CA SB854

Requires health care service plans and health insurers with outpatient prescription drug benefits to cover all FDA-approved prescription drugs for treating substance use disorders and place them on the lowest cost-sharing tier of formularies, effective January 1, 2021.

Prohibits prior authorization and step therapy requirements on FDA-approved substance use disorder medications, except when therapeutic equivalents exist and at least one is covered without such requirements.

Prohibits limits on visit frequency, treatment duration, facility requirements exceeding network adequacy standards, and exclusions based on prior treatment failure for substance use disorder coverage.

Requires health care plans and insurers to disclose which providers offer substance use disorder treatment in online and printed provider directories, including the level of care according to ASAM Criteria standards.

Exempts Medi-Cal coverage, vision-only plans, dental-only plans, and Medicare supplement policies from these requirements.