AB 539 Health care coverage: prior authorizations

What happened

The August 30 enrolled AB 539 would generally keep an approved prior authorization for an in-network provider’s service valid for one year from approval, unless the treating provider requested a shorter period. Plans and insurers could authorize longer periods. The proposal amends both regulated-plan and insurer provisions while retaining existing protections for authorized services already rendered in good faith. At the September 5 cutoff, the proposed one-year duration is not an operative new obligation.

A prescription-drug authorization could not exceed a validity period established by state or federal law or regulation. The one-year period also would end with a lawful termination of coverage under the issuing plan or insurer, except where the identified continuity provision or other applicable law required otherwise. Those conditions separate the duration of an approval from continuing coverage, expanded benefits or a general payment guarantee. Implementers would need to identify the actual product, service and coverage circumstances if a final law were adopted.

Why it matters

Utilization-management configuration could change if enacted, but applying one duration without the drug and coverage limits would overstate the proposal.

Sources

• AB 539 Health care coverage: prior authorizations, bill historyOfficial · California Legislature · 2026-09-03 · Source review 2026-09-10
• AB 539 Health care coverage: prior authorizations, current bill text (08/30/26 - Enrolled)Official · California Legislature · 2026-08-30 · Source review 2026-09-10