Assembly Health Committee advances package to speed prior authorization, bar insurer interference in crisis behavioral health care

The California State Assembly Health Committee advanced a set of bills on April 22 intended to reduce administrative delays tied to prior authorization and to protect timely access to behavioral‑health and other medically necessary care.

The special order of business convened to consider bills that proponents said will reduce delays that can harm patients, from cancer and chronic‑disease care to psychiatric and substance‑use emergencies. Committee Chair Assemblymember Rob Bonta and multiple authors framed the package as efforts to center patient care and require that utilization reviews be timely and conducted by clinicians with matching expertise.

Committee context: the package included measures to prohibit prior authorization for inpatient mental‑health or substance‑use emergency admissions (AB 384, Connolly); require same‑specialty peer‑to‑peer reviewers in appeals (AB 510, Addis); extend approved prior‑authorization durations to a year or the physician’s prescribed duration for continuing treatment (AB 539, Schiavo); bar insurers from relying on their own reviewer panels to prematurely cut addiction treatment (AB 669, Haney); shorten turnaround times for urgent and non‑urgent authorizations (AB 512, Herabedian); provide up to 12 initial physical‑therapy visits without prior authorization (AB 574, Gonzales); remove network barriers so street‑medicine teams can directly order medically necessary services for people experiencing homelessness (AB 543, Gonzales); and other related measures on data and standards.

Why it matters: witnesses and authors described repeated examples where prior authorizations delayed care, diverted clinician time into paperwork and appeals, and produced avoidable clinical deterioration. Assemblymember Damon Connolly told the committee AB 384 “would prohibit the use of prior authorizations for patients when they are admitted to an inpatient facility for a mental‑health or substance‑use emergency.” Supporters said such limits are narrowly targeted to emergency inpatient admissions where even short delays can be harmful.

Evidence and claims offered to the committee included surveys and state analyses. Witnesses cited American Medical Association surveys reporting that a large majority of physicians said prior authorization delays harmed patient care; the California Hospital Association was cited for an estimate of billions in avoidable costs tied to delayed or denied care; and several clinical societies testified that longer inpatient stays and prompt initiation of addiction medication improve outcomes.

Supporters and opponents: hospital groups, mental‑health and addiction‑treatment associations, and many physicians and nurses testified in support. Primary opposition came from trade groups representing health plans and insurers, and from some organized physician groups and delegated medical groups that manage prior authorization work under contract. Opponents warned that removing utilization management safeguards broadly could increase costs, expose patients to low‑quality or non‑evidence‑based care, and risk fraud and abuse absent clearer guardrails. They repeatedly urged electronic submissions, clinically complete requests, narrower scopes for some reforms, and phased implementation.

Select quotes from the hearing: "In these emergencies, the consequences of even the slightest delay in treatment can be severe," Assemblymember Damon Connolly said introducing AB 384. "If a doctor has to justify to an insurance provider why their decision for a patient's care is, ‘medically necessary,’ they are diverting attention away from that very patient."

Christine Matlock, who testified on AB 669 and identified herself as the mother of a young man who died after discharge from addiction treatment, said: "Ryan asked for help. He deserved help, but was denied based on a generic chart. I will continue to fight for bills like AB 669 so no other family has to face the tragedy that we live with every day."

Committee action and next steps: The committee voted to advance the package bills (most as "due pass to appropriations" or "due pass as amended to appropriations") so they can be considered by the appropriations committee and return later for further floor action. Several bills carried committee amendments and authors said they would continue to negotiate with stakeholders about details such as definitions of inpatient settings, how concurrent and retrospective reviews could still occur, electronic‑submission timelines, and limited exemptions for certain services.

Votes at a glance (committee action) - AB 384 (Connolly), mental‑health/substance‑use inpatient emergency prior‑authorization prohibition — Moved and carried; recorded as due pass to appropriations by roll call. - AB 510 (Addis), peer‑to‑peer specialty matching on appeals — Motion due pass as amended to appropriations; approved by committee. - AB 539 (Schiavo), Timely Care Act extending prior‑auth approvals (one year or duration prescribed) — Motion due pass as amended to appropriations; approved by committee (on call). - AB 669 (Haney), protections to prevent early insurer cut‑offs for addiction treatment and ensure up to 28 days of uninterrupted treatment — Motion due pass as amended to appropriations; approved by committee (on call). - AB 512 (Herabedian), shorten prior‑authorization turnaround to 24 hours for urgent and 48 for routine — Motion due pass as amended to appropriations; approved by committee. - AB 574 (Gonzales), initial 12 physical‑therapy visits without prior authorization — Motion due pass to appropriations; approved by committee (on call). - AB 543 (Gonzales), allow street‑medicine providers to order medically necessary services for Medi‑Cal enrollees experiencing homelessness — Motion due pass to appropriations; approved by committee. - AB 302 (Barbocan/author), medical‑data protections and consent for AI/third‑party use — Motion due pass to judiciary (committee accepted amendments); approved to move forward.

What authors and staff said about next steps: authors repeatedly said they would continue working with health plans, hospitals, provider groups and consumer advocates to refine definitions, timelines, and implementation details, and noted federal interoperability and electronic prior‑authorization rules that may inform state policy. Several bill authors accepted committee amendments in committee and asked for ‘aye’ votes to advance their measures to appropriations or the next committee.

Ending note: Committee members across the aisle expressed interest in preserving patient access while guarding against fraud, waste and unnecessary cost. Many said they expected continued negotiations about targeted exemptions, electronic submission timelines, specialty matching language and safeguards to prevent misuse of the reforms. The package represents a significant push by the Assembly to curtail administrative friction in care delivery and to prioritize clinician judgment for urgent behavioral‑health and other medical needs.