Mar 25, 2026
Senate		Do pass as amended, but first amend, and re-refer to the Committee on [Appropriations]passSet your home in California to see

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