CA AB369

Restricts health care service plans and health insurers from requiring patients to fail more than 2 pain medications before accessing a prescribed pain medication, unless FDA-approved labeling or clinical research supports requiring more prior therapies.

Allows the prescribing provider to determine the duration of step therapy or fail-first protocols for pain medications.

Permits plans and insurers to continue charging copayments, deductibles, and setting coverage limits, and does not require coverage of drugs outside the plan's formulary.

Applies to both health care service plans under the Knox-Keene Act and health insurers regulated by the Department of Insurance.

Establishes that willful violations by health care service plans constitute a crime and that no state reimbursement is required for local agencies under this act.