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AB 682

Relating to: fees for nonresident hunting, trapping, and fishing approvals and nonresident vehicle admission receipts. (FE)

2025-2026 Regular Session Introduced by Elijah Behnke and 13 co-sponsors

Requires health plans and insurers to publicly report prior-authorization data and monthly claims with disaggregated demographics, boosting transparency and oversight.

Read first time and referred to Committee on Sporting Heritage
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Bill Summary · AB 682

Note on title: The bill number and header you provided (AB 682, “Relating to: fees for nonresident hunting, trapping, and fishing…”) do not match the legislative text included. The documents attached show AB 682 (Ortega) as a health care–reporting bill. This summary addresses the health care coverage reporting bill reflected in the provided texts.

AB 682 (Ortega) — Summary

Subject: Health care coverage reporting — prior authorization, claims payment, and dispute data

Purpose / Intent

Require greater public transparency and regulatory oversight of health care service plans and health insurers that use prior authorization and to provide detailed, disaggregated claims and dispute-resolution reporting to regulators and the public.

Who is affected

  • Health care service plans regulated by the Department of Managed Health Care (DMHC).
  • Health insurers regulated by the California Department of Insurance (CDI).
  • Contracted entities that perform prior authorization on behalf of plans.
  • Providers, enrollees, researchers, advocates, and regulators (as users of the disclosed data).

Key provisions

  1. Prior authorization public reporting (plans; insurers later):

    • Plans that impose prior authorization must publish on their websites, by Feb 1, 2026 (and annually by Feb 1 thereafter), prior authorization data from the prior calendar year including:
      • List of items/services requiring prior authorization.
      • Percentages of standard requests approved, denied, and approved after appeal.
      • Percent of requests with extended review timeframe that were approved, including aggregated reasons for extension.
      • Percentages of expedited requests approved/denied.
      • Average and median times to determination for standard and expedited requests.
    • Entities contracted to perform prior authorization must report this information to the plan for public posting.
    • The DMHC Director may prescribe report form/content and require verification.

  2. Monthly claims payment and dispute-resolution reporting (plans; submitted to DMHC and publicly posted):

    • Plans must include (for each month) counts and costs for claims processed/adjudicated; claims denied/adjusted/contested; in‑network and out‑of‑network breakdowns; payments within vs. beyond 30 days (by provider type).
    • Denial/adjustment/contest reasons must be disaggregated (e.g., out‑of‑network, excluded service, lack of prior authorization, medical necessity, experimental treatment, clerical error, patient ineligibility, late filing, other).
    • Beginning Jan 1, 2029, claims denied/adjusted/contested must also be reported disaggregated by demographic categories (age, gender identity, sex, ethnicity, disability, sexual orientation).
    • Data must be disaggregated by specific medical procedures and diagnoses.
    • For contested claims, report the number denied that were at any point processed or reviewed using artificial intelligence or predictive algorithms.
    • Plans submit data annually to DMHC by Feb 1, beginning Feb 1, 2027; DMHC posts by April 15 each year beginning April 15, 2027.

  3. Parallel requirements for insurers:

    • Insurers that impose prior authorization must publish prior authorization data on their websites by Feb 1, 2028 (and annually thereafter).
    • Insurers must submit the required claims and prior authorization data to the Department of Insurance by Feb 1 annually beginning Feb 1, 2028; the department will post the information by April 15 starting April 15, 2028.
    • The Insurance Commissioner may reject deficient reports and assess administrative penalties against insurers that fail to correct deficiencies. The Commissioner may adopt rules about form/content.

  4. Enforcement and rulemaking:

    • DMHC Director and Insurance Commissioner authorized to adopt implementing rules and require verification.
    • A willful violation of the provisions by a health care service plan is made a crime under Knox‑Keene provisions (creating a state‑mandated local program). The bill states that no state reimbursement is required for specified reasons.

Timeline / Procedural highlights

  • Initial public posting deadlines: plans Feb 1, 2026; insurers Feb 1, 2028.
  • Plans submit to DMHC annually by Feb 1 beginning 2027; DMHC posts by Apr 15 starting 2027.
  • Insurers submit to CDI annually by Feb 1 beginning 2028; CDI posts by Apr 15 starting 2028.
  • Demographic disaggregation requirement effective Jan 1, 2029.
  • Legislative actions: passed both houses (Assembly and Senate) in 2025; enrolled and presented to Governor Sept 22, 2025; vetoed by the Governor Oct 6, 2025.

Potential impacts (factual)

  • Increases public transparency about prior authorization and claims-denial patterns, including potential use of AI in adjudication.
  • Requires operational and reporting capacities for plans/insurers and for contracted prior‑authorization entities.
  • May raise administrative costs for plans/insurers to collect, verify, and publish detailed and disaggregated data.
  • Raises issues for regulators and the public about use of demographic data, privacy protections, and interpretation of reported metrics.

For readers seeking the exact statutory language, the bill adds Health & Safety Code sections 1367.242 and 1371.33 and authorizes related regulatory action by DMHC and the Department of Insurance.

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

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