Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the acts requirements a crime. Existing law requires a health care service plan to notify an enrollee by United States mail at least 60 days before the termination date of a contract between a health care service plan and a provider group or a general acute care hospital to which the enrollee is assigned. If the plan reaches an agreement with a terminated provider after sending that notice, existing law requires the plan to offer each affected enrollee the option to return to that provider and to reassign the enrollee to another provider if the enrollee does not exercise that option.

This bill would additionally require a health care service plan to notify an enrollee by email or text message, as specified and only if the enrollee has opted in and provided their contact information, at least 60 days before the termination date of a contract between a health care service plan and a provider group or a general acute care hospital to which the enrollee is assigned. If the plan reaches an agreement with a terminating or terminated provider after sending the notice of termination, the bill would require the health care service plan to send written notice by United States mail and by email or text message, as specified and only if the enrollee has opted in and provided their contact information, to affected enrollees no later than 10 business days after department approval of the notice. If the agreement is to renew, enter into a new contract, or to not terminate their contract before the termination date in the notice of termination, the bill would require the health care service plan to notify enrollees that they will remain assigned to the provider. If the agreement is to renew, enter into a new contract, or to not terminate their contract after the termination date in the notice of termination, the bill would require the health care service plan to notify and offer each affected enrollee the option to return to that provider. The bill would require a health care service plan to submit these notices to the department for approval within 5 business days of reaching an agreement. Because a willful violation of these provisions would be a crime, this bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the acts requirements a crime. Existing law requires a health care service plan to notify an enrollee by United States mail at least 60 days before the termination date of a contract between a health care service plan and a provider group or a general acute care hospital to which the enrollee is assigned. If the plan reaches an agreement with a terminated provider after sending that notice, existing law requires the plan to offer each affected enrollee the option to return to that provider and to reassign the enrollee to another provider if the enrollee does not exercise that option.

This bill would additionally require a health care service plan to notify an enrollee by email or text message, as specified and only if the enrollee has opted in and provided their contact information, at least 60 days before the termination date of a contract between a health care service plan and a provider group or a general acute care hospital to which the enrollee is assigned. If the plan reaches an agreement with a terminating or terminated provider after sending the notice of termination, the bill would require the health care service plan to send written notice by United States mail and by email or text message, as specified and only if the enrollee has opted in and provided their contact information, to affected enrollees no later than 10 business days after department approval of the notice. If the agreement is to renew, enter into a new contract, or to not terminate their contract before the termination date in the notice of termination, the bill would require the health care service plan to notify enrollees that they will remain assigned to the provider. If the agreement is to renew, enter into a new contract, or to not terminate their contract after the termination date in the notice of termination, the bill would require the health care service plan to notify and offer each affected enrollee the option to return to that provider. The bill would require a health care service plan to submit these notices to the department for approval within 5 business days of reaching an agreement. Because a willful violation of these provisions would be a crime, this bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the acts requirements a crime. Existing law requires a health care service plan to notify an enrollee by United States mail at least 60 days before the termination date of a contract between a health care service plan and a provider group or a general acute care hospital to which the enrollee is assigned. If the plan reaches an agreement with a terminated provider after sending that notice, existing law requires the plan to offer each affected enrollee the option to return to that provider and to reassign the enrollee to another provider if the enrollee does not exercise that option.

This bill would additionally require a health care service plan to notify an enrollee by email or text message, as specified and only if the enrollee has opted in and provided their contact information, at least 60 days before the termination date of a contract between a health care service plan and a provider group or a general acute care hospital to which the enrollee is assigned. If the plan reaches an agreement with a terminating or terminated provider after sending the notice of termination, the bill would require the health care service plan to send written notice by United States mail and by email or text message, as specified and only if the enrollee has opted in and provided their contact information, to affected enrollees within 60 days of reaching the agreement. no later than 10 business days after department approval of the notice. If the agreement is to renew, enter into a new contract, or to not terminate their contract before the termination date in the notice of termination, the bill would require the health care service plan to notify enrollees that they will remain assigned to the provider. If the agreement is to renew, enter into a new contract, or to not terminate their contract after the termination date in the notice of termination, the bill would require the health care service plan to notify and offer each affected enrollee the option to return to that provider. The bill would require a health care service plan to submit these notices to the department for approval within 5 business days of reaching an agreement. Because a willful violation of these provisions would be a crime, this bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the acts requirements a crime. Existing law requires a health care service plan to notify an enrollee by United States mail at least 60 days before the termination date of a contract between a health care service plan and a provider group or a general acute care hospital to which the enrollee is assigned. If the plan reaches an agreement with a terminated provider after sending that notice, existing law requires the plan to offer each affected enrollee the option to return to that provider and to reassign the enrollee to another provider if the enrollee does not exercise that option.

This bill would additionally require a health care service plan to notify an enrollee by email or text message, as specified, specified and only if the enrollee has opted in and provided their contact information, at least 60 days before the termination date of a contract between a health care service plan and a provider group or a general acute care hospital to which the enrollee is assigned. If the plan reaches an agreement with a terminated provider after sending the notice of termination, the bill would require the health care service plan to send written notice by United States mail and by email or text message, as specified, specified and only if the enrollee has opted in and provided their contact information, to affected enrollees within 60 days of reaching the agreement. Because a willful violation of these provisions would be a crime, this bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the acts requirements a crime. Existing law requires a health care service plan to notify an enrollee by United States mail at least 60 days before the termination date of a contract between a health care service plan and a provider group or a general acute care hospital to which the enrollee is assigned. If the plan reaches an agreement with a terminated provider after sending that notice, existing law requires the plan to offer each affected enrollee the option to return to that provider and to reassign the enrollee to another provider if the enrollee does not exercise that option.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law requires a health care service plan to meet specified requirements, including notice requirements, and requires a health care service plan contract to provide to subscribers and enrollees specified basic health care services.

This bill would state the intent of the Legislature to enact legislation to require health care service plans to provide clear notice to consumers about their health care coverage.

CONCURRENCE IN SENATE AMENDMENTS

CSA1 Bill Id:AB 2613

Author:(Sharp-Collins)

As Amended Ver:August 21, 2026

Majority vote

SUMMARY

Requires a health plan to send written notice via text message or email, in addition to U.S. mail, to an affected enrollee at least 60 days before the termination date of a contract between the health plan and a provider group or a general acute care hospital, as specified. If, after sending the notice, the health plan reaches an agreement to continue the contract with the provider group or hospital, this bill requires the health plan to notify the Department of Managed Health Care (DMHC) within five business days and notify the enrollee within 10 business days of DMHC approval by U.S. mail and either text message or email.

Senate Amendments

1. Qualify notification of hospital contract termination to only apply if the enrollee is assigned to a provider group that has admitted at least one enrollee to the terminating hospital within the past 12 months.
2. Require a health plan, if they reach an agreement with a provider to renew or enter into a new contract or to not terminate their contract before the termination date, to keep the enrollee assigned to the provider they were assigned to prior to notification being sent.
3. Shorten timelines for DMHC and patient notification after an agreement is made with a provider.
4. Require electronic notification to only apply if the enrollee has opted into electronic delivery as their communication preference with the health plan and has included contact information.

COMMENTS

A block transfer occurs when a health plan moves a block of members all at once from a terminated provider group or hospital to a new one. This occurs when a contract between a health plan and the provider group or hospital is terminated or is not renewed. To ensure that enrollees aren’t left without access to care upon termination, health plans are required to plan and arrange for the transfer to new providers ahead of the termination date. Current state law and regulations require health plans to submit a block transfer filing to DMHC at least 75 days before a potential contract termination date, DMHC must subsequently review impacts and notifications that will be sent out to enrollees. After DMHC's review, plans are then statutorily required to notify enrollees by mail at least 60 days prior to the termination and transfer date. If the contract with the provider is terminated, state law requires health plans to cover the completion of covered services by a terminated provider, if requested by an enrollee for the treatment of certain conditions, and if the provider and health plan agree on terms and reimbursement. Additionally, if the provider contract is reinstated the health plan must offer the enrollee the option to return.

According to the Author

Across California, patients are increasingly caught in the middle of disputes and network changes driven by large health systems and insurance company negotiations. The author continues that when contracts break down or networks shift, patients are often reassigned to new providers with little notice. The author notes that at the same time, our notification laws remain stuck in the past. The author states that health plans continue to rely on paper mail as the primary method of communication, even as most Californians live and communicate in a digital world. The author argues that these notices are often delayed, inaccessible, or never received, leaving patients unaware of major changes until they are denied care or faced with unexpected costs. The author concludes that this bill requires automatic reinstatement of patients to their original provider when a network transition fails and modernizes notification requirements by allowing health plans to communicate through timely electronic methods, so patients receive critical information without delay.

Arguments in Support

Health Access California (HAC) supports this bill, stating that health plans continue to rely on paper mail as the primary method of communication, even while many Californians rely on digital options including email. HAC continues that for low-income patients who may move often, people with mobility issues or others with limited access to mail for differing reasons, this bill will improve their access to crucial updates from the plans and improve their access to essential care.

Arguments in Opposition

The California Association of Health Plans (CAHP) and the Association of California Life and Health Insurance Companies (ACLHIC) request an amendment to allow health plans the option of offering their enrollees an electronic delivery notification in lieu of U.S. mail, rather than both. CAHP and ACLHIC believe this bill could delay necessary reassignments because they could occur after the enrollee decides whether they would like to return to their previous provider, so they request reverting the bill back to existing law.

FISCAL COMMENTS

According to the Senate Appropriations Committee, pursuant to Senate Rule 28.8, negligible state costs.

VOTES:

ASM HEALTH: 16-0-0

YES: Bonta, Chen, Addis, Aguiar-Curry, Ahrens, Caloza, Carrillo, Mark González, Johnson, Patel, Patterson, Rogers, Sanchez, Schiavo, Sharp-Collins, Stefani

ASM APPROPRIATIONS: 15-0-0

YES: Wicks, Hoover, Bauer-Kahan, Calderon, Caloza, Ellis, Fong, Mark González, Krell, Pacheco, Pellerin, Sharp-Collins, Solache, Ta, Tangipa

ASSEMBLY FLOOR: 74-0-6

YES: Addis, Aguiar-Curry, Ahrens, Alanis, Alvarez, Ávila Farías, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Caloza, Carrillo, Castillo, Connolly, Davies, DeMaio, Dixon, Elhawary, Ellis, Flora, Fong, Gabriel, Gallagher, Gipson, Jeff Gonzalez, Mark González, Hadwick, Haney, Harabedian, Hart, Hoover, Irwin, Jackson, Johnson, Kalra, Krell, Lee, Lowenthal, Macedo, McKinnor, Muratsuchi, Nguyen, Ortega, Pacheco, Papan, Patel, Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ransom, Michelle Rodriguez, Rogers, Blanca Rubio, Sanchez, Schiavo, Schultz, Sharp-Collins, Solache, Soria, Stefani, Ta, Tangipa, Valencia, Wallis, Ward, Wicks, Wilson, Zbur, Rivas

ABS, ABST OR NV: Arambula, Chen, Garcia, Lackey, Ramos, Celeste Rodriguez

UPDATED

VERSION: August 21, 2026

CONSULTANT: Riana King / HEALTH / (916) 319-2097 FN: 0004102

 THIRD READING  

Bill No: AB 2613

Author: Sharp-Collins (D), et al.

Amended: 8/21/26 in Senate

Vote: 21

SENATE HEALTH COMMITTEE: 11-0, 6/24/26

AYES: Weber Pierson, Valladares, Caballero, Durazo, Gonzalez, Grove, Menjivar, Padilla, Pérez, Rubio, Smallwood-Cuevas

SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8

ASSEMBLY FLOOR: 74-0, 5/21/26 - See last page for vote

SUBJECT: Health care service plans: provider contract termination: notice

SOURCE: Author

DIGEST:

This bill 1) requires a health plan in a contract renewal dispute with a provider group or hospital to notify affected enrollees by text or email, if the enrollee has opted into electronic delivery and has included the necessary contact information, in addition to existing requirements to provide a notice by U.S. mail, 60 days before the termination date; and 2) requires, if the contract dispute is resolved prior to the termination date, the affected enrollees to be notified by text or email and U.S. mail that the enrollee can remain with their provider, and if the dispute is resolved after the termination date, notification that the enrollee has an option to return to their provider.

Senate Floor Amendments of 8/21/26:

1) Make clarifications to existing law that requires plans to send a written notice by U.S. mail at least 60 days before a contract termination to enrollees who are assigned to the terminating provider group or “assigned to a provider group that has admitted at least one enrollee to the terminating general acute care hospital within the past 12 calendar months” of the health plan’s block transfer filing.

2) Replace the term “terminated” with “terminating” through-out.

3) Require if there is an agreement and the contract is not terminated by the date specified, the plan to notify each affected enrollee of the agreement and notify enrollees that they will remain assigned to the provider to whom the enrollee was assigned prior to the notices being sent. Require if after the termination date specified there is an agreement and the contract is not terminated, the plan to notify and offer each affected enrollee the option to return to that provider.

4) Require within five business days (rather than 60 days) of reaching agreement, the plan to submit to the Department of Managed Health Care the written notices for approval, and no later than ten business days after approval, the plan to send the notice by U.S. mail to enrollees.

5) Exempt Medi-Cal managed care plans from this bill.

ANALYSIS:

Existing law:

1. Establishes the Department of Managed Health Care (DMHC) to regulate health plans under the Knox-Keene Health Care Service Plan Act of 1975 (Knox-Keene Act). [Health and Safety Code (HSC) §1340, et seq.]
2. Requires a health plan, at least 75 days before the termination date of its contract with a provider group or a hospital, to submit an enrollee block transfer filing to DMHC that includes the written notice the plan proposes to send to affected enrollees. Prohibits the plan from sending this notice to enrollees until DMHC has reviewed and approved its content. Requires, if DMHC does not respond within seven days of the date of its receipt of the filing, the notice to be deemed approved. Authorizes, if an individual provider terminates the provider’s contract or employment with a provider group that contracts with a health plan, the plan to require that the provider group to send the notice. [HSC §1373.65]
3. Requires a health plan, at least 60 days before the termination date of a contract between a health plan and a provider group or a hospital, to send a written block transfer notice by U.S. mail to enrollees who are assigned to the terminated provider group or hospital. [HSC §1373.65]
4. Requires a health plan that is unable to comply with the 60 days prior to termination timeframe because of exigent circumstances to apply to DMHC for a waiver. Makes the plan excused from complying with this requirement only if its waiver application is granted or DMHC does not respond within seven days of the date of its receipt of the waiver application. Requires the plan, if the terminated provider is a hospital and the plan assigns enrollees to a provider group with exclusive admitting privileges to the hospital, to send the written notice to each enrollee who is a member of the provider group and who resides within a 15-mile radius of the terminated hospital. Requires the plan, if it operates as a preferred provider organization or assigns members to a provider group with admitting privileges to hospitals in the same geographic area as the terminated hospital, the plan to send the written notice to all enrollees who reside within a 15-mile radius of the terminated hospital. [HSC §1373.65]
5. Requires a health plan, if after sending the notice required in 2) above it reaches an agreement with a terminated provider to renew or enter into a new contract or does not terminate the contract, to offer each enrollee the option to return to that provider, and if the enrollee does not exercise this option, requires the plan to reassign the enrollee to another provider. [HSC §1373.65]
6. Requires a health plan and a provider to include in all written, printed, or electronic communications sent to an enrollee concerning a contract termination or block transfer, the following statement in not less than 8-point type: “If you have been receiving care from a health care provider, you may have a right to keep your provider for a designated time period. Please contact your health plan’s customer service department, and if you have further questions, you are encouraged to contact DMHC, which protects consumers, by telephone at its toll-free number, 1-888-466-2219, or at a TDD number for the hearing and speech impaired at 1-877-688-9891, or online at www.dmhc.ca.gov.” [HSC §1373.65]

This bill:

1. Requires the health plan, in addition to sending a written notice by U.S. mail regarding the termination of a contract, to send the written notice to the enrollee electronically at least 60 days before the termination date of the contract via either of the following methods if the enrollee has opted into electronic delivery as their communication preference and has included the contact information described below:
   1. Text message to the preferred or last known cell phone number of the enrollee; or,
   2. Email to the preferred or last known email address of the enrollee.
2. Requires if after sending the notice above, a health plan reaches agreement with a terminating provider to renew or enter into a new contract or to not terminate their contract before the termination date specified in the notice in 1), the plan to notify each affected enrollee of the agreement and notify enrollees that they will remain assigned to the provider whom the enrollee was assigned prior to the notice being sent by the plan.
3. Requires if, after sending the notice required in 1) above, a plan reaches an agreement with a terminated provider to renew or enter in a new contract or to not terminate their contract after the termination date specified in the notice in 1), the plan to notify and offer each affected enrollee the option to return to that provider.
4. Requires within five business days of reaching an agreement described in 2) or 3) the plan to submit to DMHC the written notice described in 2) or 3) for approval. Requires no later than 10 business days after DMHC approval, the plan to send written notice by U.S. mail to enrollees who received the notice in 1). Requires in addition to the written notice by U.S. mail, the plan to send written notice to the enrollee electronically no later 10 business days after DMHC approval via either of the following methods if the enrollee has opted into electronic delivery as their communication preference and has included the contact information described below:
   • 1. Text message to the preferred or last known cell phone number of the enrollee; or,
     2. Email to the preferred or last known email address of the enrollee.
5. Exempts Medi-Cal managed care plans from this bill.

Background

According to the author:

Across California, patients are increasingly caught in the middle of disputes and network changes driven by large health systems and insurance companies. When contracts break down or networks shift, patients are often reassigned to new providers with little notice. At the same time, our notification laws remain stuck in the past. Health plans continue to rely on paper mail as the primary method of communication, even as most Californians live and communicate in a digital world. These notices are often delayed, inaccessible, or never received, leaving patients unaware of major changes until they are denied care or faced with unexpected costs. This bill modernizes notification requirements by allowing health plans to communicate through timely electronic methods, so patients receive critical information without delay.

Block Transfer requirements. Before the termination date of its contract with a provider group or a general acute care hospital, health plans must submit an enrollee Block Transfer Filing to DMHC. DMHC reviews these filings to ensure compliance with applicable statutory (Knox-Keene Act) and regulatory (California Code of Regulations title 28) requirements. DMHC’s review ensures (1) that the network remains adequate without the terminating provider group or hospital; and, (2) that the impacted enrollees are timely notified of the termination and informed of their rights. If DMHC approves a Block Transfer Filing, the health plan may inform its enrollees of the termination and redirect the enrollees to the alternate providers. During the block transfer filing review, DMHC also requests confirmation that health plans have reached a continuity of care agreement with terminating hospitals and provider groups which specifies reimbursement rates for the completion of covered services.

Continuity of care. Existing law allows an enrollee to request continuity of care when a doctor, medical group or hospital is no longer contracting with a health plan. The provider must agree to keep the enrollee as a patient and agree to the health plan reimbursement. Enrollees with certain conditions can obtain continuity of care if the provider agrees. For example, acute conditions, serious chronic conditions, pregnancy, terminal illness, children under three, or an already scheduled surgery or procedure would qualify. Continuity of care may last as long as the condition exists or may be limited after a course of treatment is completed and the patient can be transitioned to a provider in the plan’s network. Enrollee transfer notices must include a website link to the plan’s continuity of care policies also called completion of covered services or care, which are reviewed by DMHC. In addition, the health plans’ enrollee transfer notices must include details related to the conditions eligible for completion of care, how to request completion of care, and a statement providing information on how enrollees can contact the DMHC’s Help Center for assistance.

Notice to request completion of covered services must also be provided to enrollees in every health plan disclosure form and in any evidence of coverage documents. A health plan must also provide this notice to its providers, to its enrollees upon request, along with a specified termination of coverage notice. If enrollees are hospitalized through the emergency room, there are post-stabilization procedures that health plans must follow to authorize continued care at the hospital or to arrange for transfer to an authorized hospital. These procedures would be effective whether the hospital is contracted, non-contracted, or recently terminated.

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: Yes

SUPPORT: (Verified 8/21/26)

Health Access California

OPPOSITION: (Verified 8/21/26)

Association of California Life & Health Insurance Companies

California Association of Health Plans

ARGUMENTS IN SUPPORT: Health Access California writes, “When contracts break down between health systems and insurance companies, patients are left in the middle. While existing law requires health plans to cover the completion of services by a terminated provider, it is only if requested by the enrollee and if the provider and plan agree on terms and reimbursement. As such, this continued care is often challenging to access. Health plans continue to rely on paper mail as the primary method of communication, even while many Californians rely on digital options including email. For low-income patients who may move often, people with mobility issues or others with limited access to mail for differing reasons, this bill will improve their access to crucial updates from the plans and improve their access to essential care.”

ARGUMENTS IN OPPOSITION: The California Association of Health Plans (CAHP) and the Association of California Life and Health Insurance Companies (ACLHIC) request an amendment to allow health plans the option of offering their enrollees an electronic delivery notification in lieu of U.S. mail, rather than both. CAHP and ACLHIC believe this bill could delay necessary reassignments because they could occur after the enrollee decides whether they would like to return to their previous provider, so they request reverting the bill back to existing law.

ASSEMBLY FLOOR: 74-0, 5/21/26

AYES: Addis, Aguiar-Curry, Ahrens, Alanis, Alvarez, Ávila Farías, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Caloza, Carrillo, Castillo, Connolly, Davies, DeMaio, Dixon, Elhawary, Ellis, Flora, Fong, Gabriel, Gallagher, Gipson, Jeff Gonzalez, Mark González, Hadwick, Haney, Harabedian, Hart, Hoover, Irwin, Jackson, Johnson, Kalra, Krell, Lee, Lowenthal, Macedo, McKinnor, Muratsuchi, Nguyen, Ortega, Pacheco, Papan, Patel, Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ransom, Michelle Rodriguez, Rogers, Blanca Rubio, Sanchez, Schiavo, Schultz, Sharp-Collins, Solache, Soria, Stefani, Ta, Tangipa, Valencia, Wallis, Ward, Wicks, Wilson, Zbur, Rivas

NO VOTE RECORDED: Arambula, Chen, Garcia, Lackey, Ramos, Celeste Rodriguez

Prepared by: Teri Boughton / HEALTH / (916) 651-4111

8/24/26 13:28:08

**** END ****

 THIRD READING  

Bill No: AB 2613

Author: Sharp-Collins (D), et al.

Amended: 6/29/26 in Senate

Vote: 21

SENATE HEALTH COMMITTEE: 11-0, 6/24/26

AYES: Weber Pierson, Valladares, Caballero, Durazo, Gonzalez, Grove, Menjivar, Padilla, Pérez, Rubio, Smallwood-Cuevas

SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8

ASSEMBLY FLOOR: 74-0, 5/21/26 - See last page for vote

SUBJECT: Health care service plans: provider contract termination: notice

SOURCE: Author

DIGEST:

This bill 1) requires a health plan in a contract renewal dispute with a provider group or hospital to notify affected enrollees by text or email, if the enrollee has opted into electronic delivery and has included the necessary contact information, in addition to existing requirements to provide a notice by U.S. mail, 60 days before the termination date; and 2) requires, if the contract dispute is resolved, the affected enrollees to be notified by text or email and U.S. mail within 60 days of reaching agreement that the enrollee has an option to return to their provider, or the plan will reassign the enrollee to another provider.

ANALYSIS:

Existing law:

1. Establishes the Department of Managed Health Care (DMHC) to regulate health plans under the Knox-Keene Health Care Service Plan Act of 1975 (Knox-Keene Act). [Health and Safety Code (HSC) §1340, et seq.]
2. Requires a health plan, at least 75 days before the termination date of its contract with a provider group or a hospital, to submit an enrollee block transfer filing to DMHC that includes the written notice the plan proposes to send to affected enrollees. Prohibits the plan from sending this notice to enrollees until DMHC has reviewed and approved its content. Requires, if DMHC does not respond within seven days of the date of its receipt of the filing, the notice to be deemed approved. Authorizes, if an individual provider terminates the provider’s contract or employment with a provider group that contracts with a health plan, the plan to require that the provider group to send the notice. [HSC §1373.65]
3. Requires a health plan, at least 60 days before the termination date of a contract between a health plan and a provider group or a hospital, to send a written block transfer notice by U.S. mail to enrollees who are assigned to the terminated provider group or hospital. [HSC §1373.65]
4. Requires a health plan that is unable to comply with the 60 days prior to termination timeframe because of exigent circumstances to apply to DMHC for a waiver. Makes the plan excused from complying with this requirement only if its waiver application is granted or DMHC does not respond within seven days of the date of its receipt of the waiver application. Requires the plan, if the terminated provider is a hospital and the plan assigns enrollees to a provider group with exclusive admitting privileges to the hospital, to send the written notice to each enrollee who is a member of the provider group and who resides within a 15-mile radius of the terminated hospital. Requires the plan, if it operates as a preferred provider organization or assigns members to a provider group with admitting privileges to hospitals in the same geographic area as the terminated hospital, the plan to send the written notice to all enrollees who reside within a 15-mile radius of the terminated hospital. [HSC §1373.65]
5. Requires a health plan, if after sending the notice required in 2) above it reaches an agreement with a terminated provider to renew or enter into a new contract or does not terminate the contract, to offer each enrollee the option to return to that provider, and if the enrollee does not exercise this option, requires the plan to reassign the enrollee to another provider. [HSC §1373.65]
6. Requires a health plan and a provider to include in all written, printed, or electronic communications sent to an enrollee concerning a contract termination or block transfer, the following statement in not less than 8-point type: “If you have been receiving care from a health care provider, you may have a right to keep your provider for a designated time period. Please contact your health plan’s customer service department, and if you have further questions, you are encouraged to contact DMHC, which protects consumers, by telephone at its toll-free number, 1-888-466-2219, or at a TDD number for the hearing and speech impaired at 1-877-688-9891, or online at www.dmhc.ca.gov.” [HSC §1373.65]

This bill:

1. Requires the health plan, in addition to sending a written notice by U.S. mail regarding the termination of a contract, to send the written notice to the enrollee electronically at least 60 days before the termination date of the contract via either of the following methods if the enrollee has opted into electronic delivery as their communication preference and has included the contact information described below:
   1. Text message to the preferred or last known cell phone number of the enrollee; or,
   2. Email to the preferred or last known email address of the enrollee.
2. Requires when a plan offers affected enrollees the option to return to their provider, if the plan and provider reach an agreement, enter into a new contract, or do not terminate the existing contract, to notify the enrollees in accordance with the following:
   1. Within 60 days of reaching the agreement requires the plan to send written notice by U.S. mail to affected enrollees, and to send written notice to the enrollee electronically within 60 days of reaching the agreement via either of the following methods if the enrollee has opted into electronic delivery as their communication preference and has included the contact information described below:
      1. Text message to the preferred or last known cell phone number of the enrollee; or,
      2. Email to the preferred or last known email address of the enrollee.

Comments

According to the author:

Across California, patients are increasingly caught in the middle of disputes and network changes driven by large health systems and insurance companies. When contracts break down or networks shift, patients are often reassigned to new providers with little notice. At the same time, our notification laws remain stuck in the past. Health plans continue to rely on paper mail as the primary method of communication, even as most Californians live and communicate in a digital world. These notices are often delayed, inaccessible, or never received, leaving patients unaware of major changes until they are denied care or faced with unexpected costs. This bill modernizes notification requirements by allowing health plans to communicate through timely electronic methods, so patients receive critical information without delay.

Background

Block Transfer requirements. Before the termination date of its contract with a provider group or a general acute care hospital, health plans must submit an enrollee Block Transfer Filing to DMHC. DMHC reviews these filings to ensure compliance with applicable statutory (Knox-Keene Act) and regulatory (California Code of Regulations title 28) requirements. DMHC’s review ensures (1) that the network remains adequate without the terminating provider group or hospital; and, (2) that the impacted enrollees are timely notified of the termination and informed of their rights. If DMHC approves a Block Transfer Filing, the health plan may inform its enrollees of the termination and redirect the enrollees to the alternate providers. During the block transfer filing review, DMHC also requests confirmation that health plans have reached a continuity of care agreement with terminating hospitals and provider groups which specifies reimbursement rates for the completion of covered services.

Continuity of care. Existing law allows an enrollee to request continuity of care when a doctor, medical group or hospital is no longer contracting with a health plan. The provider must agree to keep the enrollee as a patient and agree to the health plan reimbursement. Enrollees with certain conditions can obtain continuity of care if the provider agrees. For example, acute conditions, serious chronic conditions, pregnancy, terminal illness, children under three, or an already scheduled surgery or procedure would qualify. Continuity of care may last as long as the condition exists or may be limited after a course of treatment is completed and the patient can be transitioned to a provider in the plan’s network. Enrollee transfer notices must include a website link to the plan’s continuity of care policies also called completion of covered services or care, which are reviewed by DMHC. In addition, the health plans’ enrollee transfer notices must include details related to the conditions eligible for completion of care, how to request completion of care, and a statement providing information on how enrollees can contact the DMHC’s Help Center for assistance.

Notice to request completion of covered services must also be provided to enrollees in every health plan disclosure form and in any evidence of coverage documents. A health plan must also provide this notice to its providers, to its enrollees upon request, along with a specified termination of coverage notice. If enrollees are hospitalized through the emergency room, there are post-stabilization procedures that health plans must follow to authorize continued care at the hospital or to arrange for transfer to an authorized hospital. These procedures would be effective whether the hospital is contracted, non-contracted, or recently terminated.

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: Yes

SUPPORT: (Verified 8/3/26)

Health Access California

OPPOSITION: (Verified 8/3/26)

Association of California Life & Health Insurance Companies

California Association of Health Plans

ARGUMENTS IN SUPPORT: Health Access California writes, “When contracts break down between health systems and insurance companies, patients are left in the middle. While existing law requires health plans to cover the completion of services by a terminated provider, it is only if requested by the enrollee and if the provider and plan agree on terms and reimbursement. As such, this continued care is often challenging to access. Health plans continue to rely on paper mail as the primary method of communication, even while many Californians rely on digital options including email. For low-income patients who may move often, people with mobility issues or others with limited access to mail for differing reasons, this bill will improve their access to crucial updates from the plans and improve their access to essential care.”

ARGUMENTS IN OPPOSITION: Oppose unless amended. The California Association of Health Plans (CAHP) and the Association of California Life and Health Insurance Companies (ACLHIC) request an amendment to allow health plans the option of offering their enrollees an electronic delivery notification in lieu of U.S. mail, rather than both. CAHP and ACLHIC believe this bill could delay necessary reassignments because they could occur after the enrollee decides whether they would like to return to their previous provider, so they request reverting the bill back to existing law.

ASSEMBLY FLOOR: 74-0, 5/21/26

AYES: Addis, Aguiar-Curry, Ahrens, Alanis, Alvarez, Ávila Farías, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Caloza, Carrillo, Castillo, Connolly, Davies, DeMaio, Dixon, Elhawary, Ellis, Flora, Fong, Gabriel, Gallagher, Gipson, Jeff Gonzalez, Mark González, Hadwick, Haney, Harabedian, Hart, Hoover, Irwin, Jackson, Johnson, Kalra, Krell, Lee, Lowenthal, Macedo, McKinnor, Muratsuchi, Nguyen, Ortega, Pacheco, Papan, Patel, Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ransom, Michelle Rodriguez, Rogers, Blanca Rubio, Sanchez, Schiavo, Schultz, Sharp-Collins, Solache, Soria, Stefani, Ta, Tangipa, Valencia, Wallis, Ward, Wicks, Wilson, Zbur, Rivas

NO VOTE RECORDED: Arambula, Chen, Garcia, Lackey, Ramos, Celeste Rodriguez

Prepared by: Teri Boughton / HEALTH / (916) 651-4111

8/5/26 15:12:53

**** END ****

SENATE COMMITTEE ON HEALTH

Senator Akilah Weber Pierson, Chair

BILL NO: AB 2613

SUBJECT: Health care service plans: provider contract termination: notice

SUMMARY:

• 1. Requires a health plan in a contract renewal dispute with a provider group or hospital to notify affected enrollees by text or email, in addition to existing requirements to provide a notice by U.S. mail, 60 days before the termination date. Requires, if the contract dispute is resolved, the affected enrollees to be notified by text or email and U.S. mail within 60 days of reaching agreement that the enrollee has an option to return to their provider, or the plan will reassign the enrollee to another provider.

Existing law:

1. Establishes the Department of Managed Health Care (DMHC) to regulate health plans under the Knox-Keene Health Care Service Plan Act of 1975 (Knox-Keene Act). [HSC §1340, et seq.]
2. Requires a health plan, at least 75 days before the termination date of its contract with a provider group or a hospital, to submit an enrollee block transfer filing to DMHC that includes the written notice the plan proposes to send to affected enrollees. Prohibits the plan from sending this notice to enrollees until DMHC has reviewed and approved its content. Requires, if DMHC does not respond within seven days of the date of its receipt of the filing, the notice to be deemed approved. Authorizes, if an individual provider terminates the provider’s contract or employment with a provider group that contracts with a health plan, the plan to require that the provider group to send the notice. [HSC §1373.65]
   
3. Requires a health plan, at least 60 days before the termination date of a contract between a health plan and a provider group or a hospital, to send a written block transfer notice by U.S. mail to enrollees who are assigned to the terminated provider group or hospital. [HSC §1373.65]
   
4. Requires a health plan that is unable to comply with the 60 days prior to termination timeframe because of exigent circumstances to apply to DMHC for a waiver. Makes the plan excused from complying with this requirement only if its waiver application is granted or DMHC does not respond within seven days of the date of its receipt of the waiver application. Requires the plan, if the terminated provider is a hospital and the plan assigns enrollees to a provider group with exclusive admitting privileges to the hospital, to send the written notice to each enrollee who is a member of the provider group and who resides within a 15-mile radius of the terminated hospital. Requires the plan, if it operates as a preferred provider organization or assigns members to a provider group with admitting privileges to hospitals in the same geographic area as the terminated hospital, the plan to send the written notice to all enrollees who reside within a 15-mile radius of the terminated hospital. [HSC §1373.65]
5. Requires a health plan, if after sending the notice required in 2) above it reaches an agreement with a terminated provider to renew or enter into a new contract or does not terminate the contract, to offer each enrollee the option to return to that provider, and if the enrollee does not exercise this option, requires the plan to reassign the enrollee to another provider. [HSC §1373.65]
6. Requires a health plan and a provider to include in all written, printed, or electronic communications sent to an enrollee concerning a contract termination or block transfer, the following statement in not less than 8-point type: “If you have been receiving care from a health care provider, you may have a right to keep your provider for a designated time period. Please contact your health plan’s customer service department, and if you have further questions, you are encouraged to contact the Department of Managed Health Care, which protects consumers, by telephone at its toll-free number, 1-888-466-2219, or at a TDD number for the hearing and speech impaired at 1-877-688-9891, or online at www.dmhc.ca.gov.” [HSC §1373.65]

This bill:

1. Requires the health plan, in addition to sending a written notice by U.S. mail regarding the termination of a contract, to send the written notice to the enrollee electronically at least 60 days before the termination date of the contract via either of the following methods:
   1. Text message to the preferred or last known cell phone number of the enrollee; or,
   2. Email to the preferred or last known email address of the enrollee.
      
2. Requires when a plan offers affected enrollees the option to return to their provider, if the plan and provider reach an agreement, enter into a new contract, or do not terminate the existing contract, to notify the enrollees in accordance with the following:
   1. Within 60 days of reaching the agreement requires the plan to send written notice by U.S. mail to affected enrollees, and to send written notice to the enrollee electronically within 60 days of reaching the agreement via either of the following methods:
      1. Text message to the preferred or last known cell phone number of the enrollee; or,
      2. Email to the preferred or last known email address of the enrollee.

FISCAL EFFECT:

According to the Assembly Committee on Appropriations, minor and absorbable costs to DMHC.

PRIOR VOTES:

COMMENTS:

1. Author’s statement. According to the author, across California, patients are increasingly caught in the middle of disputes and network changes driven by large health systems and insurance companies. When contracts break down or networks shift, patients are often reassigned to new providers with little notice. At the same time, our notification laws remain stuck in the past. Health plans continue to rely on paper mail as the primary method of communication, even as most Californians live and communicate in a digital world. These notices are often delayed, inaccessible, or never received, leaving patients unaware of major changes until they are denied care or faced with unexpected costs. This bill modernizes notification requirements by allowing health plans to communicate through timely electronic methods, so patients receive critical information without delay.
   
2. Block Transfer requirements. Before the termination date of its contract with a provider group or a general acute care hospital, health plans must submit an enrollee Block Transfer Filing to DMHC. DMHC reviews these filings to ensure compliance with applicable statutory (Knox-Keene Act) and regulatory (California Code of Regulations title 28) requirements. DMHC’s review ensures (1) that the network remains adequate without the terminating provider group or hospital; and, (2) that the impacted enrollees are timely notified of the termination and informed of their rights. If DMHC approves a Block Transfer Filing, the health plan may inform its enrollees of the termination and redirect the enrollees to the alternate providers. During the block transfer filing review, DMHC also requests confirmation that health plans have reached a continuity of care agreement with terminating hospitals and provider groups which specifies reimbursement rates for the completion of covered services.
   
3. Continuity of care. Existing law allows an enrollee to request continuity of care when a doctor, medical group or hospital is no longer contracting with a health plan. The provider must agree to keep the enrollee as a patient and agree to the health plan reimbursement. Enrollees with certain conditions can obtain continuity of care if the provider is in agreement. For example, acute conditions, serious chronic conditions, pregnancy, terminal illness, children under three, or an already scheduled surgery or procedure would qualify. Continuity of care may last as long as the condition exists, or may be limited after a course of treatment is completed and the patient can be transitioned to a provider in the plan’s network. Enrollee transfer notices must include a website link to the plan’s continuity of care policies also called completion of covered services or care, which are reviewed by DMHC. In addition, the health plans’ enrollee transfer notices must include details related to the conditions eligible for completion of care, how to request completion of care, and a statement providing information on how enrollees can contact the DMHC’s Help Center for assistance.
   

Notice to request completion of covered services must also be provided to enrollees in every health plan disclosure form and in any evidence of coverage documents. A health plan must also provide this notice to its providers, to its enrollees upon request, along with a specified termination of coverage notice. If enrollees are hospitalized through the emergency room, there are post-stabilization procedures that health plans must follow to authorize continued care at the hospital or to arrange for transfer to an authorized hospital. These procedures would be effective whether the hospital is contracted, non-contracted, or recently terminated.

1. Support. Health Access California writes, “When contracts break down between health systems and insurance companies, patients are left in the middle. While existing law requires health plans to cover the completion of services by a terminated provider, it is only if requested by the enrollee and if the provider and plan agree on terms and reimbursement. As such, this continued care is often challenging to access. Health plans continue to rely on paper mail as the primary method of communication, even while many Californians rely on digital options including email. For low-income patients who may move often, people with mobility issues or others with limited access to mail for differing reasons, this bill will improve their access to crucial updates from the plans and improve their access to essential care.”
   
2. Oppose unless amended. The California Association of Health Plans (CAHP) and the Association of California Life and Health Insurance Companies (ACLHIC) request an amendment to allow health plans the option of offering their enrollees an electronic delivery notification in lieu of U.S. mail, rather than both. CAHP and ACLHIC recommend an amendment to require enrollees to opt-in to electronic delivery of these types of notices which will help ensure sensitive information is being delivered appropriately. CAHP and ACLHIC believe this bill could delay necessary reassignments because they could occur after the enrollee decides whether they would like to return to their previous provider, so they request reverting the bill back to existing law.
   
3. Amendments. The committee may wish to ensure secure electronic messaging by requiring the enrollee to opt-in to electronic notification in order to receive these notifications electronically.
   

SUPPORT AND OPPOSITION:

Support: Health Access California

Oppose: Association of California Life & Health Insurance Companies (unless amended)
California Association of Health Plans (unless amended)

-- END --

ASSEMBLY THIRD READING

ATR Bill Id:AB 2613

Author:(Sharp-Collins)

As Amended Ver:April 27, 2026

Majority vote

SUMMARY

Requires a health plan to send written notice via text message or email, in addition to U.S. mail, to an affected enrollee at least 60 days before the termination date of a contract between the health plan and a provider group or a general acute care hospital. If, after sending the notice, the health plan reaches an agreement to continue the contract with the provider group or hospital, this bill requires the health plan to notify the enrollee within 60 days by U.S. mail and either text message or email.

Major Provisions

COMMENTS

A block transfer occurs when a health plan moves a block of members all at once from a terminated provider group or hospital to a new one. This occurs when a contract between a health plan and the provider group or hospital is terminated or is not renewed. To ensure that enrollees aren't left without access to care upon termination, health plans are required to plan and arrange for the transfer to new providers ahead of the termination date. Current state law and regulations require health plans to submit a block transfer filing to the Department of Managed Health Care (DMHC) at least 75 days before a potential contract termination date, DMHC must subsequently review impacts and notifications that will be sent out to enrollees. After DMHC's review, plans are then statutorily required to notify enrollees by mail at least 60 days prior to the termination and transfer date. If the contract with the provider is terminated, state law requires health plans to cover the completion of covered services by a terminated provider, if requested by an enrollee for the treatment of certain conditions, and if the provider and health plan agree on terms and reimbursement. Additionally, if the provider contract is reinstated the health plan must offer the enrollee the option to return.

According to the Author

Across California, patients are increasingly caught in the middle of disputes and network changes driven by large health systems and insurance company negotiations. The author continues that when contracts break down or networks shift, patients are often reassigned to new providers with little notice. The author notes that at the same time, our notification laws remain stuck in the past. The author states that health plans continue to rely on paper mail as the primary method of communication, even as most Californians live and communicate in a digital world. The author argues that these notices are often delayed, inaccessible, or never received, leaving patients unaware of major changes until they are denied care or faced with unexpected costs. The author concludes that this bill requires automatic reinstatement of patients to their original provider when a network transition fails and modernizes notification requirements by allowing health plans to communicate through timely electronic methods, so patients receive critical information without delay.

Arguments in Support

Health Access California (HAC) supports this bill, stating that health plans continue to rely on paper mail as the primary method of communication, even while many Californians rely on digital options including email. HAC continues that for low-income patients who may move often, people with mobility issues or others with limited access to mail for differing reasons, this bill will improve their access to crucial updates from the plans and improve their access to essential care.

Arguments in Opposition

The California Association of Health Plans (CAHP) and Association of California Life and Health Insurance Companies (ACLHIC) were opposed to a previous version of this bill, stating that health plans are already required to follow strict timelines for block transfer notices, which ensure enrollees do not experience a gap in coverage, access issues, or unnecessary interruptions in care. CAHP and ACLHIC note that timelines and notifications under current law help prevent disruptions in care if a contract is ultimately terminated. CAHP and ACLHIC continue that in some cases, enrollees may receive a notice and proactively choose a new provider before the potential termination date. CAHP and ACLHIC argue that requiring plans to move those enrollees back to their original provider, as this bill proposes, would be inappropriate and counterproductive. CAHP and ACLHIC continue that such an approach would disrupt patient choice and could result in moving patients without their consent, which is particularly problematic after care decisions have already been made. CAHP and ACLHIC state that this approach would also create billing conflicts and unnecessary confusion for enrollees. CAHP and ACLHIC argue that if a plan reaches an agreement with a terminated provider, existing law already requires the plan to offer enrollees the option, but not the obligation, to return. CAHP and ACLHIC continue that the out-of-network coverage approach in this bill undermines the core purpose of provider networks, which are designed to promote quality, coordinated, and cost-effective care. CAHP and ACLHIC conclude that by effectively guaranteeing in-network reimbursement rates outside of negotiated contracts, the proposal would disincentivize providers from reaching agreements with plans/insurers during contract negotiations.

FISCAL COMMENTS

According to the Assembly Committee on Appropriations, minor and absorbable costs to DMHC.

VOTES

ASM HEALTH: 16-0-0

YES: Bonta, Chen, Addis, Aguiar-Curry, Ahrens, Caloza, Carrillo, Mark González, Johnson, Patel, Patterson, Rogers, Sanchez, Schiavo, Sharp-Collins, Stefani

ASM APPROPRIATIONS: 15-0-0

YES: Wicks, Hoover, Bauer-Kahan, Calderon, Caloza, Ellis, Fong, Mark González, Krell, Pacheco, Pellerin, Sharp-Collins, Solache, Ta, Tangipa

UPDATED

VERSION: April 27, 2026

CONSULTANT: Riana King / HEALTH / (916) 319-2097 FN: 0002546

Date of Hearing: May 13, 2026

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Buffy Wicks, Chair

ABPCA Bill Id:AB 2613

Author:(Sharp-Collins) – As Amended Ver:April 27, 2026

Urgency: No State Mandated Local Program: Yes Reimbursable: No

SUMMARY:

This bill requires a health plan to send written notice via text message or email, in addition to U.S. mail, to an affected enrollee at least 60 days before the termination date of a contract between the health plan and a provider group or a general acute care hospital (hospital). If, after sending the notice, the health plan reaches an agreement to continue the contract with the provider group or hospital, this bill requires the health plan to notify the enrollee within 60 days by U.S. mail and either text message or email. The bill also requires the plan to reassign the enrollee to another provider if the enrollee does not opt to return to the provider.

FISCAL EFFECT:

Minor and absorbable costs to the Department of Managed Health Care.

COMMENTS:

1. Purpose. According to the author:

Across California, patients are increasingly caught in the middle of disputes and network changes driven by large health systems and insurance companies. When contracts break down or networks shift, patients are often reassigned to new providers with little notice. At the same time, our notification laws remain stuck in the past. Health plans continue to rely on paper mail as the primary method of communication, even as most Californians live and communicate in a digital world. These notices are often delayed, inaccessible, or never received, leaving patients unaware of major changes until they are denied care or faced with unexpected costs.

[This bill] requires automatic reinstatement of patients to their original provider when a network transition fails and modernizes notification requirements by allowing health plans to communicate through timely electronic methods, so patients receive critical information without delay.

1. Background. As noted in the Assembly Health Committee analysis of this bill, when a health plan’s contract with a provider is terminated, the health plan is required to provide notifications by U.S. mail. However, many people do not regularly check their mail and rely instead on electronic communication methods. This bill updates existing law to require health plans to provide electronic or text notifications on contract terminations, in addition to U.S. mail, to ensure enrollees receive important updates on the status of their coverage and care.

Analysis Prepared by: Allegra Kim / APPR. / (916) 319-2081

Date of Hearing: April 21, 2026

ASSEMBLY COMMITTEE ON HEALTH

Mia Bonta, Chair

ABPCA Bill Id:AB 2613

Author:(Sharp-Collins) – As Amended Ver:March 19, 2026

SUBJECT: Health care service plans: provider network transitions.

SUMMARY: Requires a health plan to automatically reinstate an enrollee to their previously assigned primary care provider or provider group if a provider network transition is materially delayed, terminated, rescinded, or otherwise fails, as specified. Specifically, this bill:

1. Requires, if a provider network transition is materially delayed, terminated, rescinded, or otherwise fails within 120 days of an enrollee reassignment conducted under existing law, the health plan to automatically reinstate the enrollee to the enrollee’s previously assigned primary care provider or provider group, if they remain contracted with the plan.
2. Requires automatic reinstatement to occur without any of the following:
   1. A request from the enrollee;
   2. A continuity of care determination; or,
   3. A grievance or appeal filed by the enrollee.
3. Requires a health plan to provide written notice within five business days of the reinstatement that includes all of the following:
   1. Confirmation of reassignment to the prior provider;
   2. Information regarding the enrollee’s right to select a different provider; and,
   3. Contact information for assistance in scheduling care.
4. Requires, if a provider network transition is materially delayed, terminated, rescinded, or otherwise fails within 120 days of an enrollee reassignment and the provider is no longer contracted with the plan, the plan to do one of the following:
   1. Offer continuity of care; or,
   2. Arrange for out-of-network care at in-network cost sharing until a reassignment that complies with existing law can be effectuated.
5. Requires a reinstatement conducted pursuant to this section to not be deemed a new transfer.
6. Defines “provider network transition” to include a merger, acquisition, affiliation, or contractual arrangement that results in the reassignment of enrollees to a different primary care provider, provider group, or health facility.

EXISTING LAW:

1. Establishes the Department Managed Health Care (DMHC) to regulate health plans under the Knox-Keene Health Care Service Plan Act of 1975. [Health and Safety Code (HSC) § 1340, et seq.]
2. Requires, at least 75 days before a termination date of a contract with a provider group or general acute care hospital, a health plan to submit an enrollee block transfer filing to DMHC that includes the written notice the plan proposes to send to affected enrollees. Prohibits the plan from sending the notice to enrollees until DMHC has reviewed and approved its content, unless DMHC does not respond within seven days of the date of its receipt of the filing. [HSC § 1373.65]
3. Requires, at least 60 days before a termination date of a contract with a provider group or general acute care hospital, a health plan to send the written notice described in 2) above by mail to enrollees who are assigned to the terminated provider group or hospital, as specified. [Ibid.]
4. Requires, if the plan and provider reach an agreement to renew or enter into a new contract or to not terminate the contract after sending the notice required in 3), the plan to offer each affected enrollee the option to return to that provider. Requires, if the enrollee does not exercise this option, the plan to reassign the enrollee to another provider. [Ibid.]
5. Requires a health plan and provider to include in all written, printed, or electronic communications sent to an enrollee that concern the contract termination or block transfer, the following statement in not less than 8-point type: “If you have been receiving care from a health care provider, you may have a right to keep your provider for a designated time period. Please contact your health plan’s customer service department, and if you have further questions, you are encouraged to contact the Department of Managed Health Care, which protects consumers, by telephone at its toll-free number, 1-888-466-2219, or at a TDD number for the hearing and speech impaired at 1-877-688-9891, or online at www.dmhc.ca.gov.” [Ibid.]
6. Requires health plans to cover the completion of covered services by a terminated provider, if requested by an enrollee or insured for the treatment of certain conditions, and if the provider and plan agree on terms and reimbursement, as specified. Requires health plans to cover the completion of covered services by non-participating providers for new enrollees under similar circumstances. [HSC § 1373.96]

FISCAL EFFECT: Unknown. This bill has not been analyzed by a fiscal committee.

COMMENTS:

1. PURPOSE OF THIS BILL. According to the author, across California, patients are increasingly caught in the middle of disputes and network changes driven by large health systems and insurance company negotiations. The author continues that when contracts break down or networks shift, patients are often reassigned to new providers with little notice. The author notes that at the same time, our notification laws remain stuck in the past. The author states that health plans continue to rely on paper mail as the primary method of communication, even as most Californians live and communicate in a digital world. The author argues that these notices are often delayed, inaccessible, or never received, leaving patients unaware of major changes until they are denied care or faced with unexpected costs. The author concludes that this bill requires automatic reinstatement of patients to their original provider when a network transition fails and modernizes notification requirements by allowing health plans to communicate through timely electronic methods, so patients receive critical information without delay.
2. BACKGROUND. A block transfer occurs when a health plan moves a block of members all at once from a terminated provider group or hospital to a new one. This occurs when a contract between a health plan and the provider group or hospital is terminated or is not renewed. To ensure that enrollees aren’t left without access to care upon termination, health plans are required to plan and arrange for the transfer to new providers ahead of the termination date. Current state law and regulations require health plans to submit a block transfer filing to DMHC at least 75 days before a potential contract termination date, DMHC must subsequently review impacts and notifications that will be sent out to enrollees. After DMHC’s review, plans are then statutorily required to notify enrollees by mail at least 60 days prior to the termination and transfer date. If the contract with the provider is terminated, state law requires health plans to cover the completion of covered services by a terminated provider, if requested by an enrollee for the treatment of certain conditions, and if the provider and health plan agree on terms and reimbursement. Additionally, if the provider contract is reinstated the health plan must offer the enrollee the option to return.
3. OPPOSITION. The California Association of Health Plans (CAHP) and Association of California Life and Health Insurance Companies (ACLHIC) oppose this bill, stating that health plans are already required to follow strict timelines for block transfer notices, which ensure enrollees do not experience a gap in coverage, access issues, or unnecessary interruptions in care. CAHP and ACLHIC note that timelines and notifications under current law help prevent disruptions in care if a contract is ultimately terminated. CAHP and ACLHIC continue that in some cases, enrollees may receive a notice and proactively choose a new provider before the potential termination date. CAHP and ACLHIC argue that requiring plans to move those enrollees back to their original provider, as this bill proposes, would be inappropriate and counterproductive. CAHP and ACLHIC continue that such an approach would disrupt patient choice and could result in moving patients without their consent, which is particularly problematic after care decisions have already been made. CAHP and ACLHIC state that this approach would also create billing conflicts and unnecessary confusion for enrollees. CAHP and ACLHIC argue that if a plan reaches an agreement with a terminated provider, existing law already requires the plan to offer enrollees the option, but not the obligation, to return. CAHP and ACLHIC continue that the out-of-network coverage approach in this bill undermines the core purpose of provider networks, which are designed to promote quality, coordinated, and cost-effective care. CAHP and ACLHIC conclude that by effectively guaranteeing in-network reimbursement rates outside of negotiated contracts, the proposal would disincentivize providers from reaching agreements with plans/insurers during contract negotiations.
4. OPPOSED UNLESS AMENDED. The Local Health Plans of California (LHPC) also oppose this bill, arguing that as drafted this bill creates significant operational conflicts, as Medi-Cal plans are already subject to strict 30-day and 60-day notification requirements for provider terminations under current state law and regulations. LHPC continues that adding the automatic reinstatement and specific written notices required by this bill creates "noticing fatigue" and potential confusion for Medi-Cal beneficiaries. Additionally, LHPC notes that the Medi-Cal program and Knox-Keene requirements already provide robust continuity of care protections (often up to 12 months). Finally, LHPC argues that this bill’s requirement for in-network cost-sharing during failed transitions is generally not applicable to the Medi-Cal population, as most members do not have the same cost-sharing obligations as commercial enrollees. LHPC is opposed to this bill unless it is amended to exempt Medi-Cal Managed Care plans, or at least, be modified to align with existing guidance on member transitions.
5. AMENDMENTS. There are robust state laws and regulations guiding the block transfer process, timelines, and notification requirements. Existing law also provides pathways for enrollees to pursue continued care with a terminated provider, and requires that they are offered the option to be reassigned to any terminated provider that rejoins their network. However, the author has identified a gap in existing law. Plans are statutorily required to provide notifications by U.S. mail, however in 2026 many people aren’t checking their mail on a regular basis and rely on electronic communication methods. The committee may wish to delete the current contents of this bill and instead update existing law to allow health plans to provide electronic or text notifications on contract terminations and pending block transfers, in addition to mail, to ensure that enrollees are receiving the updates they need on the status of their coverage and care.

REGISTERED SUPPORT / OPPOSITION:

Support

None on file

Opposition

Association of California Life and Health Insurance Companies

California Association of Health Plans

Analysis Prepared by: Riana King / HEALTH / (916) 319-2097