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 Bill Text - SB-950 Health care coverage: dementia.

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 |Add To My Favorites |Track Bill | Version: 07/02/26 - Amended Assembly
 04/20/26 - Amended Senate
 02/02/26 - Introduced

 SB-950 Health care coverage: dementia.(2025-2026)

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 Date Published: 07/02/2026 09:00 PM

SB950:v97#DOCUMENTBill Start

 Amended
 IN 
 Assembly
 July 02, 2026

 Amended
 IN 
 Senate
 April 20, 2026

 CALIFORNIA LEGISLATURE—
 2025–2026 REGULAR SESSION

 Senate Bill

No. 950

Introduced by Senator Weber Pierson
(Coauthors: Senators Grayson, Richardson, and Smallwood-Cuevas)
(Coauthors: Assembly Members Davies and Schiavo)

February 02, 2026

 An act to add Section 1373.15 to the Health and Safety Code, and to add Section 10123.175 to the Insurance Code, relating to health care coverage. 

LEGISLATIVE COUNSEL'S DIGEST

SB 950, as amended, Weber Pierson.
 Health care coverage: dementia.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act’s requirements a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law prohibits specified health care service plan contracts and disability insurance policies from excluding persons covered by the plan from receiving benefits if they are diagnosed as having any significant destruction of brain tissue with resultant loss of brain function, including Alzheimer’s disease.

This bill would require a health care service plan contract or health insurance policy that is issued, amended, or renewed on or after January 1, 2027, to include coverage for all medically necessary
 treatments or medications, as determined by a health care provider, approved by the United States Food and Drug Administration (FDA) for the treatment of Alzheimer’s disease or other related dementia. Under the bill, contracts and policies would not be required to cover drugs or treatments that are pharmaceutically equivalent drug products if the FDA approves more than one. On and after January 1, 2027, the bill would prohibit a health care service plan or health insurer from imposing step therapy protocols as a prerequisite to authorizing that coverage, except as provided. Because a willful violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory
 provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

Digest Key

 Vote:
 MAJORITY 
 Appropriation:
 NO 
 Fiscal Committee:
 YES 
 Local Program:
 YES 

Bill Text

The people of the State of California do enact as follows:

SECTION 1.

 Section 1373.15 is added to the Health and Safety Code, to read:

1373.15.

 (a) (1) A health care service plan contract that is issued, amended, or renewed on or after January 1, 2027, shall include coverage for all medically necessary treatments or medications, as determined by a health care provider, approved by the United States Food and Drug Administration (FDA) for the treatment of Alzheimer’s disease or other related dementia. Medically necessary treatments or medications include, but are not limited to, those that reduce clinical decline.

(2) Medically necessary treatments or medications covered pursuant to paragraph (1) include those administered through a medical benefit, an outpatient prescription drug benefit to the extent
 the health care service plan contract covers outpatient prescription drugs, or both.

(3)Coverage for all medically necessary treatment or medications pursuant to paragraph (1) does not require a health care service plan contract to cover drugs or treatments that are pharmaceutically equivalent drug products if the FDA approves more than one medication or treatment that are pharmaceutically equivalent drug products, unless otherwise required by law.

(b) (1) On and after January 1, 2027, a health care service plan shall not impose step therapy protocols as a prerequisite to authorizing coverage
 of medically necessary treatments or medications approved by the FDA for the treatment of Alzheimer’s disease, except as p