The California 2021-2022 legislative session ended on August 31, at midnight. After both houses approve a bill, it goes to the Governor and the Governor has three choices - sign the bill into law, allow it to become law without their signature, or veto it. The Governor had until midnight, September 30, to determine the fate of hundreds of bills. Most bills go into effect on the first day of January of the next year. Urgent measures take effect immediately after they are signed or allowed to become law without signature.
CAFP advocated for numerous bills that aligned with our strategic goals to – advance payment reform and system transformation, raise the profile of family medicine, prioritize justice through diversity, equity, and inclusion, and alleviate burnout and support member wellness and joy in medicine. CAFP supported 54 bills and 31 passed the Legislature. Below is a summary along with the status of CAFP-supported bills that passed the Legislature and were either signed into law or vetoed by the Governor.
Status: Signed into Law.
This measure would designate the week of March 13, 2022, to March 19, 2022, inclusive, as Family Physician Week.
Status: Signed into Law.
This bill permits a health care provider, a federally qualified health center (FQHC) or a rural health clinic (RHC) to establish a new patient relationship using an audio-only synchronous interaction (for example, a telephone call) when the visit is related to sensitive services (defined by reference to include health care services related to mental or behavioral health, sexual and reproductive health, sexually transmitted infections, substance use disorder, gender affirming care, and intimate partner violence), and when established in accordance with Department of Health Care Services (DHCS)-specific requirements and consistent with federal state law, regulations and guidance. Permits a health care provider, an FQHC or RHC to also establish a new patient relationship using an audio-only synchronous interaction when the patient requests an audio-only modality or attests they do not have access to video, and when established in accordance with DHCS specific requirements and consistent with federal and state laws, regulations and guidance. Implements these changes only to the extent that any necessary federal approvals are obtained, federal financial participation is available and not otherwise jeopardized. Authorizes DHCS, in making exceptions to the requirement that health care providers offer both audio and video, to take into consideration the availability of broadband access based on speed standards set by the Federal Communications Commission (FCC), pursuant to a specified provision of the federal Telecommunications Act of 1996 or other applicable federal law or regulation.
Status: Signed into Law.
This makes two significant changes to the Medical Injury Compensation Reform Act (MICRA) by 1) restructuring MICRA's limit on attorney fees; and 2) raising MICRA's cap on noneconomic damages. This bill restructures the metrics and instead ties the tiered fee limits to the stage of the representation at which the amount is recovered. An attorney can collect a fee of 25% for an amount recovered pursuant to a settlement agreement and release of claims executed by the parties prior to a civil complaint or demand for arbitration being filed. If it is recovered pursuant to a settlement, arbitration, or judgment after a complaint or demand for arbitration is filed, then the fee can be 33% of the dollar amount recovered. Where the action is actually tried in a civil court or arbitrated, an attorney can petition the court for a fee in excess of these limits and the court must decide whether good cause has been established for approving a higher contingency fee. These changes simplify the structure of the statute and make the ultimate fee award more logically tied to the stage of representation the amount was recovered in, loosely approximating the amount of work that it takes to secure the judgment or settlement, rather than basing it solely on the amount recovered. The bill establishes two separate caps, depending on whether a wrongful death claim is involved. In a wrongful death case against a health care provider or health care institution based on professional negligence, the cap increases to $500,000. Each January 1st thereafter, this cap increases by $50,000 until it reaches $1million. If the medical malpractice case does not involve wrongful death, the cap starts at $350,000, and increases each year by $40,000 until it reaches $750,000. While existing law applies the cap regardless of the number and type of defendants, this bill creates three separate categories for which a plaintiff is able to seek the limit. In the respective cases, a plaintiff can seek the cap against one or more health care providers, collectively; against one or more health care institutions, collectively; and against one or more health care providers or institutions that are "unaffiliated" with the other defendants based on professional acts of negligence that are separate and independent from the other acts and that occurred at, or in relation to medical transport to, a health care institution unaffiliated with the other institutions. The bill also raises the ceiling for when a court must, at the request of either party, enter a judgment ordering that an award for future damages be paid in whole or in part by periodic payments rather than by a lump-sum payment. Currently the award must equal or exceed $50,000. This bill moves this threshold to $250,000. Finally, the bill also adds a new section to the law regarding certain relevant evidence. It makes specified expressions of sympathy, benevolence, or fault in the provision of health care confidential. The covered expressions include statements regarding sympathy or even fault relating to the pain, suffering, or even death of a person, as well as an "adverse patient safety event or unexpected health outcome."
Status: Signed into Law.
This bill makes permanent by repealing the January 1, 2023, sunset date of existing law requirements for the CalOptima governing body (CalOptima is the county organized health system plan serving Medi-Cal beneficiaries in Orange County), including the requirement for nine voting members and one nonvoting member, the membership categories of the CalOptima governing board, the duties of board members, and their terms. Imposes additional requirements on the Orange County Board of Supervisors related to stakeholder consultation and a one year "cooling off" period for subsequent service as a non-board of supervisor member of the CalOptima governing board, and for specified governing board members conduct after the end of their CalOptima governing board service. Imposes additional requirements for CalOptima governing board members generally, including provisions related to the duties of board members and conflict of interest provisions.
Status: Vetoed by the Governor. See the Governor’s Veto Message here.
This bill requires the Department of Health Care Services (DHCS) to cover additional comprehensive perinatal assessments and individualized care plans and provide additional visits and units of services during the one-year post-pregnancy eligibility period in proportion to those available during pregnancy and the initial 60-day post-pregnancy period as part of services under the Comprehensive Perinatal Services Program (CPSP) under Medi-Cal. Requires DHCS, as part of CPSP, to seek federal approvals to cover preventive services that are recommended by a physician or other licensed practitioner and that are rendered by a non-licensed perinatal health worker in a beneficiary's home or other community setting away from a medical site. Requires DHCS, as part of CPSP, to seek any necessary federal approvals to allow a non-licensed perinatal health worker rendering preventive services to be supervised by either an enrolled Medi-Cal provider that is a clinic, a hospital, a community-based organization (CBO), or a licensed practitioner or a CBO that is not an enrolled Medi-Cal provider, so long as an enrolled Medi-Cal provider is available for Medi-Cal billing purposes.
Status: Signed into Law.
This bill makes various legislative findings and declarations, including: 1) Specifies that nonpharmacological therapies for pain management have been proven effective for treatment of chronic pain and their use should be promoted just as are pharmacological analgesic therapies; 2) Provides that the United States Department of Health and Human Services' Pain Management Best Practices Inter-Agency Task Force identified barriers to accessing nonpharmacological therapies for pain management related to health care providers that include underestimation of patients' reported level of pain, including unconscious biases, workforce shortages, especially among behavioral and pain management specialists, lack of research on or lack of awareness of novel and effective approaches to pain care, and cost and reimbursement issues specific to the health care system. Specifies that for patients, cost, time, and transportation barriers, as well as lack of coverage or lack of knowledge and awareness of nonpharmacological options have been identified; and, 3) Encourages the health care system, including health care providers, health care service plans, and health insurers, to the use of evidence-based nonpharmacological therapies for pain management.
Status: Signed into Law.
This bill would require CHHSA to establish metrics to measure progress and efficiency, and remedies in the case those metrics are not met, and include those metrics and remedies in any contract entered into pursuant to these provisions. The bill would eliminate the viability requirement for the manufacturing of insulin pursuant to these provisions and would require any partnership, among other things, to consider guaranteeing priority access to insulin supply for the state.
This bill would require, upon appropriation by the Legislature, the development of a California-based manufacturing facility for insulin with the intent of creating high-skill, high-paying jobs within the state.
Status: Signed into Law.
This bill authorizes a county or a city and county to operate a licensed mobile unit to provide prescription medication within its jurisdiction to specified individuals, including those individuals without fixed addresses, as well as others. This bill provides criteria for dispensation, specifically: 1) a Board-licensed mobile unit; 2) the mobile unit is staffed by a pharmacist in charge and a pharmacy technician; 3) a licensed pharmacist is on the premises and the mobile unit is under the control and management of a pharmacist while prescription medications are being dispensed; 4) all activities of the pharmacist, including the furnishing of medication by the pharmacist, are consistent with a pharmacist’s scope of practice; 5) any physician practicing in the mobile unit who might be prescribing medication must meet the requirements of the Medical Practice Act; 6) the mobile unit does not carry or dispense controlled substances. This bill authorizes the Board to license a mobile unit that meets these requirements.
Status: Vetoed by the Governor. See the Governor’s Veto Message here.
This bill: 1) Requires Covered California affordability assistance to reduce cost-sharing, including copays, coinsurance, and maximum out-of-pocket costs, and eliminate deductibles for all benefits to the extent feasible if enhanced federal premium subsidies consistent with the federal American Rescue Plan Act of 2021 (ARP) are made available for the 2023 and 2024 calendar years. 2) Requires Covered California to adopt standard benefit designs consistent with this bill. 3) Requires Covered California to provide financial assistance to California residents with household income at or below 600% of the federal poverty level if funded through an appropriation in the annual Budget Act or an amount otherwise appropriated by the Legislature.
Status: Vetoed by the Governor. See the Governor’s Veto Message here.
This bill requires coverage without cost-sharing for screening mammography, medically necessary diagnostic or supplemental breast examinations, diagnostic mammography, test for screening purposes and medically necessary diagnostic breast imaging, including diagnostic breast imaging following an abnormal mammography result and for a patient indicated to have a risk factor associated with breast cancer, including family history or known genetic mutation. Includes breast magnetic resonance imaging, breast ultrasound, and other clinically indicated diagnostic testing.
Status: Vetoed by the Governor. See the Governor’s Veto Message here.
This bill requires reimbursement for services related to the prevention and treatment of sexually transmitted diseases to uninsured, income-eligible patients or patients with health care coverage who are income-eligible and have confidentiality concerns, including, but not limited to, lesbian, gay, bisexual, transgender patients, and other individuals who are not at risk for experiencing or causing an unintended pregnancy, and who are not in need of contraceptive services.
Status: Enrolled and filed with the Secretary of State.
Enacts a constitutional amendment, expressly providing that the state shall not deny or interfere with an individual's reproductive freedom in their most intimate decisions, which includes their fundamental right to choose to have an abortion and their fundamental right to choose or refuse contraceptives.
Status: Signed into Law.
Many Native tribes hold a sacred ceremony to name a child on the tenth day of life, and some Rancherias and tribes hold the naming ceremony later than that, but current law requires a hospital to submit a baby’s birth certificate to the local registrar/health department within ten days, which places undue pressure on Native families to provide information to the hospital on the very day they are holding a naming ceremony for their new child. This bill addresses this issue by extending the time, from ten days to 21 days, by which live births are required to be registered with the local registrar.
Status: Signed into Law.
This bill requires a state or local correctional facility to post specified information on its website within 10 days after the death of a person who died while in custody, and to update that information within 30 days of any change.
Status: Signed into Law.
This bill would establish safeguards to ensure that information in California is not used as evidence in an out-of-state case related to an anti-abortion statute or a foreign penal civil action. First, this bill would prohibit compelling an individual to provide information that would identify or that is related to an individual who has sought or obtained an abortion if that information is being sought for an anti-abortion case in another state or a foreign penal civil action. Second, this bill fortifies privacy protections for medical information. This bill prohibits the release of medical information in response to a subpoena or request based on an out-of-state anti-abortion or foreign penal civil action case. It also prohibits the release of medical information to law enforcement for the purposes of an enforcing an out-of-state anti-abortion statute or a foreign penal civil action. It allows the Insurance Commissioner to issue civil penalties against health insurers who violate the confidentiality of an insured's medical information. Finally, it amends the Penal Code to prohibit prison staff from disclosing identifying abortion-related medical information if that information is being requested for an anti-abortion case in another state or a foreign penal civil action. This bill proposes to limit the ability for California courts to enforce subpoenas issued by out-of- state courts.
Status: Signed into Law.
Establishes the California Abortion and Reproductive Equity (CARE Act), and the California Reproductive Health Equity Program (Program) within the Department of Health Care Access and Information (HCAI), to ensure abortion and contraception services are affordable for and accessible to all patients and to provide financial support for safety net providers of these services. Authorizes a Medi-Cal enrolled provider to apply for a grant, and a continuation award after the initial grant, to provide abortion and contraception at no cost or reduced cost to an individual with a household income at or below 400% of the federal poverty level who is uninsured or has health care coverage that does not include both abortion and contraception, and who is not eligible to receive both abortion and contraception at no cost through the Medi-Cal and Family Planning, Access, Care and Treatment programs. Requires a health care service plan (health plan) or health insurer that provides health coverage to employees of a religious employer that does not include coverage and benefits for both abortion and contraception to provide an enrollee or insured with written information that abortion and contraception benefits and services may be available at no cost through the Program. Requires the Department of Industrial Relations (DIR) to post information regarding benefits that may be available at no cost through the Program on its website. Adds a severability clause.
Status: Vetoed by the Governor. See the Governor’s Veto Message here.
Requires, until January 1, 2028, and subject to an appropriation by the Legislature, the California Health and Human Services Agency (CHHSA) or an entity designated by CHHSA, to establish and administer a pilot program to direct funds to licensed primary care clinics that provide reproductive health care services in five counties that agree to participate. Requires CHHSA to select one county each to represent the rural north, urban north, central, rural south, and urban south regions of the state; and to report to the Legislature, on or before June 1, 2026 on the pilot program. Requires a participating primary care clinic to implement at least one of the following to improve health care delivery for marginalized patients: 1) Implement staff trainings on reproductive justice principles and trauma-informed care, with a focus on serving historically marginalized patients, including people of color, people who are lesbian, gay, bisexual, transgender, or queer, people who have low-English proficiency, and survivors of domestic and sexual violence; 2) Improve spoken language translation services for non-English speakers, as specified; or, 3) Build sustainable partnerships and inservice trainings with local centers, including domestic violence centers and homeless shelters, to strengthen wraparound care.
Status: Signed into Law.
This bill prohibits specified licensing boards from suspending, revoking, or denying a license solely for performing an abortion that is lawful in California in accordance with the licensee’s practice act.
Status: Signed into Law.
This bill would prohibit a health care service plan or an individual or group policy or certificate of health insurance or student blanket disability insurance that is issued, amended, renewed, or delivered on or after January 1, 2023, from imposing a deductible, coinsurance, copayment, or any other cost-sharing requirement on coverage for all abortion and abortion-related services, as specified. The bill would prohibit a health care service plan and an insurer subject to these requirements from imposing utilization management or utilization review on the coverage for outpatient abortion services. The bill would require that for a contract, certificate, or policy that is a high deductible health plan, the cost-sharing prohibition would apply once the enrollee’s or insured’s deductible has been satisfied for the benefit year. The bill would not require an individual or group contract or policy to cover an experimental or investigational treatment. The bill’s requirements would also apply to Medi-Cal managed care plans and their providers, independent practice associations, preferred provider groups, and all delegated entities that provide physician services, utilization management, or utilization review. The bill would require the Department of Managed Health Care and the Department of Insurance to adopt related regulations on or before January 1, 2026.
Status: Signed into Law.
This bill, the Contraceptive Equity Act of 2022, would make various changes to expand coverage of contraceptives by a health care service plan contract or health insurance policy issued, amended, renewed, or delivered on and after January 1, 2024, including requiring a health care service plan or health insurer to provide point-of-sale coverage for over-the-counter FDA-approved contraceptive drugs, devices, and products at in-network pharmacies without cost sharing or medical management restrictions. The bill would require health care service plans and insurance policies offered by public or private institutions of higher learning that directly provide health care services only to its students, faculty, staff, administration, and their respective dependents, issued, amended, renewed, or delivered, on or after January 1, 2024, to comply with these contraceptive coverage requirements. The bill would also require coverage for clinical services related to the provision or use of contraception, as specified. The bill would revise provisions applicable when a covered, therapeutic equivalent of a drug, device, or product is deemed medically inadvisable by deferring to the provider, as specified.
This bill would also prohibit a health care service plan contract or disability insurance policy issued, amended, renewed, or delivered on or after January 1, 2024, with certain exceptions, from imposing a deductible, coinsurance, copayment, or any other cost-sharing requirement on vasectomy services and procedures, as specified, under conditions similar to those applicable to other contraceptive coverage.
This bill would require a health benefit plan or contract with the Board of Public Relations of the Public Employees’ Retirement System to provide coverage for contraceptives and vasectomies consistent with the bill’s requirements, commencing January 1, 2024. The bill would prohibit the California State University and the University of California from approving a health benefit plan that does not comply with the contraceptive coverage requirements of the bill on and after January 1, 2024.
Status: Signed into Law.
This bill would establish, using a $20,000,000 appropriation made in the Budget Act of 2022 for this purpose, the Los Angeles County Abortion Access Safe Haven Pilot Program for the purpose of expanding and improving access to reproductive and sexual health care, including abortion, in the County of Los Angeles. The bill would require any funds allocated for the Los Angeles County Abortion Access Safe Haven Pilot Program to be used by the County of Los Angeles or its program administrator to administer a pilot project to support innovative approaches and patient-centered collaborations to expand and improve access to sexual and reproductive health care and to maintain a financial reporting system. The bill would authorize the funds to be used for implementing recommendations from the County of Los Angeles, including building secure infrastructure, among other things. The bill would require the program administrator to determine a funding framework to prioritize funding for pilot programs and projects and to provide an annual report to the Legislature on the projects and collaborations funded by the program. The bill would exempt specified program information from public disclosure.
Status: Signed into Law.
This bill requires a Medi-Cal managed care plan (MCMCP) to conduct annual outreach and education to its enrollees and primary care physicians regarding the mental health benefits covered by the plan. This bill requires the Department of Health Care Services (DHCS) to assess enrollee experience with mental health benefits covered by MCMCPs, develop survey tools and methodologies relating to the assessment of consumer experience, and publish reports on its website on consumer experience with mental health benefits covered by MCMCPs every three years.
Status: Vetoed by the Governor. See the Governor’s Veto Message here.
This bill requires the Department of Health Care Services (DHCS), beginning January 1, 2024 and at least every five years thereafter, to conduct a review of and prepare a report regarding current and projected behavioral health (BH) care infrastructure and service needs in each region of the state, as specified, including barriers to meeting projected future needs and suggestions to alleviate bottlenecks in the continuum.
Status: Signed into Law.
Requires, instead of permits, a health care provider and specified entities to disclose certain information from a patient's medical record or the client's record, to local health departments (LHDs) operating countywide or regional immunization information and reminder systems and to the Department of Public Health (DPH). Includes a patient's or client's race and ethnicity in the existing list of information that must be disclosed by health care providers and other agencies as specified, from a patient's or client's medical record. Expands the purposes for the use of information collected by and reported to immunization information systems, to include, in the case of school, childcare facilities, family childcare homes and county human services agencies, in the event of a public health emergency, to perform immunization status assessment of pupils, adults, and clients to ensure health and safety. Specifies in the case of schools, this only applies if the school's governing board or body has adopted a policy mandating COVID-19 immunization for school attendance and the school limits the use of the data to verifying immunization status for this purpose. Sunsets these provisions on January 1, 2026. Recasts existing law effective January 1, 2026.
Status: Vetoed by the Governor. See the Governor’s Veto Message here.
Requires a health care service plan (health plan) contract or a disability insurance policy issued, amended, or renewed on or after January 1, 2023, that provides coverage for hospital, medical, or surgical benefits, issued, amended, or renewed on or after January 1, 2023, to provide coverage without cost sharing for the human papillomavirus (HPV) vaccine, as approved by the U.S. Food and Drug Administration (FDA). Expands comprehensive clinical family planning services under the Family Planning, Access, Care, and Treatment (PACT) Program to include the HPV vaccine for persons for whom it is FDA approved.
Status: Vetoed by the Governor. See the Governor’s Veto Message here.
Requires the Department of Public Health (DPH), no later than January 1, 2024, to complete an evaluation of the effectiveness of the state's viral surveillance capacity. Requires DPH, no later than January 1, 2025, to establish the Viral Surveillance Hub (VSH) responsible for timely communication with any laboratory that conducts viral surveillance that identifies a potential novel virus or variant.
Status: Signed into Law.
This bill would require the State Department of Public Health to coordinate specified school district, county office of education, and charter school COVID-19 testing programs that are currently federally funded or organized under the California COVID-19 Testing Task Force, as provided. The bill would authorize the department to provide supportive services, including technical assistance, vendor support, guidance, monitoring, and testing education, related to testing programs for teachers, staff, and pupils to help schools reopen and keep schools operating safely for in-person learning. The bill would also encourage the department to expand its contagious, infectious, or communicable disease testing guidance and other public health mitigation efforts to include prekindergarten and childcare centers, as provided. This bill would require each local educational agency, defined to mean a school district, county office of education, or charter school, after consulting with its local health department, as defined, to create a COVID-19 testing plan, or adopt the State Department of Public Health’s framework, as defined, that is consistent with guidance from the department, as provided. The bill would require each local educational agency to publish the testing plan on its internet website. The bill would authorize each local educational agency to designate one staff member to report information on its COVID-19 testing program to the department, as provided. The bill would require that all COVID-19 testing data be in a format that facilitates a simple process by which parents and local educational agencies may report data to the department or a local health department, as provided. By imposing new obligations on local educational agencies, and to the extent new duties are imposed on local health departments, the bill would impose a state-mandated local program. The bill would require the department to determine which COVID-19 tests are appropriate for the testing program.
Status: Vetoed by the Governor. See the Governor’s Veto Message here.
This bill requires a health care service plan (health plan) or health insurer's utilization management (UM) process to ensure that an appeal of a denial, is reviewed by a clinical peer, as specified. Defines clinical peer as a physician or other health professional who holds an unrestricted license or certification from any state and whose practice is in the same or a similar specialty as the medical condition, procedures, or treatment under review. Requires health plans and health insurers that require step therapy or prior authorization to maintain specified information, including, but not limited to, the number of step therapy exception requests and prior authorization requests received by the plan or insurer, and, upon request, to provide the information in a deidentified format to the Department of Managed Health Care (DMHC) or the California Department of Insurance (CDI) commissioner, as appropriate.
Status: Signed into Law.
This bill Requires a health care service plan (health plan) or health insurer to furnish specified information about a prescription drug upon request by an enrollee or insured, or their prescribing provider. Prohibits a health plan or health insurer from restricting a prescribing provider from sharing the information furnished about the prescription drug, including information about the cash price of the drug, or penalizing a provider for prescribing, administering, or ordering a lower cost or clinically appropriate alternative drug.
Status: Signed into Law.
This bill requires denial of an initial physician and surgeon license application, requires automatic physician and surgeon license revocation, and requires denial of a petition from a physician and surgeon to reinstate a license for individuals who have committed acts of sexual abuse, misconduct, or relations with a patient.
Status: Signed into Law.
This bill establishes the California Reproductive Health Service Corps (RHSC) program within the Department of Health Care Access and Information (HCAI) to reduce the debt burden of current and future health care professionals dedicated to providing reproductive health care in underserved areas of California.
