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AB 512

Health care coverage: prior authorization.

2025-2026 Regular Session Introduced by John Harabedian and 1 co-sponsor

AB 512 streamlines prior authorization in California, ensuring health care decisions are made within 3-5 days, or 24-48 hours for urgent cases, improving patient access to care.

Consideration of Governor's veto pending.
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Bill Summary · AB 512

Summary of AB 512: Health Care Coverage - Prior Authorization

Purpose and Intent

AB 512, introduced by Assemblymember Harabedian, aims to streamline the prior authorization process for health care services in California. The bill seeks to reduce delays in obtaining necessary medical treatments by modifying the timelines for utilization review decisions made by health care service plans and disability insurers.

Key Provisions

  • Timeline Changes:

    • The bill mandates that decisions on prior or concurrent authorization requests must be made within 3 business days for electronic submissions and 5 business days for non-electronic submissions.
    • In cases where the enrollee faces an imminent and serious threat to their health, decisions must be made within 24 hours for electronic submissions and 48 hours for non-electronic submissions.

  • Exclusion of Medi-Cal Managed Care Plans: The new timelines established by AB 512 do not apply to Medi-Cal managed care plans, which are governed by separate regulations.

  • Utilization Review Compliance: Health care service plans must have written policies and procedures that ensure decisions are based on medical necessity and are consistent with established clinical guidelines.

  • Criminal Penalties: A willful violation of the provisions set forth in this bill would be classified as a crime, thereby imposing a state-mandated local program.

  • No Reimbursement Requirement: The bill specifies that no reimbursement is required for local agencies or school districts for costs mandated by this act.

Impact

  • Affected Entities: The bill primarily impacts health care service plans and disability insurers operating in California. It aims to benefit enrollees by facilitating quicker access to necessary health care services.

  • Health Care Providers: Providers will need to adapt to the new timelines for authorization requests, potentially improving their ability to deliver timely care to patients.

  • Legislative Status: As of now, AB 512 is pending consideration of the Governor's veto, which was issued on October 6, 2025. The bill has undergone various amendments and approvals in both the Assembly and Senate before reaching this stage.

Procedural Timeline

  • Introduced: October 15, 2025
  • Governor's Veto: October 6, 2025
  • Pending Consideration: Following the veto, the bill awaits further legislative action.

AB 512 represents a significant effort to reform the prior authorization process in California, aiming to enhance the efficiency of health care delivery and improve patient outcomes.

Compiled from official sources — confirm details with the bill’s official record.

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