California Gives Providers 90 Days to Fix a Denied Claim From January 1

Governor Newsom signed SB 1049 on September 30 as Chapter 1001, Statutes of 2026. From January 1, 2027, about three months from now, when a California plan or insurer denies a claim, or sends an overpayment notice, "based in whole or in part on a defect that may be remedied by submitting a corrected claim," the provider has "no less than 90 calendar days from the plan's most recent action to submit a corrected claim."

The turn: the protection is against the other deadline

The 90 days isn't the important part. Subdivision (b) is: a plan "shall not deny a corrected claim … on the grounds that the claim was not submitted within an applicable claim filing deadline other than the deadline specified in subdivision (a)." A denial that comes back near the end of a timely-filing window can no longer turn a fixable error, like a wrong modifier or unit count, into a write-off. The clock restarts from the plan's latest action.

Disputes over corrected claims must be eligible for the plan's "fast, fair, and cost-effective dispute resolution mechanism."

What the law covers

• Health and Safety Code §1371.21, for plans licensed under Knox-Keene and regulated by DMHC.
• Insurance Code §10123.134, for insurers regulated by CDI.
• DMHC and CDI may issue guidance and regulations outside the Administrative Procedure Act. DHCS "may also issue" consistent guidance.

A second bill signed the same day, AB 2499 (Chapter 945), starts later. From May 26, 2028, plans and insurers must accept electronic medical records and supporting documentation through a standard electronic submission method, and can't "deny, pend, or delay a claim solely because" their own systems can't accept documentation that otherwise meets requirements.

The limits

The statute doesn't define which defects "may be remedied" by a corrected claim, and it doesn't say how it treats denials issued before January 1. Medi-Cal plans aren't covered automatically: the DHCS language is permissive, and not every Medi-Cal plan is Knox-Keene licensed. Self-funded employer plans aren't reached by state law.

What you must know or do

• Billers: from January 1, log the date of every denial and overpayment notice from a DMHC or CDI plan, and calendar 90 days from it for the corrected claim.
• If a corrected claim submitted inside that window is rejected for timely filing, cite H&S §1371.21(b) or Ins. Code §10123.134(b), and file through the plan's dispute process.
• Owners: pull your commercial contracts and write down each one's current corrected-claim window. Any that's shorter than 90 days changes on January 1.