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AB 384

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2025-2026 Regular Session Introduced by Clint Anderson and 10 co-sponsors

AB 384 bans prior authorization for 24‑hour inpatient mental health and substance use care and related services, speeding access when medically necessary.

Failed to pass pursuant to Senate Joint Resolution 1
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Bill Summary · AB 384

AB 384 (Connolly) — California Mental Health Protection Act

Status: In committee — Held under submission (last action: 2025-05-23)
Introduced: February 3, 2025
Subject: Health care coverage; inpatient admissions for mental health and substance use disorders

Purpose / Intent

AB 384 prohibits health plans, health insurers, and Medi‑Cal managed care from requiring prior authorization for (1) admission to medically necessary 24‑hour inpatient care for mental health or substance use disorders and (2) medically necessary services delivered while a patient is admitted. The bill seeks to reduce authorization delays that can impede timely inpatient treatment.

Key provisions (summary)

  • Title: California Mental Health Protection Act.
  • Adds:
    • Health & Safety Code §1371.45 (applies to Knox‑Keene regulated health care service plans),
    • Insurance Code §10112.76 (applies to health insurers),
    • Welfare & Institutions Code §14133.87 (applies to Medi‑Cal).
  • Effective trigger: applies to plan contracts or insurance policies issued, amended, or renewed on or after January 1, 2027.
  • Prohibitions:
    • No prior authorization may be required for admission to medically necessary 24‑hour inpatient care for mental health disorders, substance use disorders, or co‑occurring disorders, when determined necessary by a physician.
    • No prior authorization may be required for medically necessary services provided while the patient is admitted for such 24‑hour inpatient care.
  • Definition: “24‑hour care in inpatient settings” explicitly includes:
    • General acute care and rural general acute care hospitals,
    • Acute psychiatric hospitals,
    • Psychiatric health facilities,
    • Chemical dependency recovery hospitals,
    • Psychiatric residential treatment facilities.
  • Enforcement and penalties:
    • Department of Managed Health Care (DMHC) Director may assess administrative penalties (referencing §1368.04); willful plan violations may be criminal under Knox‑Keene (creating a state‑mandated local program).
    • California Insurance Commissioner may impose civil penalties after notice and hearing under the Administrative Procedure Act.
    • For Medi‑Cal, the Department of Health Care Services may terminate contracts or impose sanctions for violations.
  • Medi‑Cal implementation is conditioned on availability of federal financial participation and receipt of any necessary federal approvals.

Who is affected

  • Enrollees and insureds covered for mental health or substance use disorder care (private plans, insurers, and Medi‑Cal beneficiaries).
  • Health care service plans, health insurers, and entities under Medi‑Cal managed care contracts (must change prior authorization policies and workflows).
  • Hospitals and inpatient behavioral health facilities (may see reduced administrative delays for admissions and in‑stay services).

Procedural / timeline notes

  • Introduced Feb 3, 2025 by Assemblymember Connolly.
  • Passed out of Assembly Health (do pass) and re‑referred to Appropriations; currently held in committee (suspense file as of May 14 and held under submission May 23, 2025).
  • Would take effect for contracts/policies beginning Jan 1, 2027 (for private coverage); Medi‑Cal provisions await federal approval and funding availability.

Potential impacts (high level)

  • Aims to speed access to inpatient behavioral health care by removing preauthorization barriers.
  • Could require administrative changes for payers and may affect utilization patterns and cost management practices.
  • Enforcement mechanisms create regulatory consequences for noncompliance; Medi‑Cal changes contingent on federal sign‑off.

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

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