The California Department of Managed Health Care (DMHC) released its 2025 Year in Review Highlights newsletter, covering various topics, including responses to federal policy changes, prescription drug costs, access to care, and enforcement actions.
Included in the newsletter was a recap of 2025 legislative actions, including:
- Assembly Bill (AB) 260, which prohibits a health plan with prescription drug benefits from limiting coverage for mifepristone, regardless of its Food and Drug Administration approval status, if it is recognized by the World Health Organization, the National Academies of Science, Engineering, and Medicine, or state-approved peer-reviewed studies. This bill took effect on September 26, 2025.
- Senate Bill (SB) 40, which prohibits a health plan from imposing a copayment or other cost-sharing requirement of more than $35 for a 30-day supply of an insulin prescription drug. The bill also prohibits a health plan from requiring step therapy for at least one formulation of insulin in specified categories. This bill takes effect on January 1, 2026, for large group health plans, and on January 1, 2027, for small group and individual health plans.
Other legislative items discussed focus on health plan and pharmacy benefit manager practices, essential health benefits (contingent on other actions), payment to providers, and several other areas. Also included is a summary of AB 951, which NFP reviewed in a prior September 2025 Compliance Corner article New California Law Prohibits Rediagnosis Requirements for Certain Behavioral Health Treatments.
To read the full text, see DMHC’s newsletter 2025 Year in Review Highlights. To view the finalized version passed by California’s legislature, click Assembly Bill (AB) 260 or Senate Bill (SB) 40.