California: Prior Authorization (AB512)

Prior authorization (PA) is a utilization management protocol used by insurance companies to require health care providers to obtain approval from the health plan before a treatment or service is covered.  PAs cause significant delays in care, harming patient outcomes and increasing patient costs.  PAs are a tremendous strain on resources, diverting oncology nurses’ attention away from direct patient care activities to instead battle with insurance representatives who often lack relevant clinical expertise and inappropriately deny medically necessary care.

Bill Summaries

• AB 512 would shorten the timeline for PA request determinations from when a health plan receives the reasonably necessary information to make the determination.
  • from 5 business days to no more than 48 hours for standard requests; and
  • from 72 hours to 24 hours for urgent requests.

How can YOU Help?
AB 512 has advanced out of the Assembly Appropriations Committee. Contact your lawmakers and ask for support for AB 512! Personalized messages make a difference!