I am pleased to announce that Assembly Bill 512 (AB 512), the Timely Access to Care Act, has been signed into law! Starting January 1, 2026, this new legislation will shorten prior authorization timelines and speed up prior authorization to ensure Californians are not left waiting for essential care.
Why AB 512 Matters:
Delays in prior authorization decisions can prevent patients from receiving timely care, leading to worsened health outcomes and unnecessary suffering. By shortening review timelines, especially for urgent requests, AB 512 ensures that patients can access critical treatments more quickly, reduces administrative barriers for providers, and helps align health plan processes with the speed of modern electronic communication. Ultimately, the bill prioritizes patient health and improves efficiency in the healthcare system.
What AB 512 Does
- Current Prior Authorization Timelines
- Under current law, health plans must respond to prior authorization requests within
- 72 hours for urgent requests, and
- 5 business days for non-urgent requests.
- Changes Under AB 512
- AB 512 shortens these timelines:
- Urgent requests:
- Submitted electronically - reduced from 72 hours to 24 hours.
- Submitted non-electronically - reduced from 72 hours to 48 hours.
- Non-urgent requests:
- Submitted electronically - reduced from 5 business days to 3 business days.
- Submitted non-electronically - remains at 5 business days.
- Urgent requests:
- AB 512 shortens these timelines:
- Under current law, health plans must respond to prior authorization requests within
Guidance for Patients:
If your health plan is not following the new prior authorization timelines, reach out to your health care provider to file a complaint. If you encounter any difficulties, you can also file a complaint directly with the appropriate state agency.
The agency you contact depends on the type of health coverage you have. The Department of Managed Health Care (DMHC) regulates most HMOs and many Covered California plans, the Department of Insurance (CDI) oversees most PPOs and other insurance products, and the Department of Health Care Services (DHCS) manages Medi-Cal.
- Identify Your Plan Type
- HMO (Health Maintenance Organization): Most HMO complaints go to the DMHC.
- PPO (Preferred Provider Organization): Most PPO complaints go to the CDI.
- Covered California: Start with the DMHC. If your plan is regulated by the CDI, the DMHC will redirect you.
- Medi-Cal: Overseen by the DHCS.
- Contact the Right Agency
- DMHC (HMOs and most Covered California plans): File a complaint through the DMHC’s “File a Complaint” page or call their Help Center for support at 1-888-466-2219.
- CDI (PPOs and other insurance products):File a complaint with the CDI or reach out to their Consumer Services Division for assistance at 800-927-4357.
- DHCS (Medi-Cal): For issues with Medi-Cal services, file a complaint with DHCS.
- Additional Resources
- You can also contact our district office at (626) 351-1917.
We extend our sincere thanks to our sponsor, the California Medical Association, and to Governor Gavin Newsom for signing this critical measure into law.
AB 512 is a step forward in innovating our healthcare system and putting patients first.
