Assembly Health Committee advances broad package to curb prior authorization delays, expand street medicine and tighten medical-data rules; moves kratom, ambuln

The Assembly Health Committee on April 22 moved a package of measures aimed at reducing delays from health-plan utilization management, expanding access to street-based medical care for people experiencing homelessness, and tightening rules around medical-data use. The committee voted to send multiple bills to the Appropriations Committee or next committees after debate and testimony from clinicians, patient advocates, insurers and provider associations.

Why it matters: Lawmakers said the bills respond to widespread complaints from physicians and patients that prior authorizations and other utilization‑management practices are causing harmful delays in care. Members also advanced measures to improve access for unhoused Medi‑Cal members, raise nonemergency ambulance reimbursement rates, and set new guardrails on use of clinical encounters for artificial‑intelligence training and translation tools.

Most significant actions - AB 384 (Connolly): Prohibits prior authorization when a patient is admitted to an inpatient facility for a mental‑health or substance‑use emergency and for medical care provided while the patient is enrolled in that inpatient facility. Assemblymember Damon Connolly, the bill’s author, told the committee “AB 384...would prohibit the use of prior authorizations for patients when they're admitted to an inpatient facility for a mental health or substance use emergency.” The bill was moved out of committee.

- AB 510 (Addis): Requires that when a treating provider appeals a prior‑authorization denial, the insurer must provide a peer reviewer of the same or similar specialty on request. Assemblymember Buffy Wicks Addis said the measure “requires that when a treating provider appeals a prior authorization decision, that the plan must provide a peer of the same or similar specialty upon request of the treating provider.” Supporters argued specialty matching reduces needless delays; insurers warned of workforce and timing challenges.

- AB 539 (Schiavo): Extends the duration of an approved prior authorization to either one year or the duration of the treating physician's prescribed treatment, to reduce repeated renewals for chronic care. Assemblymember Schiavo said, “No one battling a chronic illness should have to fight their insurance company just to keep getting the treatment that's already been prescribed and approved.”

- AB 669 (Haney): Limits insurer-appointed corporate review panels from prematurely cutting off addiction treatment and guarantees up to 28 days of uninterrupted in‑network addiction treatment in certain cases. During testimony Christine Matlock described the stakes: “He was approved for 7 days of detox, and yet after 3 days, the insurance company...denied the care he needed. Just 48 hours later, he overdosed and died.” The committee moved the bill forward.

- AB 543 (Mark Gonzalez): Allows licensed street‑medicine providers to order medically necessary services for Medi‑Cal members experiencing homelessness even if the patient is not formally assigned to that clinic’s primary‑care provider. Brett Feldman of USC Street Medicine said the change addresses situations in which “I cannot order a back x‑ray for a gentleman who needs it to return to work as an electrician and resolve his own homelessness.” The bill advanced out of committee.

- AB 1328 (Michelle Rodriguez): Raises Medi‑Cal fee‑for‑service reimbursements for nonemergency and interfacility ambulance transports to 100% of the applicable Medicare ambulance fee schedule. Sean Sullivan, an EMT and ambulance operator, told the committee private ambulance reimbursement “has not been addressed in a long time.” The committee moved the measure.

- AB 302 (author: bill referred in hearing): Would strengthen patient protections when clinical encounters or recordings are provided to third‑party AI vendors and clarify consent practices under California’s Confidentiality of Medical Information Act. Advocacy groups urged clearer limits on marketing uses and stronger patient notice. Supporters called for explicit prohibitions on sharing patient encounters for nonhealthcare uses; some hospital and provider representatives said they were working with the author on conforming language.

- AB 1242 (Calderon): Establishes a language‑access director inside CalHHS, requires human review where machine/AI translation is used, and updates how limited‑English languages are designated for agency services. Julia Liao of Asian Health Services urged passage to reduce disparities, noting many limited‑English patients are unaware of interpreter rights.

- AB 1088 (Banes): Would restrict kratom products by: (1) prohibiting sale to persons under 21, (2) requiring child‑resistant packaging, (3) banning marketing that appeals to children, and (4) capping concentration of the semi‑synthetic alkaloid (7‑OH) at 2%. The measure drew sharply divided testimony: the author argued concentrated 7‑OH poses new risks; several advocates and industry representatives urged caution and urged science‑based regulation rather than a de facto ban.

Other actions and themes - Providers and physician groups repeatedly cited surveys and studies — including American Medical Association and CHBRP findings referenced in testimony — documenting that prior authorization delays increase administrative burdens and can worsen patient outcomes. Emergency physicians and specialists emphasized acute examples where treatment windows are narrow.

- Payors and plan representatives consistently urged amendments to narrow timelines, require electronic submission of authorizations, and limit specialty‑matching requirements to complex cases; they warned of workforce constraints and potential unintended consequences if timelines are shortened without implementation support.

- Multiple bills included committee amendments accepted on the floor; committee chairs and authors said they will continue negotiations with stakeholders as the measures proceed.

Votes at a glance (committee action) - AB 384 (Connolly): Moved out of committee (due pass to appropriations / committee action recorded). (Proponent testimony: physicians, psychiatric organizations; opposition: some insurers.) - AB 510 (Addis): Motioned due pass as amended to appropriations; advanced. - AB 539 (Schiavo): Motioned due pass as amended to appropriations; advanced. - AB 669 (Haney): Motioned due pass as amended to appropriations; advanced. - AB 512 (Herabidian): Timelines for urgent/standard prior‑authorization determinations (24/48 hours); moved as amended. - AB 574 (Mark Gonzales): Permits up to 12 physical‑therapy visits without prior authorization for a new episode of care; moved as amended. - AB 543 (Mark Gonzales): Street medicine access for Medi‑Cal members experiencing homelessness; moved as amended. - AB 302 (author): Medical‑data protections for AI; moved to Judiciary with amendments. - AB 220 (Jackson): Subacute pediatric admission criteria and standardized documentation; moved as amended. - AB 425 (Davies): Requires ASAM criteria alignment for certified outpatient alcohol and other drug programs; moved as amended. - AB 1328 (Michelle Rodriguez): Increase nonemergency ambulance Medi‑Cal rates to Medicare schedule; forward to appropriations. - AB 1356 (Dixon): Requires follow‑up reporting by drug‑treatment facilities after resident deaths; moved as amended. - AB 1088 (Banes): Kratom controls; moved to Environmental Safety & Toxic Materials committee for further review. - AB 1242 (Calderon): Language‑access director, human review for machine translations; moved (motion recorded).

What to watch next: Authors and advocates said they will continue to negotiate language on specific timelines, the scope of specialty matching for peer reviews, and technical fixes (electronic submissions, exclusions for pharmacy products, and definitions of inpatient/residential settings). Several bills will next go to Appropriations or other policy committees where fiscal and implementation issues will be explored.

Sources and attribution: Reporting here is drawn from live testimony recorded at the Assembly Health Committee hearing on April 22, 2025. Direct quotes in this article come from committee testimony by Assemblymember Damon Connolly (author, AB 384), Assemblymember Addis (author, AB 510), Assemblymember Schiavo (author, AB 539), Christine Matlock (family member, AB 669 testimony), Brett Feldman (USC Street Medicine, AB 543 testimony), Sean Sullivan (ambulance operator, AB 1328 testimony), Julia Liao (Asian Health Services, AB 1242 testimony) and others who testified on the record. The committee roll calls and motions were taken during the hearing and recorded in the transcript.