CA AB1091

Prohibits health care practitioners and health facilities from entering into contracts with health plans or insurers on or after January 1, 2024, that restrict steering to other providers, require bundled contracting with affiliates, impose non-party payment terms, or prevent disclosure of cost and quality information.

Requires medical groups, hospitals, health facilities, health plans, insurers, and pharmacy benefit managers to obtain written Attorney General consent before material transactions valued at $15,000,000 or more, with a 90-day review period extendable by 45 days.

Authorizes Attorney General to consent, conditionally consent, or deny transactions based on impact to market competition, care quality, access, rural/low-income communities, and public interest, with judicial review available by writ of mandate.

Requires Attorney General to conduct public meetings before issuing decisions on major transactions, with at least one meeting in the affected county for medical groups and hospitals.

Allows Attorney General to contract with experts and consultants for transaction review and ongoing compliance monitoring, with costs reimbursed by entities seeking consent; permits waivers for entities facing imminent business failure if conditions are met.