---
type: "Bill"
title: "Health care coverage: step therapy."
description: "Existing law, the Knox-Keene Health Care Service Plan Act of 1975 (Knox-Keene) , 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 a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law authorizes a health insurer to require step therapy if there is more than one drug that is appropriate for the treatment of a medical condition, and authorizes a health care service plan to utilize step therapy consistent with Knox-Keene. Under existing law, if a health care service plan, health insurer, or contracted physician group fails to respond to a completed prior authorization request from a prescribing provider within a specified timeframe, the prior authorization request is deemed to have been granted."
jurisdiction: "us/states/ca"
legislature: "California Legislature"
session: "20212022"
identifier: "AB 347"
citation: "California AB 347 (20212022)"
classification: ["bill"]
subjects: ["Health care coverage: step therapy."]
status: "enacted"
primary_sponsors: ["Arambula"]
version_count: 10
action_count: 29
vote_count: 8
first_action: "2021-01-28"
last_action: "2021-10-09"
source: "openstates"
source_identifier: "ocd-bill/f216f451-b689-4c78-94f3-354846d7c416"
source_url: "http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB347"
source_hash: "c285ba9b3600d7c468bbe9745d1a8e9ae256d5c9f66802df0b23f19b95a28138"
vintage: "2026-07-01"
source_snapshot: "https://data.openstates.org/daily/2026-07-01/public.pgdump"
retrieved_at: "2026-07-06"
confidence: "reported"
tags: ["legislation", "bill", "us-ca"]
---

# California AB 347 (20212022) — Health care coverage: step therapy.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975 (Knox-Keene) , 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 a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law authorizes a health insurer to require step therapy if there is more than one drug that is appropriate for the treatment of a medical condition, and authorizes a health care service plan to utilize step therapy consistent with Knox-Keene. Under existing law, if a health care service plan, health insurer, or contracted physician group fails to respond to a completed prior authorization request from a prescribing provider within a specified timeframe, the prior authorization request is deemed to have been granted.

## Version chain

The bill's text revisions, in order — the diff chain from filing to enrollment.

1. **01/28/21 - Introduced** (filed) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB347&version=20210AB34799INT)
2. **04/08/21 - Amended Assembly** (committee substitute) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB347&version=20210AB34798AMD)
3. **05/24/21 - Amended Assembly** (committee substitute) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB347&version=20210AB34797AMD)
4. **06/29/21 - Amended Senate** (committee substitute) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB347&version=20210AB34796AMD)
5. **07/13/21 - Amended Senate** (committee substitute) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB347&version=20210AB34795AMD)
6. **08/26/21 - Amended Senate** (committee substitute) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB347&version=20210AB34794AMD)
7. **09/03/21 - Amended Senate** (committee substitute) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB347&version=20210AB34793AMD)
8. **10/09/21 - Chaptered** (committee substitute) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB347&version=20210AB34791CHP)
9. **AB347** (committee substitute) — [source](http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB347)
10. **09/13/21 - Enrolled** (enrolled) — [source](https://leginfo.legislature.ca.gov/faces/billPdf.xhtml?bill_id=202120220AB347&version=20210AB34792ENR)

## Votes

- Do pass as amended. — **13–3** (pass) · lower
- Do pass as amended, but first amend, and re-refer to the Committee on [Appropriations] — **8–0** (pass) · upper
- AB 347 Arambula Concurrence in Senate Amendments — **72–0** (pass) · lower
- AB 347 Arambula Assembly Third Reading — **69–1** (pass) · lower
- Do pass as amended and be re-referred to the Committee on [Appropriations] — **13–1** (pass) · lower
- 3rd Reading AB347 Arambula et al. By Wiener — **37–0** (pass) · upper
- Placed on suspense file — **7–0** (pass) · upper
- Do pass as amended — **5–1** (pass) · upper

## Sponsors

- Arambula — primary (person)
- Nazarian — coauthor (person)
- Wiener — coauthor (person)

## Timeline

The legislative action history — every referral, reading, and vote.

- **2021-01-28** Read first time. To print. `reading-1`
- **2021-01-29** From printer. May be heard in committee February 28.
- **2021-02-12** Referred to Com. on HEALTH. `referral-committee`
- **2021-04-07** From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 13. Noes 1.) (April 6). `amendment-introduction, amendment-passage, committee-passage, referral-committee`
- **2021-04-08** Read second time and amended. `amendment-passage, reading-1, reading-2`
- **2021-04-12** Re-referred to Com. on APPR. `referral-committee`
- **2021-04-28** In committee: Set, first hearing. Referred to APPR. suspense file. `referral-committee`
- **2021-05-20** From committee: Amend, and do pass as amended. (Ayes 13. Noes 3.) (May 20). `amendment-introduction, amendment-passage, committee-passage`
- **2021-05-24** Read second time and amended. Ordered returned to second reading. `amendment-passage, reading-1, reading-2`
- **2021-05-25** Read second time. Ordered to third reading. `reading-1, reading-2`
- **2021-06-02** Read third time. Passed. Ordered to the Senate. (Ayes 69. Noes 1. Page 1841.) `passage, reading-1, reading-3`
- **2021-06-03** In Senate. Read first time. To Com. on RLS. for assignment. `reading-1`
- **2021-06-16** Referred to Com. on HEALTH. `referral-committee`
- **2021-06-28** In committee: Hearing postponed by committee.
- **2021-06-29** From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on HEALTH. `amendment-introduction, amendment-passage, reading-1, reading-2, referral-committee`
- **2021-07-12** From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 8. Noes 0.) (July 7). `amendment-introduction, amendment-passage, committee-passage, referral-committee`
- **2021-07-13** Read second time and amended. Re-referred to Com. on APPR. `amendment-passage, reading-1, reading-2, referral-committee`
- **2021-08-16** In committee: Referred to suspense file. `referral-committee`
- **2021-08-26** From committee: Amend, and do pass as amended. (Ayes 5. Noes 1.) (August 26). `amendment-introduction, amendment-passage, committee-passage`
- **2021-08-26** Read second time and amended. Ordered returned to second reading. `amendment-passage, reading-1, reading-2`
- **2021-08-30** Read second time. Ordered to third reading. `reading-1, reading-2`
- **2021-09-03** Read third time and amended. Ordered to second reading. `amendment-passage, reading-1, reading-3`
- **2021-09-07** Read second time. Ordered to third reading. `reading-1, reading-2`
- **2021-09-08** Read third time. Passed. Ordered to the Assembly. (Ayes 37. Noes 0. Page 2498.). `passage, reading-1, reading-3`
- **2021-09-08** In Assembly. Concurrence in Senate amendments pending.
- **2021-09-09** Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 72. Noes 0. Page 3026.). `amendment-passage, committee-passage-favorable`
- **2021-09-17** Enrolled and presented to the Governor at 3 p.m.
- **2021-10-09** Approved by the Governor. `executive-signature`
- **2021-10-09** Chaptered by Secretary of State - Chapter 742, Statutes of 2021. `became-law`

## Source

OpenStates / OpenCivicData bulk snapshot [2026-07-01](https://data.openstates.org/daily/2026-07-01/public.pgdump); origin `ocd-bill/f216f451-b689-4c78-94f3-354846d7c416`. Confidence: reported (aggregated from official California legislature records).