Prescription Drug Coverage: Dose Adjustments
Summary
California SB964 was passed by the State Senate, adding Section 1367.225 to the Health and Safety Code and Section 10123.1934 to the Insurance Code. The bill requires health care coverage plans to provide coverage for prescription drug dose adjustments. Sponsored by Senator Lola Smallwood-Cuevas, the bill passed the Senate Committee on Appropriations with an 11-0 vote on March 25, 2026.
What changed
California SB964 enacts new statutory requirements for prescription drug coverage related to dose adjustments. The bill adds identical provisions to both the California Health and Safety Code (Section 1367.225) and the Insurance Code (Section 10123.1934), establishing that health care service plans and health insurers must cover dose modifications when prescribed by a licensed health care provider. The bill passed through committee review with unanimous support.
Health care service plans and health insurers offering prescription drug coverage in California must update their coverage policies and plan documents to comply with the dose adjustment coverage requirement. Entities should review current formulary and utilization management practices to ensure dose modifications are covered without inappropriate restrictions. Implementation should align with any effective date provisions in the legislation.
What to do next
- Review and update prescription drug coverage policies to include dose adjustment coverage
- Ensure formulary management and utilization review processes accommodate dose modifications
- Update provider and member communications regarding the new coverage requirement
Source document (simplified)
ChangeBridge / California / SB964 Passed SB964 Senate Bill Passed 2026-02-03
Prescription drug coverage: dose adjustments.
An act to add Section 1367.225 to the Health and Safety Code, and to add Section 10123.1934 to the Insurance Code, relating to health care coverage.
Bill Details
State California
Session 2025-2026 Regular Session
Chamber Senate
Committee Appropriations
Official Source leginfo.legislature.ca.gov/faces/billStatu...
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Sponsors
Lola Smallwood-Cuevas (Sen - D)
Action History
2026-03-26 S From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 11. Noes 0.) (March 25). 2026-03-09 S Set for hearing March 25. 2026-02-11 S Referred to Com. on HEALTH. 2026-02-04 S From printer. May be acted upon on or after March 6. 2026-02-03 S Introduced. Read first time. To Com. on RLS. for assignment. To print.
Votes
2026-03-25 Do pass as amended, but first amend, and re-refer to the Committee on [Appropriations] Yea: 11 Nay: 0
Committee Referrals
2026-02-03 S Rules 2026-02-11 S Health 2026-03-26 S Appropriations
Bill Text Versions
2026-02-03 Introduced Legislative data powered by LegiScan (CC BY 4.0)
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