The bill was introduced by Assemblymember John Harabedian, D-Sierra Madre.

The Assembly Health Committee plans to consider the bill at a hearing April 22.

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The committee is also planning to consider at least five other bills that could affect how group health insurance providers manage use of care:

◆ A bill that would let health care providers have any prior authorization denials reviewed by providers in their own specialties or similar specialties.

◆ A bill that would require prior authorization approvals to remain valid for at least one year.

◆ A bill that would exclude a patient's first 12 visits for physical therapy from any prior authorization requirements.

◆ A bill that would prohibit a plan from requiring prior authorization for a patient's first 24 hours of medically necessary inpatient mental health care or substance use disorder care.

◆ A bill that would give a health plan 24 hours to decide whether inpatient care for a substance use disorder was medically necessary. If the plan decided inpatient care was necessary, the bill would then prohibit the plan from conducting concurrent or retrospective reviews of medical necessity for the first 28 days of a patient's use of in-network inpatient care for substance use disorder.

The backdrop: The California Assembly committee hearing agenda shows how actively health care providers and patient groups are fighting health plan care management efforts.

A National Association of Insurance Commissioners panel recently put 166 pages of background material on the topic in a meeting packet.

Dr. Mehmet Oz, the newly confirmed administrator of the Centers for Medicare and Medicaid Services, has suggested that one way to ease the problem might be to persuade all payers to adopt the same, relatively short list of procedures subject to prior authorization reviews.

What it means: Employers and benefits advisors could benefit from efforts to streamline prior authorization programs and utilization management programs in ways that make the programs cheaper, more efficient and easier for the patients to use.

Employer plans could suffer if aggressive or poorly thought-out efforts to streamline the programs increase the number of patients who get unnecessary, overly expensive or even dangerous care.

In the courts, for example, some patients are suing employer plans over restrictions on access to Wegovy and other new, expensive GLP-1 agonist weight-loss drugs. But other patients are suing pharmaceutical manufacturers over allegations about health problems that may have been caused by the drugs. One implication is that the care patients request may not always be the care the patients should have.