CA AB2486

Requires opioid manufacturers and wholesalers selling in California to submit annual reports to the State Department of Public Health detailing all opioid drugs sold or distributed, starting with the 2020-21 fiscal year.

Establishes a $100,000,000 annual opioid stewardship payment to be divided proportionally among manufacturers and wholesalers based on morphine milligram equivalents (MMEs) of opioids sold, with quarterly payment requirements beginning 2020-21.

Creates the Opioid Prevention and Rehabilitation Program Fund, continuously appropriated to distribute collected payments to counties for opioid prevention and rehabilitation programs based on overdose death rates, emergency department visits, and hospitalization ratios.

Imposes civil penalties for non-compliance: up to $1,000 per day for failing to report, 10-300% of unpaid ratable share for payment failures, and up to $1,000,000 per incident for passing costs to drug purchasers.

Exempts buprenorphine, methadone, and morphine from MME calculations and excludes opioids manufactured in California but delivered outside the state; requires a two-thirds legislative vote as a tax levy.