text:
(a) The office shall monitor cost trends, including conducting research and studies on the health care market, including, but not limited to, the impact of consolidation, market power, venture capital activity, profit margins, and other market failures on competition, prices, access, quality, and equity. In a manner supportive of the efforts of the Attorney General, the Department of Managed Health Care, and the Department of Insurance, as appropriate, the office shall promote competitive health care markets by examining mergers, acquisitions, corporate affiliations, or other transactions that entail a material change to ownership, operations, or governance structure involving health care service plans, health insurers, hospitals or hospital systems, physician organizations, providers, pharmacy benefit managers, and other health care entities. The office shall prospectively analyze those transactions likely to have significant effects, seek input from the parties and the public, and report on the anticipated impacts to the health care market. The role of the office is to collect and report information that is informative to the public.

(b) This article does not apply to an exempted provider unless that provider is being acquired by, or affiliating with, an entity that is not an exempted provider. If an entity that is not an exempted provider is acquiring or affiliating with an exempted provider, the entity that is not an exempted provider shall meet the requirements of this article.

(c) (1) A health care entity shall provide the office with written notice of agreements or transactions that do either of the following:

(A) Sell, transfer, lease, exchange, option, encumber, convey, or otherwise dispose of a material amount of its assets to one or more entities.

(B) Transfer control, responsibility, or governance of a material amount of the assets or operations of the health care entity to one or more entities.

(2) (A) A noticing entity shall provide the office with written notice of agreements or transactions between the noticing entity and a health care entity or management services organization, or an entity that owns or controls the health care entity or management services organization that do either of the following:

(i) Sell, transfer, lease, exchange, option, encumber, convey, or otherwise dispose of a material amount of the health care entity’s or management services organization’s assets to one or more entities.

(ii) Transfer control, responsibility, or governance of a material amount of the assets or operations of the health care entity or management services organization to one or more entities.

(B) In addition to reporting obligations under subparagraph (A), a management services organization shall provide the office with written notice of any agreement or transaction that is described in clauses (i) and (ii) of subparagraph (A) between the management services organization and any other entity.

(C) The office shall adopt regulations to eliminate duplicative reporting if a noticing entity or health care entity is required to submit notice to the office under more than one provision in subdivision (c).

(3) Written notice pursuant to paragraph (1) shall be provided to the office at least 90 days prior to entering into the agreement or transaction. If the conditions in paragraph (1) of subdivision (a) of Section 127507.2 apply, the office shall make the notice of material change publicly available, including all information and materials submitted to the office for review with regard to the material change.

(4) The office shall adopt regulations for proposed material changes that warrant a notification, establish appropriate fees, and consider appropriate thresholds, including, but not limited to, annual gross and net revenues and market share in a given service or region.

(d) The requirement to provide notice of a material change pursuant to subdivision (c) does not apply to any of the following:

(1) Agreements or transactions involving health care service plans that are subject to review by the Director of the Department of Managed Health Care for cost impact or market consolidation under the Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2 (commencing with Section 1340) of Division 2).

(2) Agreements or transactions involving health insurers that are subject to review by the Insurance Commissioner under Article 14 (commencing with Section 1091) of Chapter 1 of Part 2, of Division 1 of the Insurance Code.

(3) Agreements or transactions where a county is purchasing, acquiring, or taking control, responsibility, or governance of an entity to ensure continued access in that county.

(4) Agreements or transactions involving nonprofit corporations that are subject to review by the Attorney General under Article 2 (commencing with Section 5914) of Chapter 9 of Part 2, Division 2 of Title 1 of the Corporations Code.

(e) Agreements or transactions exempted under subdivision (d) from the requirement to provide a notice of material change may be referred to the office for a cost and market impact review by the reviewing authority.

(f) This article does not limit the Attorney General’s review of the conversion or restructuring of charitable trusts held by a nonprofit health facility or by an affiliated nonprofit health system or the Attorney General’s review of any health care agreement or transaction under any state or federal law.

(g) This article does not narrow, abrogate, or otherwise alter the corporate practice of medicine doctrine, which expressly prohibits the practice of medicine or control of medicine, medical corporations, medical partnerships, or physician practices by entities or individuals other than licensed physicians and surgeons.

(h) For purposes of this article, “noticing entity” includes all of the following:

(1) A private equity group or hedge fund.

(2) A newly created business entity created for the purpose of entering into agreements or transactions with a health care entity.

(3) A management services organization.

(4) An entity that owns, operates, or controls a provider, regardless of whether the provider is currently operating, providing health care services, or has a pending or suspended license.

history: (History: Amended by Stats. 2025, Ch. 641, Sec. 4. (AB 1415) Effective January 1, 2026.)

article: 8. Health Care Market Trends

path: 107. HEALTH CARE ACCESS AND INFORMATION > 2. HEALTH POLICY AND PLANNING > 2.6. Health Care Affordability > 8. Health Care Market Trends


kind: section

code: HSC

text:
(a) (1) If the office finds that a material change noticed pursuant to Section 127507 is likely to have a risk of a significant impact on market competitions, the state’s ability to meet cost targets, or costs for purchasers and consumers, the office shall conduct a cost and market impact review that examines factors relating to a health care entity’s business and its relative market position, including, but not limited to, changes in size and market share in a given service or geographic region, prices for services compared to other providers for the same services, quality, equity, cost, access, or any other factors the office determines to be in the public interest. The office also may conduct cost and market impact reviews on any health care entity based on a determination by the director under subdivision (g) of Section 127502.5, or in association with agreements or transactions referred to the office by a reviewing authority listed in paragraphs (1) to (4), inclusive, of subdivision (d) of Section 127507.

(2) In conducting the review, the office shall consider the benefits of the material change to consumers of health care services, where those benefits could not be achieved without that transaction, including, but not limited to, increased access to health care services, higher quality, and more efficient health care services where consumers of health care services benefit directly from those efficiencies. The party subject to the review may provide information demonstrating the benefits of the material change or information demonstrating the benefits of an integrated organization where the material change would increase those benefits, and where the benefits involve cost, quality, or access to care for consumers of health care services.

(3) (A) Within 60 days of receipt of a notice of material change, the office shall either advise the noticing health care entity of the office’s determination to conduct a cost and market impact review or provide a written waiver from the review. An agreement or transaction for which a cost and market impact review proceeds shall not be implemented until 60 days after the office issues a final report.

(B) The office may adopt regulations that expedite these timelines, as warranted, depending on the nature of the agreement or transaction.

(4) In furtherance of this article, the office shall conduct investigations, including, but not limited to, compelling, by subpoena, health care entities and other relevant market participants to submit data and documents.

(5) Upon completion of the cost and market impact review, the office shall make factual findings and issue a preliminary report of its findings. After allowing for the affected parties and the public to respond in writing to the findings in the preliminary report, the office shall issue its final report.

(b) The office shall adopt regulations for notification to affected parties for the basis of the review, factors considered in the review, requests for data and information from affected parties, the public, and other relevant market participants, and relevant timelines.

(c) (1) The office, the department, employees, contractors, and advisors of the office and the department, the board, and the board members shall keep confidential all nonpublic information and documents obtained under this article that were not required with the notice of material change or from the parties to the transaction, and shall not disclose the confidential information or documents to any person, other than the Attorney General, without the consent of the source of the information or documents, except in a preliminary report or final report under this section if the office believes that disclosure should be made in the public interest after taking into account any privacy, trade secret, or anticompetitive considerations. Prior to disclosure in a report, the office shall notify the relevant party and provide the source of nonpublic information an opportunity to specify facts documenting why release of the information is damaging or prejudicial to the source of the information and why the public interest is served in withholding the information. Information that is otherwise publicly available, or that has not been confidentially maintained by the source, shall not be considered nonpublic information.

(2) Notwithstanding any other law, all nonpublic information and documents obtained under this article shall not be required to be disclosed pursuant to the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code), or any similar local law requiring the disclosure of public records.

(d) (1) The office may refer its findings, including the totality of documents gathered and data analysis performed, to the Attorney General for further review of any unfair methods of competition, anticompetitive behavior, or anticompetitive effects.

(2) This section does not limit the authority of the Attorney General to protect consumers in the health care market or to protect the economy of the state, or any significant part thereof, insofar as health care is concerned, under any state or federal law. The authority of the Attorney General to maintain competitive markets and prosecute state and federal antitrust and unfair competition violations shall not be narrowed, abrogated, or otherwise altered by this section.

history: (History: Amended by Stats. 2023, Ch. 131, Sec. 131. (AB 1754) Effective January 1, 2024.)

division: 107. HEALTH CARE ACCESS AND INFORMATION

part: 2. HEALTH POLICY AND PLANNING

chapter: 2.6. Health Care Affordability

article: 8. Health Care Market Trends


text:
In furtherance of this article, the office may do all of the following:

(a) Contract with, consult, and receive advice from any state agency on terms and conditions that the office deems appropriate.

(b) Contract with experts or consultants to assist in reviewing a proposed agreement or transaction.

(1) Contract costs shall not exceed an amount that is reasonable and necessary to conduct the review and complete the report.

(2) The office shall be entitled to reimbursement from the health care entity subject to review for all actual, reasonable, and direct costs incurred in reviewing, evaluating, and making the determination referred to in Section 127507.2, including administrative costs. The health care entity subject to review shall promptly pay the office, upon request, for all of those costs.

history: (History: Added by Stats. 2022, Ch. 47, Sec. 19. (SB 184) Effective June 30, 2022.)

article: 8. Health Care Market Trends


text: In addition to any legal remedies, the office shall be entitled to specific performance, injunctive relief, and other equitable remedies a court deems appropriate for enforcement of any of the requirements of this article and shall be entitled to recover its attorney’s fees and costs incurred in remedying each violation.

article: 8. Health Care Market Trends


text:
For purposes of this chapter:

(a) “Abortion” has the same meaning as defined in Section 123464.

(b) “Contraception” means the services and contraceptive methods described in paragraph (1) of subdivision (b) of Section 1367.25.

(c) “Department” means the Department of Health Care Access and Information.

(d) “Fund” means the California Reproductive Health Equity Fund established pursuant to Section 127631.

(e) “Gender-affirming health care” and “gender-affirming mental health care” have the same meanings as defined in Section 16010.2 of the Welfare and Institutions Code.

(f) “Program” means the California Reproductive and TGI Health Equity Program established pursuant to Section 127632.

(g) “Religious employer” has the same meaning as described in Section 1367.25.

history: (History: Amended by Stats. 2026, Ch. 27, Sec. 41. (SB 164) Effective June 29, 2026.)

chapter: 6. Reproductive Health Equity

path: 107. HEALTH CARE ACCESS AND INFORMATION > 2. HEALTH POLICY AND PLANNING > 6. Reproductive Health Equity


text:
(a) The California Reproductive Health Equity Fund is hereby established.

(b) The primary purpose of the fund is to provide grant funding to safety net providers of abortion, contraception, or gender-affirming care services through the California Reproductive and TGI Health Equity Program and to otherwise ensure affordability of and access to abortion, contraception, or gender-affirming care to anyone who seeks care in California, regardless of their ability to pay for care. The department shall distribute moneys in the fund to further its primary purpose.

(c) The fund shall also be used to pay for the cost of administering the program and for any other purpose authorized by this chapter. The level of expenditure by the department for the administrative support of the program created pursuant to this chapter shall be subject to review and approval annually through the annual budget process.

(d) The department may receive private donations to be deposited into the fund.

(e) The money in the fund is continuously appropriated to the department for the purposes of this chapter. The department shall manage this fund prudently in accordance with the law.

history: (History: Amended by Stats. 2026, Ch. 27, Sec. 42. (SB 164) Effective June 29, 2026.)


text: In addition to the California Reproductive Health Equity Fund established in this chapter, the department may also use the money in the Abortion Access Fund established in Section 127641 to provide grant funding for abortion services to safety net providers of abortion services through the California Reproductive and TGI Health Equity Program.

history: (History: Added by Stats. 2026, Ch. 27, Sec. 43. (SB 164) Effective June 29, 2026.)


text:
(a) The California Reproductive and TGI Health Equity Program is hereby established within the department.

(b) The purpose of the program is to ensure abortion, contraception, and gender-affirming care are affordable for and accessible to all patients, regardless of their ability to pay, and to provide financial support for safety net providers of these services to offset the costs of providing uncompensated care to patients with low incomes who would otherwise lack access to care.

(c) The department may carry out the program described in this chapter through grants and contracts, including exclusive or nonexclusive contracts, or amending existing contracts, on a bid or negotiated basis. Contracts and grants entered into or amended pursuant to this chapter shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Section 19130 of the Government Code, Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and the State Administrative Manual.

(d) Contracts, grants, and related information created pursuant to this chapter shall not be made public and are exempt from disclosure under the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code).

(e) In administering this chapter, the department shall be exempt from the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.

history: (History: Amended by Stats. 2026, Ch. 27, Sec. 44. (SB 164) Effective June 29, 2026.)


text:
(a) A Medi-Cal enrolled provider, as determined by the State Department of Health Care Services, may apply for a grant, and a continuation award after the initial grant, under this chapter if they agree to provide either, both abortion and contraception services, or gender-affirming care services in accordance with all of the following:

(1) The abortion, contraception, or gender-affirming care services provided are within the provider’s scope of practice and licensure.

(2) The provider agrees to be identified, in a manner determined by the department, as a participating provider in the program. An institutional provider shall not be required to identify any individual who is an abortion or gender-affirming care provider as a condition of a grant awarded pursuant to this chapter.

(3) To the extent services provided are covered pursuant to Section 14132 of the Welfare and Institutions Code, the services shall be provided at no cost or a reduced cost to an individual with a household income at or below 400 percent of the federal poverty level who meets both of the following criteria:

(A) Is uninsured or has health care coverage that does not include both abortion and contraception or does not include coverage for gender-affirming care.

(B) Is not otherwise eligible to receive both abortion and contraception care at no cost through the Medi-Cal and Family PACT programs or receive gender-affirming care at no cost through the Medi-Cal program.

(b) For purposes of this chapter, an individual’s self-declaration of income and source of health care coverage made to the provider at the time of service shall be all that is required to determine whether the individual may be able to access no-cost or reduced-cost services pursuant to this chapter.

(c) This chapter does not require a provider to accept additional patients if, in the reasonable professional judgment of the provider, accepting additional patients would endanger access to, or continuity of, care for existing patients.

(d) The department shall work with the State Department of Health Care Services to notify Medi-Cal enrolled providers of the availability of funding under this chapter, including any pertinent deadlines and other requirements.

history: (History: Amended by Stats. 2026, Ch. 27, Sec. 45. (SB 164) Effective June 29, 2026.)


text:
(a) An application for a grant under this chapter shall be made on a form to be developed by the department.

(b) An application shall include both of the following:

(1) A justification of the amount of grant funds requested, including both of the following:

(A) The cost of uncompensated abortion, contraception, and gender-affirming care services the applicant provided to patients with household incomes at or below 400 percent of the federal poverty level in the previous 12 months.

(B) The anticipated cost of uncompensated abortion, contraception, and gender-affirming care services to be provided to patients with household incomes at or below 400 percent of the federal poverty level in the upcoming 12 months.

(2) Other pertinent information that the department requires.

(c) The department shall develop an application form and shall begin accepting applications for grants pursuant to this chapter on or before January 1, 2027.

(d) For purposes of subdivision (b), the cost of uncompensated abortion, contraception, and gender-affirming care services shall:

(1) Be calculated based on the amount the provider would expect to receive for providing these services to a patient enrolled in the Medi-Cal program.

(2) Include those services provided through prescription, including laboratory and pharmaceutical, as well as services that are the result of complications related to services provided pursuant to this chapter, to the extent they would be covered pursuant to Section 14132 of the Welfare and Institutions Code.

(e) For purposes of this section, the department shall not require the submission of personal information about individuals receiving uncompensated abortion, contraception, and gender-affirming care services as part of an application. Information required by the department shall only include information in summary, statistical, or other forms that do not identify particular individuals.

(f) Contracts, grants, and related information created pursuant to this chapter shall not be made public and are exempt from disclosure under the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code).

history: (History: Amended by Stats. 2026, Ch. 27, Sec. 46. (SB 164) Effective June 29, 2026.)


text:
(a) Within the limits of funds available, the department may award grants that, in the department’s judgment, best promote the purposes described in Section 127632, taking into account all of the following:

(1) The extent to which abortion, contraception, and gender-affirming care services are needed locally.

(2) The ability of the applicant to advance health equity.

(3) The relative need of the applicant.

(b) The department shall determine the amount of an award on the basis of the amount of funds requested.

(c) Unless otherwise specified by the department, an initial grant shall be for a 12-month period.

(d) Determination regarding a grant award shall be made within 60 days of receipt of a completed application.

history: (History: Amended by Stats. 2026, Ch. 27, Sec. 47. (SB 164) Effective June 29, 2026.)


text:
(a) An application for a continuation award under this chapter shall be made on a form to be developed by the department.

(b) Decisions regarding continuation awards and the funding level of those awards shall be made after consideration of factors that include the recipient’s anticipated level of need and the availability of funds.

(c) Unless otherwise specified by the department, a continuation award shall be for a 12-month period.

(d) An application for a continuation award under this chapter shall be exempt from disclosure under the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code).

history: (History: Added by Stats. 2022, Ch. 562, Sec. 2. (AB 2134) Effective January 1, 2023.)


text: Funds awarded pursuant to this chapter shall be expended solely for the purpose for which the funds were awarded, in accordance with the approved application and budget, implementation guidance issued by the department, and the terms and conditions of the grant or continuation award.


text: In implementing the program, the department shall consult with interested parties, including the State Department of Health Care Services, the Department of Managed Health Care, the Department of Insurance, abortion and contraception providers, gender-affirming care providers, consumer advocates, and other stakeholders it deems appropriate.

history: (History: Amended by Stats. 2026, Ch. 27, Sec. 48. (SB 164) Effective June 29, 2026.)


text: The department shall conduct an evaluation of the program and shall report its findings to the Legislature by no later than July 1, 2024, and on an annual basis no later than each July 1 thereafter. The department may use funds in the fund for the evaluation of the program. The report shall be submitted in compliance with Section 9795 of the Government Code.


text:
For purposes of this chapter:

(a) “Abortion” has the same meaning as defined in Section 123464.

(b) “Department” means the Department of Health Care Access and Information, or any other entity within, and as designated by, the California Health and Human Services Agency.

(c) “Fund” means the Abortion Access Fund established pursuant to Section 127641.

history: (History: Added by Stats. 2025, Ch. 105, Sec. 42. (AB 144) Effective September 17, 2025. Inoperative July 1, 2029, pursuant to Section 127643. Repealed as of January 1, 2030, pursuant to Section 127643.)

chapter: 6.1. Reproductive Health Protection

path: 107. HEALTH CARE ACCESS AND INFORMATION > 2. HEALTH POLICY AND PLANNING > 6.1. Reproductive Health Protection


text:
(a) The Abortion Access Fund is hereby established in the State Treasury.

(b) Notwithstanding any other law, all of the following apply:

(1) The fund is a special fund, permanently separate and apart from the General Fund or any other state fund or account.

(2) Notwithstanding Section 16305.7 of the Government Code, any interest or dividends earned on moneys in the fund shall be retained in the fund and used solely as set forth in this chapter.

(3) The purpose of the fund is to provide funding for abortion services, including for abortion services funded through grants to provide abortion access.

(4) The moneys in the fund are continuously appropriated to the department without regard to fiscal year for the purposes of this chapter.


text:
(a) The department shall distribute moneys in the fund for the purpose of funding abortion services.

(b) The department may carry out the program described in this chapter through grants and contracts, including exclusive or nonexclusive contracts, or amending existing contracts, on a bid or negotiated basis. Contracts and grants entered into or amended pursuant to this chapter shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Section 19130 of the Government Code, Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and the State Administrative Manual.

(c) Contracts, grants, and related information created pursuant to this chapter shall not be made public and are exempt from disclosure under the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code).

(d) In administering this chapter, the department shall be exempt from the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.


text: This chapter shall become inoperative on July 1, 2029, and, as of January 1, 2030, is repealed.

history: (History: Added by Stats. 2025, Ch. 105, Sec. 42. (AB 144) Effective September 17, 2025. Repealed as of January 1, 2030, by its own provisions. Note: Repeal affects Chapter 6.1, commencing with Section 127640.)


text:
(a) The Legislature hereby requests the University of California to establish the California Health Benefit Review Program to assess legislation proposing to mandate a benefit or service, as defined in subdivision (d), and legislation proposing to repeal a mandated benefit or service, as defined in subdivision (e), and to prepare a written analysis with relevant data on the following:

(1) Public health impacts, including, but not limited to, all of the following:

(A) The impact on the health of the community, including the reduction of communicable disease and the benefits of prevention such as those provided by childhood immunizations and prenatal care.

(B) The impact on the health of the community, including diseases and conditions where disparities in outcomes associated with the social determinants of health as well as gender, race, sexual orientation, or gender identity are established in peer-reviewed scientific and medical literature.

(C) The extent to which the benefit or service reduces premature death and the economic loss associated with disease.

(2) Medical impacts, including, but not limited to, all of the following:

(A) The extent to which the benefit or service is generally recognized by the medical community as being effective in the screening, diagnosis, or treatment of a condition or disease, as demonstrated by a review of scientific and peer-reviewed medical literature.

(B) The extent to which the benefit or service is generally available and utilized by treating physicians.

(C) The contribution of the benefit or service to the health status of the population, including the results of any research demonstrating the efficacy of the benefit or service compared to alternatives, including not providing the benefit or service.

(D) The extent to which mandating or repealing the benefits or services would not diminish or eliminate access to currently available health care benefits or services.

(3) Financial impacts, including, but not limited to, all of the following:

(A) The extent to which the coverage or repeal of coverage will increase or decrease the benefit or cost of the benefit or service.

(B) The extent to which the coverage or repeal of coverage will increase the utilization of the benefit or service, or will be a substitute for, or affect the cost of, alternative benefits or services.

(C) The extent to which the coverage or repeal of coverage will increase or decrease the administrative expenses of health care service plans and health insurers and the premium and expenses of subscribers, enrollees, and policyholders.

(D) The impact of this coverage or repeal of coverage on the total cost of health care.

(E) The impact of this coverage or repeal of coverage on anticipated costs or savings estimated upon implementation for one subsequent calendar year, or, if applicable, two subsequent calendar years through a long-range estimate.

(F) The potential cost or savings to the private sector, including the impact on small employers as defined in paragraph (1) of subdivision (l) of Section 1357, the Public Employees’ Retirement System, other retirement systems funded by the state or by a local government, individuals purchasing individual health insurance, and publicly funded state health insurance programs, including the Medi-Cal program.

(G) The extent to which costs resulting from lack of coverage or repeal of coverage are or would be shifted to other payers, including both public and private entities.

(H) The extent to which mandating or repealing the proposed benefit or service would not diminish or eliminate access to currently available health care benefits or services.

(I) The extent to which the benefit or service is generally utilized by a significant portion of the population.

(J) The extent to which health care coverage for the benefit or service is already generally available.

(K) The level of public demand for health care coverage for the benefit or service, including the level of interest of collective bargaining agents in negotiating privately for inclusion of this coverage in group contracts, and the extent to which the mandated benefit or service is covered by self-funded employer groups.

(L) In assessing and preparing a written analysis of the financial impact of legislation proposing to mandate a benefit or service and legislation proposing to repeal a mandated benefit or service pursuant to this paragraph, the Legislature requests the University of California to use a certified actuary or other person with relevant knowledge and expertise to determine the financial impact.

(4) The impact on essential health benefits, as defined in Section 1367.005 of this code and Section 10112.27 of the Insurance Code, and the impact on the California Health Benefit Exchange.

(b) The Legislature further requests that the California Health Benefit Review Program assess legislation that impacts health insurance benefit design, cost sharing, premiums, and other health insurance topics.

(c) The Legislature requests that the University of California provide every analysis to the appropriate policy and fiscal committees of the Legislature not later than 60 days, or in a manner and pursuant to a timeline agreed to by the Legislature and the California Health Benefit Review Program, after receiving a request made pursuant to Section 127661. In addition, the Legislature requests that the university post every analysis on the Internet and make every analysis available to the public upon request.

(d) As used in this section, “legislation proposing to mandate a benefit or service” means a proposed statute that requires a health care service plan or a health insurer, or both, to do any of the following:

(1) Permit a person insured or covered under the policy or contract to obtain health care treatment or services from a particular type of health care provider.

(2) Offer or provide coverage for the screening, diagnosis, or treatment of a particular disease or condition.

(3) Offer or provide coverage of a particular type of health care treatment or service, or of medical equipment, medical supplies, or drugs used in connection with a health care treatment or service.

(e) As used in this section, “legislation proposing to repeal a mandated benefit or service” means a proposed statute that would repeal an existing requirement that a health care service plan or a health insurer, or both, do any of the following:

(1) Permit a person insured or covered under the policy or contract to obtain health care treatment or services from a particular type of health care provider.

(2) Offer or provide coverage for the screening, diagnosis, or treatment of a particular disease or condition.

(3) Offer or provide coverage of a particular type of health care treatment or service, or of medical equipment, medical supplies, or drugs used in connection with a health care treatment or service.

history: (History: Amended by Stats. 2025, Ch. 318, Sec. 1. (SB 439) Effective January 1, 2026. Inoperative July 1, 2033, pursuant to Section 127665.\n Repealed as of January 1, 2034, pursuant to Section 127665.)

path: 107. HEALTH CARE ACCESS AND INFORMATION > 2. HEALTH POLICY AND PLANNING > 7. University of California Assessment on Legislation Proposing Mandated Benefits or Services


text: A request pursuant to this chapter may be made by an appropriate policy or fiscal committee chairperson, the Speaker of the Assembly, or the President pro Tempore of the Senate, who shall forward the introduced bill to the University of California for assessment.

history: (History: Added by Stats. 2002, Ch. 795, Sec. 2. Effective January 1, 2003. Inoperative July 1, 2033, pursuant to Section 127665.\n Repealed as of January 1, 2034, pursuant to Section 127665.)

chapter: 7. University of California Assessment on Legislation Proposing Mandated Benefits or Services


text:
(a) In order to effectively support the University of California and its work in implementing this chapter, there is hereby established in the State Treasury, the Health Care Benefits Fund. The university’s work in providing the bill analyses shall be supported from the fund.

(b) For the 2026–27 to 2032–33 fiscal years, inclusive, each health care service plan, except a specialized health care service plan, and each health insurer offering health insurance, as defined in Section 106 of the Insurance Code, shall be assessed an annual fee in an amount determined through regulation. The amount of the fee shall be determined by the Department of Managed Health Care and the Department of Insurance in consultation with the university and shall be limited to the amount necessary to fund the actual and necessary expenses of the university and its work in implementing this chapter. The total annual assessment on health care service plans and health insurers shall not exceed three million two hundred thousand dollars ($3,200,000).

(c) The Department of Managed Health Care and the Department of Insurance, in coordination with the university, shall assess the health care service plans and health insurers, respectively, for the costs required to fund the university’s activities pursuant to subdivision (b).

(1) Health care service plans shall be notified of the assessment on or before June 15 of each year with the annual assessment notice issued pursuant to Section 1356. The assessment pursuant to this section is separate and independent of the assessments in Section 1356.

(2) Health insurers shall be noticed of the assessment in accordance with the notice for the annual assessment or quarterly premium tax revenues.

(3) The assessed fees required pursuant to subdivision (b) shall be paid on an annual basis no later than August 1 of each year. The Department of Managed Health Care and the Department of Insurance shall forward the assessed fees to the Controller for deposit in the Health Care Benefits Fund immediately following their receipt.

(4) “Health insurance,” as used in this subdivision, does not include Medicare supplement, vision-only, dental-only, or CHAMPUS supplement insurance, or hospital indemnity, accident-only, or specified disease insurance that does not pay benefits on a fixed benefit, cash payment only basis.

history: (History: Amended by Stats. 2025, Ch. 318, Sec. 2. (SB 439) Effective January 1, 2026. Inoperative July 1, 2033, pursuant to Section 127665.\n Repealed as of January 1, 2034, pursuant to Section 127665.)


text: In order to avoid conflicts of interest, the Legislature requests the University of California to develop and implement conflict-of-interest provisions to prohibit a person from participating in any analysis in which the person knows or has reason to know he or she has a material financial interest, including, but not limited to, a person who has a consulting or other agreement with a person or organization that would be affected by the legislation.


text: This chapter shall become inoperative on July 1, 2033, and, as of January 1, 2034, is repealed.

history: (History: Amended by Stats. 2025, Ch. 318, Sec. 3. (SB 439) Effective January 1, 2026. Repealed as of January 1, 2034, by its own provisions. Note: Repeal affects Chapter 7, commencing with Section 127660.)


text:
(a) The Legislature finds and declares that California has a substantial public interest in the price, cost, utilization, equity, and quality of health care services. California is a major purchaser of health coverage through the Public Employees’ Retirement System, the State Department of Health Care Services, the Department of General Services, the Department of Corrections and Rehabilitation, the California Health Benefit Exchange, and other entities acting on behalf of a state purchaser. California also provides major tax expenditures through the tax exclusion of employer-sponsored coverage and tax deductibility of coverage purchased by individuals, as well as tax deductibility of excess health care costs for individuals and families.

(b) It is the intent of the Legislature in enacting this chapter to establish a system to collect information regarding health care costs, utilization, quality, and equity. Health care data is reported and collected through many disparate systems. Creating a process to aggregate and use this data will provide greater transparency regarding health care costs, utilization, quality, and equity, and the information may be used to inform policy decisions regarding the provision of quality health care, improving public health, reducing disparities, advancing health coverage, reducing health care costs, oversight of the health care system and health care companies, and providing public benefit for Californians and the state, while preserving consumer privacy.

(c) It is the intent of the Legislature to improve data transparency to achieve a sustainable health care system with more equitable access to affordable and quality health care for all.

(d) It is the intent of the Legislature in enacting this chapter to encourage state agencies, researchers, health care service plans, health insurers, providers, suppliers, and other stakeholders to use this data to develop innovative approaches, services, and programs that may have the potential to deliver health care that is both cost effective and responsive to the needs of enrollees, including recognizing the diversity of California and the impact of social determinants of health.

(e) It is the intent of the Legislature that the development of a Health Care Payments Data System be substantially completed no later than July 1, 2023, pursuant to this chapter.

(f) For purposes of this chapter:

(1) “Director” means the Director of the Department of Health Care Access and Information.

(2) “Fund” means the Health Care Payments Data Fund established pursuant to Section 127674.

(3) “Department” means the Department of Health Care Access and Information.

(4) “Program” means the Health Care Payments Data Program established pursuant to Section 127671.1.

(5) “Qualified applicants” includes state agencies, mandatory submitters, established nonprofit research institutions, the University of California, nonprofit educational institutions, providers, suppliers, labor unions, self-insured multiemployer plans that submit data to the system, and consumer organizations certified for the Consumer Participation Program administered by the Department of Managed Health Care pursuant to Section 1348.9 that have been awarded reasonable advocacy and witness fees in a proceeding or proceedings of the department.

(6) “Research” has the same meaning as defined in Section 164.501 of Title 45 of the Code of Federal Regulations.

(7) “System” means the Health Care Payments Data System.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 89. (AB 133) Effective July 27, 2021.)

chapter: 8.5. Health Care Payments Data Program

path: 107. HEALTH CARE ACCESS AND INFORMATION > 2. HEALTH POLICY AND PLANNING > 8.5. Health Care Payments Data Program


text:
(a) The department shall establish, implement, and administer the Health Care Payments Data Program to implement and administer the system in accordance with this chapter.

(b) The system shall collect data on all California residents to the extent feasible and permissible subject to the state constitutional right to privacy and any other applicable state or federal law.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 90. (AB 133) Effective July 27, 2021.)


text:
(a) (1) The Department of Health Care Access and Information shall convene a Health Care Payments Data Program advisory committee, composed of health care stakeholders and experts, including, but not limited to, all of the following:

(A) Health care service plans, including specialized health care service plans.

(B) Insurers that have a certificate of authority from the Insurance Commissioner to provide health insurance, as defined in Section 106 of the Insurance Code.

(C) Suppliers, as defined in paragraph (3) of subdivision (b) of Section 1367.50.

(D) Providers, as defined in paragraph (2) of subdivision (b) of Section 1367.50.

(E) Self-insured employers.

(F) Multiemployer self-insured plans that are responsible for paying for health care services provided to beneficiaries or the trust administrator for a multiemployer self-insured plan.

(G) Businesses that purchase health care coverage for their employees.

(H) Organized labor.

(I) Organizations representing consumers.

(J) Pharmacy benefit managers, as defined in Section 127673.05.

(2) The advisory committee shall consist of no fewer than 10 and no more than 12 persons.

(3) In addition to the members specified by paragraph (2), the director of the department, the director of the State Department of Health Care Services, and the executive director of the California Health Benefit Exchange, or their officially designated representatives, shall be nonvoting ex officio members of the advisory committee.

(4) Each appointed member shall serve a term of two years, except one-half of the initial appointments shall be for one year. Each appointed member shall serve at the discretion of the director and may be removed at any time.

(5) The chairperson of the advisory committee shall be an appointed member and shall be elected by a majority of the appointed members.

(6) The advisory committee shall meet at least quarterly or when requested by the director.

(7) The advisory committee shall assist and advise the director in formulating program policies regarding data collection, management, use, and access, and development of public information to meet the goals of the program. The advisory committee shall, through its meetings, provide a forum for stakeholder and public engagement. Upon request of the director, the advisory committee may assist and advise on the department’s other data programs.

(8) On or before July 1, 2024, the advisory committee shall make recommendations to the department on how existing state public health data functions may be integrated into the system. The advisory committee shall also recommend options for state public health data integration. These recommendations shall be published on the department’s internet website.

(9) The advisory committee shall not have decisionmaking authority related to the administration of the system and shall not have a financial interest, individually or through a family member, in the recommendations made to the department. The advisory committee shall hold public meetings with stakeholders, solicit input, and set its own meeting agendas. Meetings of the advisory committee are subject to the Bagley-Keene Open Meeting Act (Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of the Government Code).

(10) The members of the advisory committee appointed from outside government shall serve without compensation, but shall receive a per diem for each day’s attendance at an advisory committee meeting. All members shall be reimbursed for any actual and necessary expenses incurred in connection with their duties as members of the committee.

(b) The department may convene other committees or workgroups as necessary to support effective operation of the system. These committees may be standing committees or time-limited workgroups, at the discretion of the director.

history: (History: Amended by Stats. 2025, Ch. 21, Sec. 39. (AB 116) Effective June 30, 2025.)


text: The department shall ensure that the system can map to other datasets, including public health datasets on morbidity and mortality, and data regarding the social determinants of health.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 92. (AB 133) Effective July 27, 2021.)


text: Until June 30, 2028, for purposes of implementing this chapter, including, but not limited to, hiring staff and consultants, facilitating and conducting meetings, conducting research and analysis, and developing the required reports, the department may enter into exclusive or nonexclusive contracts on a bid or negotiated basis. Contracts entered into or amended pursuant to this section are exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code and Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and are exempt from the review or approval of any division of the Department of General Services.

history: (History: Amended by Stats. 2025, Ch. 21, Sec. 40. (AB 116) Effective June 30, 2025.)


text:
(a) The department shall develop guidance to require data submission from the entities specified in this chapter. The guidance shall include a methodology for the collection, validation, refinement, analysis, comparison, review, and improvement of health care data to be submitted by entities specified in this chapter, including, but not limited to, data from fee-for-service, capitated, integrated delivery system, and other alternative, value-based, payment sources, and any other form of payment to health care providers and suppliers by health plans, health insurers, or other entities described in this chapter.

(b) Notwithstanding any other state law, for the purpose of providing information for inclusion in the system, mandatory submitters shall, and voluntary submitters may, provide health care data, including claim and encounter, member enrollment, provider and supplier information, nonclaims-based payments, premiums, and pharmacy rebate data, and provide all of the following to the department:

(1) Utilization data from the health care service plans’ and insurers’ medical payments or, in the case of entities that do not use payments data, including, but not limited to, integrated delivery systems, encounter data consistent with the core set of data elements for data submission proposed by the All-Payer Claims Database Council, the University of New Hampshire, and the National Association of Health Data Organizations.

(2) Pricing information for health care items, services, and medical and surgical episodes of care gathered from payments for covered health care items and services, including contracted rates, allowed amounts, fee schedules, and other information regarding the cost of care necessary to determine the amounts paid by health plans, health insurers, and public programs to health care providers, suppliers, and other entities. This shall include nonclaims-based payment information such as deductibles, copayments, and coinsurance and other information as needed to determine the total cost of care.

(3) Personally identifiable information that the mandatory submitter is otherwise required to collect, which may include detailed patient identifiers such as first and last name, address, date of birth, gender or gender identity, and Social Security Number or individual taxpayer identification number, in order to support analyses, including, but not limited to, longitudinal, public health impacts, and social determinants of health analyses. Personally identifiable information shall be subject to the privacy protections of this chapter and shall not be publicly available, except as specified in this chapter.

(4) Personal health information that the mandatory submitter is otherwise required to collect, which may include age, gender, gender identity, race, ethnicity, sexual orientation, health status, health condition, and any other data elements that constitute personal health information in this chapter.

(c) For purposes of this chapter, “mandatory submitters” include all of the following:

(1) A health care service plan, including a specialized health care service plan.

(2) An insurer licensed to provide health insurance, as defined in Section 106 of the Insurance Code, including dental-only insurance.

(3) A self-insured plan subject to Section 1349.2, or a state entity, city, county, or other political subdivision of the state, or a public joint labor management trust, that offers self-insured or multiemployer-insured plans that pay for or reimburse any part of the cost of health care services.

(4) The State Department of Health Care Services, for those enrolled in Medi-Cal and other insurance affordability programs, whether enrolled in Medi-Cal managed care, fee-for-service Medi-Cal, or any other payment arrangement.

(d) The department will accept, at its discretion, voluntarily submitted data. For purposes of this chapter, “voluntary submitters” include, but are not limited to:

(1) A self-insured employer that is not subject to Section 1349.2.

(2) A multiemployer self-insured plan that is responsible for paying for health care services provided to beneficiaries.

(3) The trust administrator for a multiemployer self-insured plan.

(4) A provider, as defined in paragraph (2) of subdivision (b) of Section 1367.50, that is a hospital or clinic.

(5) A supplier, as defined in paragraph (3) of subdivision (b) of Section 1367.50, that has an independent scope of practice and submits claims electronically.

(e) On or before December 31, 2021, the department shall adopt emergency regulations pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 to implement this chapter, including on all of the following:

(1) Plan size thresholds for submitters, with consideration given to implementation costs for both the submitter and the department. Thresholds shall not apply to qualified health plans offered by the California Health Benefit Exchange or submitters covering more than a total of 50,000 Californians through both Medicare Advantage plans and the private plans and insurance described in subdivision (b).

(2) Required and exempted lines of business.

(3) Coordination of submission in cases where submitters contract with other entities to administer health care benefits.

(4) The content, file formats, and timelines for data submission, and the methods of data collection. In the development of regulations, the department shall consider national, regional, and other all-payer claims databases’ standards.

(5) Frequency of submission by health plans, insurers, and other mandatory submitters of all core data, including claims, encounters, eligibility, and provider files.

(6) Frequency of submission of nonclaims payment data files.

(f) The initial adoption, by the department, of regulations implementing subdivision (e) shall be deemed to be an emergency and necessary to avoid serious harm to the public peace, health, safety, or general welfare for purposes of Sections 11346.1 and 11349.6 of the Government Code. Any emergency regulation adopted pursuant to this section shall be repealed by operation of law unless the adoption, amendment, or repeal of the regulation is promulgated by the department pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code within two years of the initial adoption of the emergency regulation. After the adoption of the emergency regulation pursuant to subdivision (e), the department may thereafter establish regulations pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code.

(g) (1) A qualified health plan shall submit information either directly or through the California Health Benefit Exchange, as determined by the exchange.

(2) The State Department of Health Care Services shall submit information for those enrolled in Medi-Cal and other insurance affordability programs, whether enrolled in Medi-Cal managed care, fee-for-service Medi-Cal, or any other payment arrangement.

(h) (1) In its initial implementation, the department shall seek data for the three years prior to the effective date of this chapter.

(2) In ongoing administration of the system, the department shall provide data for no less than three years and may seek data for longer time periods to support the intent of this chapter.

(i) To the extent possible, the department shall incorporate into the system any data collected by the department from providers and suppliers, including hospital discharge abstract data records and emergency care data records provided to the department by health facilities and ambulatory surgery data records provided to the department by ambulatory surgical centers.

(j) The department may accept and incorporate into the system any available information that will further the goals of the program.

(k) (1) On or before March 1, 2024, the department shall submit a report to the Legislature that includes all of the following:

(A) Claims data reported by mandatory submitters.

(B) Claims data reported by voluntary submitters.

(C) Data on the covered lives reported, percentage of the population for which the department has data, the number of self-insured plans, providers and suppliers who have voluntarily submitted data, variation of completeness of data across geographic regions, such as the California Health Benefit Exchange’s rating regions, the extent of data submitted on hospitals, physicians, and physician groups, the extent to which mandatory and voluntary submitters are submitting data specified in subdivision (b), frequency of submission of all core data, including claims, encounters, eligibility, and provider files, frequency of submission of nonclaims payment data files, and any other information that is available to determine if hospital and physician data are captured.

(D) A cost estimate if providers and suppliers become mandatory submitters.

(E) The number of data requests from qualified applicants and their data uses.

(2) The department may request the data release committee established pursuant to Section 127673.84 to assist with the report.

(3) The report shall be submitted in compliance with Section 9795 of the Government Code.

(l) Entities regulated pursuant to Article 4.7 (commencing with Section 742.20) of Part 2 of Division 1 of the Insurance Code are exempt from this chapter.

(m) The program performs public health activities described in subdivision (b) of Section 164.512 of Title 45 of the Code of Federal Regulations. The information collected in accordance with this chapter is necessary to carry out projects with public health purposes.

(n) Article 8 (commencing with Section 1798.30) of Chapter 1 of Title 1.8 of Part 4 of Division 3 of the Civil Code shall not apply to records and personal information collected by the system pursuant to this section.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 94. (AB 133) Effective July 27, 2021.)


text:
(a) (1) The department shall report the information it receives pursuant to this chapter in a form that allows valid comparisons across care delivery systems.

(2) The department shall develop policies and procedures to outline the format and type of data to be submitted pursuant to this chapter.

(b) All entities submitting health care data are responsible for submitting complete and accurate data directly to the system and facilitating data submissions from data owners, including, but not limited to, data feeds from pharmacy benefit managers, behavioral health organizations, and any subsidiaries, affiliates, or subcontractors that a submitter has contracted with for services covered by this chapter.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 95. (AB 133) Effective July 27, 2021.)


text:
(a) In the development of the system, the department or its designee shall consult with state and federal entities, as necessary, to implement the program. State entities shall assist and provide to the department access to datasets needed to effectuate the intent of this chapter.

(b) The department shall seek data on Medicare enrollees from the federal Centers for Medicare and Medicaid Services and shall incorporate that data, to the extent possible.

(c) The department shall accept data from voluntary submitters if it is provided in a manner and format specified by the office.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 96. (AB 133) Effective July 27, 2021.)


text:
(a) The department shall develop and maintain a master person index, a master index of providers and suppliers, and a master payer index that will enable the matching of California residents longitudinally and across coverage sources, and will enable the matching of providers and suppliers across practice arrangements, payment sources, and regulators.

(b) The department shall supplement these indices with data from other public and private sources, such as the following:

(1) Other data maintained by the department.

(2) Vital statistics.

(3) Facility licensure data from the State Department of Public Health.

(4) Health professional licensure data from the Department of Consumer Affairs.

(5) Private sources of valid and reliable data, such as a provider and supplier directory utility if it is demonstrably accurate over time.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 97. (AB 133) Effective July 27, 2021.)


text:
(a) The department shall develop regulations on data quality and improvement processes and shall make these processes publicly available.

(b) Data quality processes shall be applied to each major phase of the system life cycle, including, but not limited to:

(1) Source data intake.

(2) Data conversion and processing.

(3) Data analysis, reporting, and release.

(4) Other data processes necessary for the system.

(c) The department shall provide, upon request of an interested party, to the interested party, and shall regularly report to the health care data policy advisory committee, information on data quality and data quality improvement processes, including, but not limited to, the following:

(1) Descriptions of processes and methodologies.

(2) Periodic updates on known issues and the implications of the issues for data quality and data availability.

(3) Other impediments to the functioning of the system.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 98. (AB 133) Effective July 27, 2021.)


text:
(a) For purposes of this section, “pharmacy benefits manager” or “PBM” means an entity that is required to be licensed pursuant to Section 1385.008.

(b) Notwithstanding any other state law, for the purpose of providing information for inclusion in the system, PBMs shall provide to the department data regarding drug pricing, the fees paid for pharmacy benefit management services, payments or rebates to or from pharmacy benefits managers regarding drugs or services, and other information as needed to provide transparency on pricing and payments related to prescription drugs. This may include all of the following:

(1) Drug codes, names, therapeutic category, and manufacturer.

(2) Wholesale acquisition costs.

(3) Average wholesale prices.

(4) National average drug acquisition cost.

(5) Fees paid to pharmacy benefit managers by manufacturers, health care service plans, health insurers, employers, and pharmacies.

(6) Prescription counts.

(7) Member counts.

(8) Payment amounts collected and paid by pharmacy benefit managers.

(9) Discounts and rebate amounts collected and paid by pharmacy benefit managers.

(10) Information grouped by National Drug Code and Generic Product Identifier.

(11) Information grouped by pharmacies owned by, or under common control of, the pharmacy benefit manager and pharmacies not owned by, or under common control of, the pharmacy benefit manager.

(12) Information grouped by business relationship, including by exclusive relationships under a contract, agreement, or other arrangement between a pharmacy benefit manager and a pharmaceutical manufacturer to exclusively dispense or provide a drug to a health care service plan’s or health insurer’s employees, enrollees, or insureds.

(13) Information needed to calculate any of the following:

(A) The number of participants or beneficiaries who filled a prescription.

(B) Total out-of-pocket spending by participants or beneficiaries.

(C) Total net price by drug.

(D) Payer total net spending by drug.

(E) Payer average net spending per 30-day and 90-day supply.

(F) Percentage of prescriptions dispensed by pharmacies owned by, or under common control of, the pharmacy benefit manager.

(G) Comparisons of the amounts charged to patients and payers by pharmacies owned by, or under common control of, the pharmacy benefit manager, with the amounts charged by pharmacies not owned by, or under common control of, the pharmacy benefit manager.

(H) Average sales price of drugs dispensed at pharmacies owned by, or under common control of, the pharmacy benefit manager.

(I) Average wholesale acquisition cost of drugs dispensed at pharmacies owned by, or under common control of, the pharmacy benefit manager.

(J) Average drug acquisition cost per dosage unit of drugs dispensed at pharmacies owned by, or under common control of, the pharmacy benefit manager.

(K) Average drug acquisition cost per 30-day and 90-day supply.

(c) The department shall promulgate regulations for the purpose of carrying out this section, including regulations relating to the content, file formats, frequency, and timelines for data submission by pharmacy benefit managers. In the development of regulations, the department may consider national or regional standards and standards from other databases.

(d) Until January 1, 2028, any necessary rules and regulations for the purpose of implementing this section may be adopted as emergency regulations in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). The adoption of emergency regulations pursuant to this section shall be deemed to be an emergency and necessary for the immediate preservation of the public peace, health and safety, or general welfare.

(e) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, including subdivisions (e) and (h) of Section 11346.1 of the Government Code, an emergency regulation adopted pursuant to this section shall be repealed by operation of law unless the adoption, amendment, or repeal of the regulation is promulgated by the office pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code within two years of the initial adoption of the emergency regulation.

(f) In its initial implementation of this section, the department shall seek historical data for three years before the effective date of the regulations described in subdivision (d).

(g) The provisions of this section are severable. If any provision of this section or its application is held invalid, that invalidity shall not affect other provisions or applications that can be given effect without the invalid provision or application.

history: (History: Added by Stats. 2025, Ch. 21, Sec. 41. (AB 116) Effective June 30, 2025.)


text:
(a) (1) The purpose of the system is to learn about and seek to improve public health, population health, social determinants of health, and the health care system, not about individual patients.

(2) All policies and procedures developed in implementing this chapter shall ensure that the privacy, security, and confidentiality of consumers’ individually identifiable health information is protected, consistent with state and federal privacy laws.

(b) The department shall develop policies regarding data aggregation and the protection of individual confidentiality, privacy, and security for individual consumers and patients.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 99. (AB 133) Effective July 27, 2021.)


text: The department shall develop an information security program that uses existing state standards and complies with applicable state and federal laws.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 100. (AB 133) Effective July 27, 2021.)


text:
The department shall include in an annual analysis, such as, but not limited to, the following:

(a) Population and regional level data on prevention, screening, and wellness utilization.

(b) Population and regional level data on chronic conditions, management, and outcomes.

(c) Population and regional level data on trends in utilization of procedures for treatment of similar conditions to evaluate medical appropriateness.

(d) Regional variation in payment level for the treatment of identified chronic conditions.

(e) Data regarding hospital and nonhospital payments, including inpatient, outpatient, and emergency department payments and nonhospital ambulatory service data.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 101. (AB 133) Effective July 27, 2021.)


text:
(a) The department shall use the program data to produce publicly available information, including data products, summaries, analyses, studies, and other reports, to support the goals of the program. The department shall receive input on priorities for the public information portfolio from the advisory committee. The department may establish a pricing mechanism for data products.

(b) The department may establish a public liaison function through which individuals may submit requests for specific products or analyses. The department may establish a pricing mechanism for custom reports. The department shall maintain copies of custom reports as part of the program public information portfolio.

(c) The department may establish a research program to conduct research, as defined in Section 164.501 of Title 45 of the Code of Federal Regulations, to support program policy goals.

(d) Publicly available data products and reports shall protect patient and consumer privacy.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 102. (AB 133) Effective July 27, 2021.)


text:
(a) (1) All personal consumer information obtained or maintained by the program shall be confidential.

(2) Only deidentified aggregate patient or other consumer data shall be included in a publicly available analysis, data product, or research.

(b) All policies and procedures developed in implementing this chapter shall ensure that the privacy, security, and confidentiality of consumers’ individually identifiable health information is protected, consistent with state and federal privacy laws, including the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA)(Public Law 104-191) and the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code), and data shall not be disclosed until the department has developed a policy regarding the release of data.

(c) (1) The system and all program data shall be exempt from the disclosure requirements of the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code), and shall not be made available except pursuant to this chapter.

(2) The department shall develop policies and procedures for the disclosure of information described in paragraph (2) of subdivision (a).

(d) Program data shall not be used for determinations regarding individual patient care or treatment and shall not be used for any individual eligibility or coverage decisions or similar purposes.

history: (History: Amended by Stats. 2022, Ch. 28, Sec. 106. (SB 1380) Effective January 1, 2023.)


text:
(a) The department shall develop a comprehensive program for data use, access, and release that includes data use agreements that require data users to comply with this chapter. The purpose of the data use, access, and release program is to ensure that only aggregated, deidentified information is publicly accessible.

(b) Access to nonpublic data shall be governed by the data use, access, and release program.

(c) To meet the research and policy goals of the program, controlled access to nonpublic data by outside data analysts, researchers, and other qualified applicants is necessary.

(d) The department shall establish a secure research environment for access to potentially identifiable information. The environment shall include access controls sufficient to ensure that users access only the data specified in an approved data request and that personal information is protected from unapproved use.

(e) The department shall, with the advice of the advisory committee and data release committee, develop criteria, policies, and procedures for access to and release of nonpublic data. The policies shall be designed to recognize a patient’s right of privacy and shall include at least the privacy protection standards specified in Section 127673.83.

(f) The department shall establish a pricing mechanism for the use of nonpublic data.

(g) The department shall maintain information about requests and the disposition of requests, and shall develop processes for the timely consideration and release of nonpublic data.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 104. (AB 133) Effective July 27, 2021.)


text:
(a) In accessing or obtaining nonpublic data through the secure environment, users shall only have access to the minimum amount of potentially identifiable data necessary for an approved project or access to a dataset designed for an approved purpose. Each person who accesses or obtains nonpublic personal data shall sign a data use agreement. Violation of a data use agreement shall be considered a violation of Section 1798.56 of the Civil Code and, if applicable, Section 1798.57 of the Civil Code.

(b) Access to data in the secure research environment shall be permissible as follows:

(1) If the data does not include any of the direct personal identifiers listed in Section 164.514(e) of Title 45 of the Code of Federal Regulations, access may be provided to qualified applicants for research and analysis purposes consistent with program goals.

(2) If the data includes any of the direct personal identifiers listed in Section 164.514(e) of Title 45 of the Code of Federal Regulations, access may be provided only to qualified applicants for research projects that offer significant opportunities to achieve program goals and meet all of the following criteria:

(A) Project approval has been recommended by the data release committee.

(B) The project has been approved by the Committee for the Protection of Human Subjects pursuant to subdivision (t) of Section 1798.24 of the Civil Code. Pursuant to that section, the department may release data to established nonprofit research institutions, the University of California, and other nonprofit educational institutions.

(C) The requester has documented expertise with privacy protection and with the analysis of large sets of confidential data.

(D) The research shall be made available to the department.

(c) The department’s policies shall limit release or transmittal of personal information outside the secure environment.

(1) The department may develop standardized limited datasets that do not include any of the direct personal identifiers listed in Section 164.514(e) of Title 45 of the Code of Federal Regulations, and have the minimum necessary personal information for types of purposes specified by the department. Standardized datasets may be transmitted to qualified applicants if the requester has documented expertise with privacy protection and with the analysis of large sets of confidential data, data security will meet the standards that the department shall apply to personal data, and project approval has been recommended by the data release committee.

(2) Data described in paragraph (2) of subdivision (b) may be transmitted to an outside researcher only if the researcher meets all the criteria of that paragraph, the researcher has documented expertise with data security and the protection of large sets of confidential data, and data security will meet the standards that the department shall apply to personal data.

(d) Program data, including personal information, may be shared with other state agencies pursuant to subdivision (e) of Section 1798.24 of the Civil Code. For purposes of that section, personal information has been collected for the purposes specified in Section 127671, which include analyzing and improving state programs related to public health and the provision of health care or health care coverage.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 105. (AB 133) Effective July 27, 2021.)


text:
(a) The department shall establish a data release committee with a membership of at least 7 and no more than 11 members appointed by the director. Notwithstanding any other law, a quorum shall be achieved with one fewer member than one-half of the full membership.

(b) The appointed members shall include representatives of health care payers, providers, suppliers, purchasers, researchers, consumers, and labor. Representatives of program data submitters shall not constitute a majority of members. The members shall have knowledge and experience with health care data, privacy, and security.

(c) Each appointed member shall serve a term of two years, except one-half of the initial appointments shall be for one year. The director may remove a member for cause.

(d) (1) The data release committee shall make recommendations about all applications seeking either program data with direct personal identifiers or the transmission of standardized datasets, except for data requests from other state agencies. Upon request of the director, the data release committee shall also make recommendations about other applications for program data.

(2) In making recommendations about applications seeking program data, except for data requests from other state agencies, the data release committee shall consider whether the use of the data is consistent with the goals of the system, whether it provides greater transparency regarding health care costs, utilization, quality, or equity, or how the information may be used to inform policy decisions regarding the provision of quality health care, improving public health, reducing health disparities, advancing health coverage, or reducing health care costs.

(e) Upon request of the director, the data release committee shall generally advise the director about privacy and security matters related to the program and provide feedback on the program’s data application review processes and other matters.

(f) The chairperson of the data release committee shall be appointed from among the members by the director.

(g) A member of the data release committee appointed from outside state government shall serve without compensation, but shall receive a per diem for each day’s attendance at a data release committee meeting. All members shall be reimbursed for any actual and necessary expenses incurred in connection with their duties as members of the committee.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 106. (AB 133) Effective July 27, 2021.)


text:
(a) The department shall expend the General Fund moneys appropriated in the 2018–19 Budget Act (Chapter 23 of the Statutes of 2019) for the purposes of this chapter and the former Health Care Transparency Database to fund the implementation and operation of the program.

(b) The Health Care Payments Data Program shall not be funded with General Fund moneys beyond moneys appropriated in the 2018–19 Budget Act.

(c) The Health Care Payments Data Fund is hereby established within the department for the purpose of receiving and expending revenues collected pursuant to this chapter.

(d) All revenues collected pursuant to this chapter shall be deposited in the fund. Any amounts raised by the collection of the revenues shall remain in the fund and shall be available in succeeding years upon appropriation by the Legislature.

(e) The department shall seek to maximize federal financial participation from the Medicaid program for the system, working through the sole state agency for Medicaid, the State Department of Health Care Services, and shall do so while relying on moneys appropriated from the General Fund in the 2018–19 Budget Act, and on an ongoing basis using any federally allowed fund source for the state match.

(f) (1) The department may impose a data user fee for an eligible user that is in compliance with this chapter, including, but not limited to, provisions related to consumer privacy and data security.

(2) In establishing the user fee schedule and fee waivers, the department shall work with the advisory committee to make considerations for state agencies, data submitters, and consumer organizations that have been awarded reasonable advocacy and witness fees in a proceeding or proceedings of the Department of Managed Health Care pursuant to Section 1348.9.

(3) The department shall adopt regulations on the fee waiver consistent with subdivisions (e) and (f) of Section 127673.

(g) On or before March 1, 2023, the office shall submit a report to the Legislature on recommendations for funding options for the program pursuant to Section 9795 of the Government Code.

(h) The department may accept foundation funding from foundations not affiliated or controlled by a health care entity.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 107. (AB 133) Effective July 27, 2021.)


text: The department shall notify the Department of Managed Health Care or the Department of Insurance, as appropriate, if a health care service plan or health insurer fails to comply with this chapter. The Department of Managed Health Care and the Department of Insurance shall take appropriate action necessary to bring the plan or insurer into compliance.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 108. (AB 133) Effective July 27, 2021.)


text:
(a) This chapter shall apply to a manufacturer of a prescription drug that is purchased or reimbursed by any of the following:

(1) A state purchaser in California, including, but not limited to, the Public Employees’ Retirement System, the State Department of Health Care Services, the Department of General Services, and the Department of Corrections and Rehabilitation, or an entity acting on behalf of a state purchaser.

(2) A licensed health care service plan.

(3) A health insurer holding a valid outstanding certificate of authority from the Insurance Commissioner.

(4) A pharmacy benefit manager as defined in subdivision (j) of Section 4430 of the Business and Professions Code.

(b) For the purposes of this chapter, the term “department” shall mean the Department of Health Care Access and Information.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 109. (AB 133) Effective July 27, 2021.)

path: 107. HEALTH CARE ACCESS AND INFORMATION > 2. HEALTH POLICY AND PLANNING > 9. Prescription Drug Pricing for Purchasers


text:
(a) The Legislature finds and declares that the State of California has a substantial public interest in the price and cost of prescription drugs. California is a major purchaser through the Public Employees’ Retirement System, the State Department of Health Care Services, the Department of General Services, the Department of Corrections and Rehabilitation, and other entities acting on behalf of a state purchaser. California also provides major tax expenditures through the tax exclusion of employer sponsored coverage and tax deductibility of coverage purchased by individuals, as well as tax deductibility of excess health care costs for individuals and families.

(b) (1) It is the intent of the Legislature in enacting this chapter to provide notice and disclosure of information relating to the cost and pricing of prescription drugs in order to provide accountability to the state for prescription drug pricing.

(2) It is further the intent of the Legislature to permit a manufacturer of a prescription drug to voluntarily make pricing decisions regarding a prescription drug, including any price increases. It is further the intent of the Legislature to permit purchasers, both public and private, as well as pharmacy benefit managers, to negotiate discounts and rebates consistent with existing state and federal law.

history: (History: Added by Stats. 2017, Ch. 603, Sec. 4. (SB 17) Effective January 1, 2018.)

chapter: 9. Prescription Drug Pricing for Purchasers


text:
(a) A manufacturer of a prescription drug with a wholesale acquisition cost of more than forty dollars ($40) for a course of therapy shall notify each purchaser described in Section 127675 if the increase in the wholesale acquisition cost of a prescription drug is more than 16 percent, including the proposed increase and the cumulative increases that occurred within the previous two calendar years prior to the current year. For purposes of this section, a “course of therapy” is defined as either of the following:

(1) The recommended daily dosage units of a prescription drug pursuant to its prescribing label as approved by the federal Food and Drug Administration for 30 days.

(2) The recommended daily dosage units of a prescription drug pursuant to its prescribing label as approved by the federal Food and Drug Administration for a normal course of treatment that is less than 30 days.

(b) The notice required by subdivision (a) shall be provided in writing at least 60 days prior to the planned effective date of the increase.

(c) (1) The notice required by subdivision (a) shall include the date of the increase, the current wholesale acquisition cost of the prescription drug, and the dollar amount of the future increase in the wholesale acquisition cost of the prescription drug.

(2) The notice required by subdivision (a) shall include a statement regarding whether a change or improvement in the drug necessitates the price increase. If so, the manufacturer shall describe the change or improvement.

(d) The notice required by subdivision (a) shall be provided to each state purchaser and other purchasers described in paragraphs (2) to (4), inclusive, of subdivision (a) of Section 127675 if a purchaser registers with the department for the purpose of this notification. The department shall make available to manufacturers a list of registered purchasers for the purpose of this notification.

(e) If a pharmacy benefit manager receives a notice of an increase in wholesale acquisition cost consistent with subdivision (a), it shall notify its large contracting public and private purchasers of the increase. For the purposes of this section, a “large purchaser” means a purchaser that provides coverage to more than 500 covered lives.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 110. (AB 133) Effective July 27, 2021.)


text:
(a) On a quarterly basis at a time prescribed by the department and in a format prescribed by the department, commencing no earlier than January 1, 2019, a manufacturer shall report to the department all of the following information for each drug for which an increase in wholesale acquisition cost is described in Section 127677:

(1) A description of the specific financial and nonfinancial factors used to make the decision to increase the wholesale acquisition cost of the drug and the amount of the increase, including, but not limited to, an explanation of how these factors explain the increase in the wholesale acquisition cost of the drug.

(2) A schedule of wholesale acquisition cost increases for the drug for the previous five years if the drug was manufactured by the company.

(3) If the drug was acquired by the manufacturer within the previous five years, all of the following information:

(A) The wholesale acquisition cost of the drug at the time of acquisition and in the calendar year prior to acquisition.

(B) The name of the company from which the drug was acquired, the date acquired, and the purchase price.

(C) The year the drug was introduced to market and the wholesale acquisition cost of the drug at the time of introduction.

(4) The patent expiration date of the drug if it is under patent.

(5) If the drug is a multiple source drug, an innovator multiple source drug, a noninnovator multiple source drug, or a single source drug, as defined in subparagraph (A) of paragraph (7) of subdivision (k) of Section 1396r–8 of Title 42 of the United States Code.

(6) A description of the change or improvement in the drug, if any, that necessitates the price increase.

(7) Volume of sales of the manufacturer’s drug in the United States for the previous year.

(b) The manufacturer may limit the information reported pursuant to subdivision (a) to that which is otherwise in the public domain or publicly available.

(c) The department shall publish the information provided to it pursuant to this section on its internet website on no less than a quarterly basis. The information shall be published within 60 days of receipt from a manufacturer. The information shall be published in a manner that identifies the information that is disclosed on a per-drug basis and shall not be aggregated in a manner that would not allow identification of the drug.

(d) The department shall be responsible for the enforcement of this section.

(e) A manufacturer of a prescription drug subject to this chapter that does not report the information required pursuant to this section is liable for a civil penalty of one thousand dollars ($1,000) per day for every day after the reporting period described in this section that the required information is not reported.

(f) A civil penalty shall be assessed and recovered in a civil action brought by the office in the name of the people of the State of California. Assessment of a civil penalty may, at the request of any manufacturer of a prescription drug subject to this section, be reviewed on appeal, and the penalty may be reduced or waived for good cause.

(g) Any money received by the department pursuant to this section shall be paid into the Managed Care Fund.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 111. (AB 133) Effective July 27, 2021.)


text:
(a) A manufacturer of a prescription drug shall notify the department in writing if it is introducing a new prescription drug to market at a wholesale acquisition cost that exceeds the threshold set for a specialty drug under the Medicare Part D program (Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173)). The notice shall be provided in writing within three days after the release of the drug in the commercial market. A manufacturer may make this notification pending approval by the federal Food and Drug Administration, if commercial availability is expected within three days of approval.

(b) No later than 30 days after notification pursuant to this section, a manufacturer shall report all of the following information to the department in a format prescribed by the department:

(1) A description of the marketing and pricing plans used in the launch of the new drug in the United States and internationally.

(2) The estimated volume of patients that may be prescribed the drug.

(3) If the drug was granted breakthrough therapy designation or priority review by the federal Food and Drug Administration prior to final approval.

(4) The date and price of acquisition if the drug was not developed by the manufacturer.

(c) The manufacturer may limit the information reported pursuant to subdivision (b) to that which is otherwise in the public domain or publicly available.

(d) The department shall publish the information provided to it pursuant to this section on its internet website on no less than a quarterly basis. The information shall be published in a manner that identifies the information that is disclosed on a per-drug basis and shall not be aggregated in a manner that would not allow identification of the drug.

(e) The department shall be responsible for the enforcement of this section.

(f) A manufacturer of a prescription drug subject to this chapter that does not report the information required pursuant to this section is liable for a civil penalty of one thousand dollars ($1,000) per day for every day after the notification period described in this section that the required information is not reported.

(g) A civil penalty shall be assessed and recovered in a civil action brought by the department in the name of the people of the State of California. Assessment of a civil penalty may, at the request of any manufacturer of a prescription drug subject to this section, be reviewed on appeal, and the penalty may be reduced or waived for good cause.

(h) Any money received by the department pursuant to this section shall be paid into the Managed Care Fund.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 112. (AB 133) Effective July 27, 2021.)


text:
(a) Funding for the actual and necessary expenses of the department to conduct the activities described in this section and in Sections 127676, 127679, 127681, and 127685, shall be provided, subject to appropriation by the Legislature, from transfers of moneys from the Managed Care Fund and the Insurance Fund.

(b) The share of funding from the Managed Care Fund shall be based on the number of covered lives in the state that are covered under plans regulated by the Department of Managed Health Care, including covered lives under Medi-Cal managed care, as determined by the Department of Managed Health Care, in proportion to the total number of all covered lives in the state.

(c) The share of funding to be provided from the Insurance Fund shall be based on the number of covered lives in the state that are covered under health insurance policies and benefit plans regulated by the Department of Insurance, including covered lives under Medicare supplement plans, as determined by the Department of Insurance, in proportion to the total number of all covered lives in the state.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 113. (AB 133) Effective July 27, 2021.)


text:
(a) The department may adopt regulations or issue guidance for the implementation of this chapter. All information that is required to be reported to the department pursuant to this chapter shall be reported in a form prescribed by the department, commencing in the first calendar quarter of 2019.

(b) The department may consult with the Department of Managed Health Care, the Department of Insurance, the California State Board of Pharmacy, and any state purchaser of prescription drugs, or an entity acting on behalf of a state purchaser, in issuing guidance or adopting necessary regulations pursuant to subdivision (a), in posting information on its internet website pursuant to this chapter, and in taking any other action for the purpose of implementing this chapter.

history: (History: Amended by Stats. 2021, Ch. 143, Sec. 114. (AB 133) Effective July 27, 2021.)


text: This chapter may be cited as the California Affordable Drug Manufacturing Act of 2020.

history: (History: Added by Stats. 2020, Ch. 207, Sec. 1. (SB 852) Effective January 1, 2021.)

path: 107. HEALTH CARE ACCESS AND INFORMATION > 2. HEALTH POLICY AND PLANNING > 10. California Affordable Drug Manufacturing Act of 2020


text:
For purposes of this chapter, the following definitions apply:

(a) “Generic drug” means a drug that is approved pursuant to subdivision (j) of Section 355 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. Sec. 301 et seq.), or a biosimilar, as defined under the federal Public Health Service Act (42 U.S.C. Sec. 262).

(b) “Partnerships” include, but are not limited to, agreements for the procurement of generic prescription drugs by way of contracts, grant agreements, or purchasing by a payer, state governmental agency, group purchasing organization, nonprofit organization, or other entity.

(c) “California Health and Human Services Agency” or “CHHSA” means the California Health and Human Services Agency, or any of its departments, including the Department of Health Care Access and Information, selected to implement this chapter.

history: (History: Amended by Stats. 2023, Ch. 42, Sec. 50. (AB 118) Effective July 10, 2023.)

chapter: 10. California Affordable Drug Manufacturing Act of 2020


text:
(a) The California Health and Human Services Agency (CHHSA) or its departments shall enter into partnerships, consistent with subdivision (b) of Section 127693, in consultation with other state departments as necessary, to increase competition, lower prices, and address shortages in the market for generic prescription drugs, to reduce the cost of prescription drugs for public and private purchasers, taxpayers, and consumers, and to increase patient access to affordable drugs.

(b) For purposes of implementing this chapter, CHHSA and its departments, including the Department of Health Care Access and Information, may enter into exclusive or nonexclusive contracts on a bid or negotiated basis. Contracts entered into or amended pursuant to this section are exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code and Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and are exempt from the review or approval of any division of the Department of General Services. When appropriate, CHHSA shall establish initial and ongoing metrics to measure progress and efficiency, and remedies in the case those metrics are not met in any partnership contract entered into pursuant to this section.

(c) CHHSA shall have the ability to hire staff or contractors to oversee and project-manage the partnerships for manufacturing, procurement, or distribution of generic prescription drugs, contingent upon an appropriation by the Legislature for this purpose.

(d) It is the Legislature’s intent that any manufacturing partnership contract entered into pursuant to subdivision (b) is a partnership intended to create a California-branded label for generic drugs. It is further the Legislature’s intent that any manufacturing that is done under this section is intended to benefit the residents of this state by ensuring adequate supplies and access to generic prescription drugs and lowering health care costs through savings to public health care programs and private health insurance coverage.

history: (History: Amended by Stats. 2023, Ch. 42, Sec. 51. (AB 118) Effective July 10, 2023.)