Menopause.
AB 432
California Bills
20250AB__043292ENR INTRODUCED 2025-02-05 AMENDED_ASSEMBLY 2025-04-23 AMENDED_ASSEMBLY 2025-05-27 AMENDED_SENATE 2025-07-09 AMENDED_SENATE 2025-07-17 AMENDED_SENATE 2025-08-29 AMENDED_SENATE 2025-09-05 PASSED_ASSEMBLY 2025-09-10 PASSED_SENATE 2025-09-09 ENROLLED 2025-09-12 2025 AB ENR Introduced by Assembly Member Bauer-Kahan (Coauthors: Assembly Members Aguiar-Curry, Boerner, Bonta, Lowenthal, Pellerin, and Stefani) (Coauthors: Senators Rubio and Weber Pierson) LEAD_AUTHOR ASSEMBLY Bauer-Kahan COAUTHOR ASSEMBLY Aguiar-Curry COAUTHOR ASSEMBLY Boerner COAUTHOR ASSEMBLY Bonta COAUTHOR ASSEMBLY Lowenthal COAUTHOR ASSEMBLY Pellerin COAUTHOR ASSEMBLY Stefani COAUTHOR SENATE Rubio COAUTHOR SENATE Weber Pierson
An act to amend
Section of, and to add Sections 2190.4 and 2454.7 to, the Business and Professions Code, to add
Section 1367.252 to the Health and Safety Code, and to add
Section 10123.1962 to the Insurance Code, relating to menopause. menopause Menopause.
(1) Existing law, the Medical Practice Act, provides for the licensure and regulation of physicians and surgeons by the Medical Board of California and requires the board to adopt and administer standards for the continuing education of those licensees. Existing law requires the board, in determining its continuing education requirements, to consider including a course in menopausal mental or physical health. This bill would delete that requirement of the board.
The bill would require, beginning July 1, 2026, and until July 1, 2032, a qualifying physician and surgeon, as defined, who completes continuing medical education courses in perimenopause, menopause, and postmenopausal care to receive hours of credit for each hour completed of that coursework, as specified. Existing law, the Osteopathic Act, provides for the licensure and regulation of osteopathic physicians and surgeons by the Osteopathic Medical Board of California and requires the board to adopt and administer standards for the continuing education of those licensees.
This bill would require osteopathic physicians and surgeons to receive the same credit as described above for completed coursework relating to perimenopause, menopause, and postmenopausal care.
(2) 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 a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law sets forth specified coverage requirements for health care service plan contracts and health insurance policies.
This bill would require a health care service plan contract or health insurance policy that covers outpatient prescription drugs, except as specified, that is issued, amended, or renewed on or after January 1, 2026, to include coverage for evaluation and treatment options for symptoms of perimenopause and menopause. The bill would require a health care service plan or health insurer to annually provide clinical care recommendations, as specified, for hormone therapy to all contracted primary care providers who treat individuals with perimenopause and menopause.
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.
(3) 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. MAJORITY NO YES YES NO NO NO NO NO NO NO The people of the State of California do enact as follows:
SECTION
Section 2190.4 is added to the Business and Professions Code , to read: 2190.4. (
a) For purposes of this section, “qualifying physician and surgeon” means a holder of a physician’s and surgeon’s certificate from the board who is certified by a member board of the American Board of Medical Specialties as a general internist, family physician, obstetrician and gynecologist, cardiologist, endocrinologist, neurologist, or psychiatrist and whose patient population is composed of percent or more of adult women under years of age. (
b) Beginning July 1, 2026, and until July 1, 2032, a qualifying physician and surgeon who completes continuing medical education courses in perimenopause, menopause, and postmenopausal care shall receive two hours of credit for each hour completed of that coursework, for a total earned credit that does not exceed eight course hours, toward the requirement set forth in
Section of Title of the California Code of Regulations.
SEC. 2.
Section of the Business and Professions Code is amended to read: 2191. (
a) In determining its continuing education requirements, the board shall consider including a course in human sexuality, defined as the study of a human being as a sexual being and how they function with respect thereto, and nutrition to be taken by those licensees whose practices may require knowledge in those areas. (
b) The board shall consider including a course in child abuse detection and treatment to be taken by those licensees whose practices are of a nature that there is a likelihood of contact with abused or neglected children. (
c) The board shall consider including a course in acupuncture to be taken by those licensees whose practices may require knowledge in the area of acupuncture and whose education has not included instruction in acupuncture. (
d) The board shall encourage every physician and surgeon to take nutrition as part of their continuing education, particularly a physician and surgeon involved in primary care. (
e) The board shall consider including a course in elder abuse detection and treatment to be taken by those licensees whose practices are of a nature that there is a likelihood of contact with abused or neglected persons years of age and older. (
f) In determining its continuing education requirements, the board shall consider including a course in the early detection and treatment of substance abusing pregnant women to be taken by those licensees whose practices are of a nature that there is a likelihood of contact with these women. (
g) In determining its continuing education requirements, the board shall consider including a course in the special care needs of drug-addicted infants to be taken by those licensees whose practices are of a nature that there is a likelihood of contact with these infants. (
h) In determining its continuing education requirements, the board shall consider including a course providing training and guidelines on how to routinely screen for signs exhibited by abused women, particularly for physicians and surgeons in emergency, surgical, primary care, pediatric, prenatal, and mental health settings. In the event the board establishes a requirement for continuing education coursework in spousal or partner abuse detection or treatment, that requirement shall be met by each licensee within no more than four years from the date the requirement is imposed. (
i) In determining its continuing education requirements, the board shall consider including a course in the special care needs of individuals and their families facing end-of-life issues, including, but not limited to, all of the following:
(1) Pain and symptom management.
(2) The psychosocial dynamics of death.
(3) Dying and bereavement.
(4) Hospice care. (
j) In determining its continuing education requirements, the board shall give its highest priority to considering a course on pain management and the risks of addiction associated with the use of
Schedule II drugs. (
k) In determining its continuing education requirements, the board shall consider including a course in geriatric care for emergency room physicians and surgeons.
SEC.
Section 2454.7 is added to the Business and Professions Code , to read: 2454.7. Beginning July 1, 2026, an osteopathic physician and surgeon who completes continuing medical education courses in perimenopause, menopause, and postmenopausal care shall receive two hours of credit for each hour completed of that coursework, for a total earned credit that does not exceed eight course hours, toward the requirement set forth in
Section of Title of the California Code of Regulations.
SEC.
Section 1367.252 is added to the Health and Safety Code , to read: 1367.252. (
a) A health care service plan contract that covers outpatient prescription drugs, except for a specialized health care service plan contract, that is issued, amended, or renewed on or after January 1, 2026, shall include coverage for evaluation and treatment options for symptoms of perimenopause and menopause, as is deemed medically necessary by the treating health care provider under contract with the health care service plan or in accordance with the contract if there is an out-of-network benefit, without utilization management for treatments approved by the federal Food and Drug Administration, that includes, but is not limited to, all of the following:
(1) At least one outpatient prescription drug in each formulation of, and the associated method of administration for, federal Food and Drug Administration-regulated systemic hormone therapy.
(2) At least one outpatient prescription drug in each formulation of, and the associated method of administration for, nonhormonal medications for each menopause symptom.
(3) At least one outpatient prescription drug in each formulation of, and the associated method of administration for, treatment for genitourinary syndrome of menopause.
(4) At least one outpatient prescription drug from each class of medications approved to prevent and treat osteoporosis. (
b) Coverage required under this
section includes authority for the treating provider to adjust the dose of a drug consistent with clinical care recommendations. (
c) A health care service plan shall annually provide current clinical care recommendations for hormone therapy from the Menopause Society or other nationally recognized professional associations to all contracted primary care providers who treat enrollees with perimenopause and menopause. A health care service plan shall encourage primary care providers to review those recommendations. (
d) For purposes of this section, the following terms have the following meanings: (1) “Formulation” means all of the following: (
A) A tablet or capsule. (
B) A transdermal patch. (
C) A topical spray. (
D) A cream, gel, or lotion. (
E) A suppository, cream, or silicone ring. (2) “Method of administration” means administering a formulation via an oral, topical, vaginal, rectal, subcutaneous, injectable, or intravenous route of administration. (
e) Coverage for the evaluation and treatment options for symptoms of perimenopause and menopause shall be provided without discrimination on the basis of gender expression or identity. (
f) Nothing in this
section shall be construed to limit coverage for medically necessary outpatient prescription drugs pursuant to
Section 1342.71 or any other provision under this chapter. (
g) This
section does not apply to a Medi-Cal managed care plan contract with the State Department of Health Care Services pursuant to
Chapter 7 (commencing with
Section 14000) or
Chapter 8 (commencing with
Section 14200) of Part of Division of the Welfare and Institutions Code.
SEC.
Section 10123.1962 is added to the Insurance Code , to read: 10123.1962. (
a) A health insurance policy that covers outpatient prescription drugs, except for a specialized health insurance policy, that is issued, amended, or renewed on or after January 1, 2026, shall include coverage for evaluation and treatment options for symptoms of perimenopause and menopause, as is deemed medically necessary by the treating health care provider under contract with the health insurer or in accordance with the policy for out-of-network benefits, without utilization management for treatments approved by the federal Food and Drug Administration, that includes, but is not limited to, all of the following:
(1) At least one outpatient prescription drug in each formulation of, and the associated method of administration for, federal Food and Drug Administration-regulated systemic hormone therapy.
(2) At least one outpatient prescription drug in each formulation of, and the associated method of administration for, nonhormonal medications for each menopause symptom.
(3) At least one outpatient prescription drug in each formulation of, and the associated method of administration for, treatment for genitourinary syndrome of menopause.
(4) At least one outpatient prescription drug from each class of medications approved to prevent and treat osteoporosis. (
b) Coverage required under this
section includes authority for the treating provider to adjust the dose of a drug consistent with clinical care recommendations. (
c) A health insurer shall annually provide current clinical care recommendations for hormone therapy from the Menopause Society or other nationally recognized professional associations to all contracted primary care providers who treat insureds with perimenopause and menopause. A health insurer shall encourage primary care providers to review those recommendations. (
d) For purposes of this section, the following terms have the following meanings: (1) “Formulation” means all of the following: (
A) A tablet or capsule. (
B) A transdermal patch. (
C) A topical spray. (
D) A cream, gel, or lotion. (
E) A suppository, cream, or silicone ring. (2) “Method of administration” means administering a formulation via an oral, topical, vaginal, rectal, subcutaneous, injectable, or intravenous route of administration. (
e) Coverage for the evaluation and treatment options for symptoms of perimenopause and menopause shall be provided without discrimination on the basis of gender expression or identity. (
f) Nothing in this
section shall be construed to limit coverage for medically necessary outpatient prescription drugs pursuant to
Section 10123.193 or any other provision under this chapter.
SEC. 6. No reimbursement is required by this act pursuant to
Section of
Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of