AB-2499 Health care coverage: claims payments

What happened

AB 2499 would require plans and insurers, from May 26, 2028, to accept electronic medical records and supporting documentation needed to process claims through a standard electronic submission method. They would need file-size capacity sufficient for typical claims documentation and electronic receipt confirmation, and could not deny, pend or delay a claim solely because their systems cannot accept material that otherwise meets stated requirements. The pending proposal addresses document intake; it does not by itself make every submitted claim complete, covered or payable.

Other lawful denial, pend and delay grounds remain available. The proposed requirement would not apply while acceptance is impaired by circumstances outside reasonable control, including power outages, natural disasters and cybersecurity incidents. A specific state or federal file-size, count or capacity standard would control if adopted. The text defines electronic submission to include a designated portal or submission under the relevant interoperability rules. Providers and payers can assess attachment capacity, receipt evidence and outage handling without treating the proposed 2028 start as an existing deadline.

Why it matters

Claims operations depend on proof that the right supporting records were received. Intake capacity and outage controls are distinct from substantive coverage and payment decisions.

Sources

• AB2499 proposed bill text, historical selected versionOfficial · California Legislature · 2026-09-01 · Source review 2026-10-15
• AB2499 official bill historyOfficial · California Legislature · Source review 2026-10-15