AB 539 Health care coverage: prior authorizations

What happened

AB 539’s enrolled proposal 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 approval, or for a shorter period requested by the treating provider. A plan or insurer could authorize a longer period. The proposed changes address both the Health and Safety Code and Insurance Code, alongside existing protections against rescinding an authorization after good-faith services have been rendered. The one-year rule was not an enacted requirement during this edition’s coverage.

The proposed minimum would not permit a prescription-drug authorization period longer than a period established by state or federal law or regulation. It also would not continue after the member’s coverage with the issuing plan or insurer ended consistently with law, except as otherwise required by specified continuity-of-care provisions or other applicable law. Those boundaries distinguish authorization duration from benefit expansion, uninterrupted coverage or a guarantee of payment in every circumstance. Utilization-management planning therefore needs the final disposition and precise product and treatment scope.

Why it matters

Authorization-renewal logic and provider communications could change if the proposal became law, with important limits for drugs and coverage termination.

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