CA| California Insurance Bulletin 2025-14 announces the immediate effect of Assembly Bill 144, which strengthens and expands requirements for health insurers to provide coverage for preventive care services, including immunizations, by establishing January 1, 2025, as the baseline for recommended services and empowering the California Department of Public Health (CDPH) to update coverage requirements. The law ensures California consumers maintain access to preventive care no matter future changes in federal recommendations and requires insurers to quickly adopt any additional state recommendations. CDPH has also issued detailed guidance on immunization coverage for COVID-19, influenza, and RSV, which insurers must now implement per the new state law, even if federal recommendations differ.
Key Issues:
- Health insurers must cover, without cost-sharing, all preventive care items and immunizations recommended by federal agencies as of January 1, 2025, and swiftly incorporate any CDPH updates or supplements within 15 business days.
- Coverage persists even if federal recommendations are later downgraded or withdrawn, with CDPH authorized to further expand coverage requirements considering input from leading medical organizations.
- CDPH has issued updated immunization recommendations for COVID-19, influenza, and RSV, which insurers must now cover, including for populations and in situations that may go beyond current FDA advisories.