CA AB948

Removes biologics from the definition of Tier 4 drugs in health plan drug formularies, effective indefinitely by deleting the January 1, 2024 repeal date.

Requires health care service plans and insurers to apply the lowest cost sharing to enrollees/insureds when a generic equivalent exists for a brand name drug, regardless of whether both are on the formulary.

Maintains existing copayment and coinsurance limits of $250 for standard plans and $500 for bronze-level plans for individual prescriptions covering up to 30 days.

Requires Tier 4 drugs to consist only of those requiring specialty pharmacy distribution, special training for self-administration, or costing over $600 per month net of rebates.

Exempts the state from reimbursing local agencies or school districts for costs related to this act.