Assembly BillVetoedHealth and Safety
AB 539: Health care coverage: prior authorizations.
What AB 539 does, verified September 21, 2026
This bill aims to amend existing health care coverage laws in California. It requires a prior authorization for a health care service to remain valid for at least one year from the date of approval, or throughout the course of prescribed treatment if less than one year. This provision aims to prevent health care service plans from rescinding or modifying prior authorizations after a health care provider has rendered the service in good faith. The bill also states that any violation of this provision would be a crime, requiring a state-mandated local program. Additionally, the bill provides that reimbursement is not required for certain costs associated with implementing this new law.
Bill journey
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Last action: Vetoed by Governor. (2026-09-20)Alert me
Author and sponsors
Full contact details, staff, and committees with Connect, $16/moUnlockRecent actions26 total · showing 5
| Sep. 20, 2026 | Vetoed by Governor. |
| Sep. 03, 2026 | Enrolled and presented to the Governor at 4 p.m. |
| Aug. 26, 2026 | Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 64. Noes 4. Page 6560.). |
| Aug. 25, 2026 | In Assembly. Concurrence in Senate amendments pending. |
| Aug. 25, 2026 | Read third time. Passed. Ordered to the Assembly. (Ayes 31. Noes 0.). |
Latest bill textEnrolled version, August 30, 2026 · 1,086 words
| Enrolled August 30, 2026 |
| Passed IN Senate August 25, 2026 |
| Passed IN Assembly August 26, 2026 |
| Amended IN Senate August 21, 2026 |
| Amended IN Senate July 02, 2026 |
| Amended IN Assembly April 28, 2025 |
CALIFORNIA LEGISLATURE— 2025–2026 REGULAR SESSION
Assembly Bill
No. 539
| Introduced by Assembly Member Schiavo |
February 11, 2025 |
An act to amend Section 1371.8 of the Health and Safety Code, and to amend Section 796.04 of the Insurance Code, relating to health care coverage.
LEGISLATIVE COUNSEL'S DIGEST
AB 539, Schiavo. Health care coverage: prior authorizations.
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 provides that a health care service plan or a health insurer that authorizes a specific type of treatment by a health care provider shall not rescind or modify this authorization after the provider renders the health care service in good faith and pursuant to the authorization.
This bill would require an approved prior authorization for a health care service requested by an in-network provider to remain valid for at least one year from the date of approval, or the period requested by the treating provider if less than one year. Because a violation of the bill 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 1371.8 of the Health and Safety Code is amended to read:1371.8.
(a) A health care service plan that authorizes a specific type of treatment by a provider shall not rescind or modify this authorization after the provider renders the health care service in good faith and pursuant to the authorization for any reason, including, but not limited to, the plan’s subsequent rescission, cancellation, or modification of the enrollee’s or subscriber’s contract or the plan’s subsequent determination that it did not make an accurate determination of the enrollee’s or subscriber’s eligibility. This section shall not be construed to expand or alter the benefits available to the enrollee or subscriber under a plan. The Legislature finds and declares that by adopting the amendments made to this section by Assembly Bill 1324 of the 2007–08 Regular Session it does not intend to instruct a court as to whether or not the amendments are existing law.(b) An approved prior authorization for a health care service requested by an in-network provider shall remain valid for at least one year from the date of approval, or the period requested by the treating provider if less than one year. This does not prohibit a plan from authorizing a prior authorization period greater than one year.
(c) This section shall not be interpreted to permit a period of validity for an approved prior authorization request for a prescription drug that is longer than a validity period for that prescription drug established pursuant to state or federal law or regulation.
(d) The one-year validity period established in subdivision (b) does not apply if the enrollee’s coverage under the plan that issued the approval is terminated for any reason consistent with state or federal law. In these cases, the approval duration shall expire on the date of termination of the enrollee’s coverage under the plan that issued the approval, unless otherwise required by Section 1373.96 or any other applicable law.
SEC. 2.
Section 796.04 of the Insurance Code is amended to read:796.04.
(a) A health insurer that provides coverage for hospital, medical, or surgical expenses that authorizes a specific type of treatment for services covered under a policyholder’s contract or plan by a provider shall not rescind or modify this authorization after the provider renders the health care service in good faith and pursuant to the authorization for any reason, including, but not limited to, the insurer’s subsequent rescission, cancellation, or modification of the insured’s or policyholder’s contract or the insurer’s subsequent determination that it did not make an accurate determination of the insured’s eligibility. This section shall not be construed to expand or alter the benefits available or the terms and conditions of the contract as may be agreed upon between a policyholder, certificate holder, or trust, and the insurer. The Legislature finds and declares that by adopting the amendments made to this section by Assembly Bill 1324 of the 2007–08 Regular Session it does not intend to instruct a court as to whether or not the amendments are existing law.(b) An approved prior authorization for a health care service requested by an in-network provider shall remain valid for at least one year from the date of approval, or the period requested by the treating provider if less than one year. This does not prohibit an insurer from authorizing a prior authorization period greater than one year.
(c) This section shall not be interpreted to permit a period of validity for an approved prior authorization request for a prescription drug that is longer than a validity period for that prescription drug established pursuant to state or federal law or regulation.
(d) The one-year validity period established in subdivision (b) does not apply if the insured’s coverage under the insurer that issued the approval is terminated for any reason consistent with state or federal law. In these cases, the approval duration shall expire on the date of termination of the insured’s coverage under the insurer that issued the approval, unless otherwise required by Section 10133.56 or any other applicable law.
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 539 as enrolled, from the official record. Connect Plus keeps every version and highlights what changed.Compare versions