CA SB 1023: new version, 09/26/26 - Chaptered

California SB 1023, chaptered September 26, 2026 as Chapter 470, Statutes of 2026, amends existing California law governing health care service plans under the Knox-Keene Health Care Service Plan Act of 1975 and health insurers regulated by the Department of Insurance. The bill expands the existing prohibition on prior authorization and step therapy for antiretroviral drugs medically necessary for HIV/AIDS prevention to also cover antiretroviral drug devices and drug products, closing a gap in the prior statutory text that referenced only "drugs." For health care service plan contracts or health insurance policies issued, amended, or renewed on or after January 1, 2027, the bill imposes an additional coverage mandate: any non-self-administered antiretroviral drug, drug device, or drug product that the FDA has approved for HIV/AIDS prevention must be covered under both the plan or policy's medical benefit and its prescription drug benefit. If the item is obtained under the prescription drug benefit, it must be dispensed and administered by a health care provider acting within the scope of their license. Medi-Cal managed care plans are expressly excluded from the bill's requirements, consistent with the carve-out in existing law. Willful violation of these provisions by a health care service plan constitutes a crime under the Knox-Keene Act, making the bill a state-mandated local program under the California Constitution. The bill provides that no state reimbursement to local agencies or school districts is required under the act's mandated-program framework.