Assembly BillChaptered/SignedHealth and Safety
AB 1887: Prescription drug coverage for rare diseases.
What AB 1887 does, verified September 29, 2026
The bill aims to improve healthcare coverage for individuals with rare diseases. It prohibits health plans from imposing prior authorization or step therapy for a drug approved for treating a rare disease if prescribed by a specialist with expertise in the condition and deemed medically necessary. The provision applies to drugs prescribed after January 1, 2027, unless a biosimilar, interchangeable biologic, or generic version is available. The bill also includes a state-mandated local program to prevent willful violations, making it a crime. No reimbursement is required for certain costs associated with implementing this new provision.
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Last action: Chaptered by Secretary of State - Chapter 557, Statutes of 2026. (2026-09-27)Alert me
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| Sep. 27, 2026 | Chaptered by Secretary of State - Chapter 557, Statutes of 2026. |
| Sep. 27, 2026 | Approved by the Governor. |
| Sep. 10, 2026 | Enrolled and presented to the Governor at 3 p.m. |
| Aug. 30, 2026 | Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 78. Noes 0. Page 6932.). |
| Aug. 30, 2026 | In Assembly. Concurrence in Senate amendments pending. |
Latest bill textChaptered version, September 27, 2026 · 958 words
Assembly Bill No. 1887
CHAPTER 557
An act to add Section 1342.76 to the Health and Safety Code, and to add Section 10123.1936 to the Insurance Code, relating to health care coverage.
[ Approved by Governor September 27, 2026. Filed with Secretary of State September 27, 2026. ]
LEGISLATIVE COUNSEL'S DIGEST
AB 1887, Zbur. Prescription drug coverage for rare diseases.
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 sets forth specified prior authorization and step therapy limitations for health care service plans and health insurers.
This bill would require a health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2027, to require a health care service plan or health insurer to complete prior authorization within 30 days upon initial request, as specified, for a drug approved by the United States Food and Drug Administration (FDA) for the treatment of a rare disease if the drug is prescribed by a specialist with expertise in the condition or disease being treated, the specialist has determined the drug is medically necessary, and the drug is the only FDA-approved treatment for the rare disease. 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.
The people of the State of California do enact as follows:
SECTION 1.
Section 1342.76 is added to the Health and Safety Code, to read:1342.76.
(a) (1) A health care service plan contract issued, amended, or renewed on or after January 1, 2027, shall require a health care service plan to complete prior authorization within 30 days upon initial request for a prescription drug approved by the United States Food and Drug Administration (FDA) that is approved for the treatment of a rare disease if the drug is prescribed by a specialist with expertise in the condition or disease being treated, the specialist has determined the drug is medically necessary, and the drug is the only FDA-approved treatment for the rare disease.(2) For purposes of paragraph (1), an initial request occurs when a health care provider or the health care provider’s staff sends a prior authorization request to the health care service plan or health care service plan’s delegate.
(3) Prior authorization for a drug prescribed pursuant to paragraph (1) shall be immediately approved under either of the following conditions:
(A) A decision approving or denying prior authorization has not been made by the end of the 30-day period.
(B) A dispute between the plan and provider or enrollee regarding the prior authorization is ongoing at the end of the 30-day period.
(b) For purposes of this section, “rare disease” means a disease that affects fewer than 200,000 people in the United States.
(c) This section does not affect the timelines described in subdivision (h) of Section 1367.01 or in Section 1367.241.
(d) This section does not apply to Medi-Cal managed care contracts with the State Department of Health Care Services entered into pursuant to Chapter 7 (commencing with Section 14000) of, or Chapter 8 (commencing with Section 14200) of, Part 3 of Division 9 of the Welfare and Institutions Code.
SEC. 2.
Section 10123.1936 is added to the Insurance Code, to read:10123.1936.
(a) (1) A health insurance policy issued, amended, or renewed on or after January 1, 2027, shall require a health insurer to complete prior authorization within 30 days upon initial request for a prescription drug approved by the United States Food and Drug Administration (FDA) that is approved for the treatment of a rare disease if the drug is prescribed by a specialist with expertise in the condition or disease being treated, the specialist has determined the drug is medically necessary, and the drug is the only FDA-approved treatment for the rare disease.(2) For purposes of paragraph (1), an initial request occurs when a health care provider or the health care provider’s staff sends a prior authorization request to the health insurer or health insurer’s delegate.
(3) Prior authorization for a drug prescribed pursuant to paragraph (1) shall be immediately approved under either of the following conditions:
(A) A decision approving or denying prior authorization has not been made by the end of the 30-day period.
(B) A dispute between the insurer and provider or insured regarding the prior authorization is ongoing at the end of the 30-day period.
(b) For purposes of this section, “rare disease” means a disease that affects fewer than 200,000 people in the United States.
(c) This section does not affect the timelines described in subdivision (h) of Section 10123.135 or in Section 10123.191.
SEC. 3.
No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.Text of AB 1887 as chaptered, from the official record. Connect Plus keeps every version and highlights what changed.Compare versions