CA AB3275

Effective January 1, 2026, requires health care service plans and health insurers to reimburse complete claims or portions thereof within 30 calendar days after receipt (changes from 30-45 working days under current law).

Plans must notify claimants of contested or denied claims within 30 calendar days, specifying which services are disputed and what additional information is needed to reconsider the claim.

Increases interest penalties on late claim payments to 15% per annum for both health care service plans and insurers (previously 15% for plans, 10% for insurers), with automatic inclusion in payment and additional fees for non-compliance.

Requires complaints about claim payment delays or denials to health care service plans to be treated as grievances subject to the plan's grievance process.

Applies new claim reimbursement requirements to Medi-Cal managed care plans and exempts departmental guidance and regulations from Administrative Procedure Act requirements through December 31, 2027.