On September 30, 2026, Governor Newsom signed Assembly Bill 1199 (AB 1199), and it will take effect on January 1, 2027. This new law extends the required medical staff reappointment cycle in California from two years to three.

What AB 1199 Changes

AB 1199 amends three statutes.

First, it amends Business and Professions Code section 2282 so that a hospital’s rules must provide for a formal medical staff with staff reappointments “at least every three years,” replacing the “annual or biennial” standard.

Second, it amends the Business and Professions Code section 2453 so that physician and surgeon staff must require members to demonstrate their ability to perform surgical and other procedures competently, and to the satisfaction of an appropriate staff committee, at original appointment and “at least every three years thereafter,” replacing “at least every two years.”

Third, the bill amends Health and Safety Code section 1275.6 by adding subdivision (e). That subdivision requires the governing body of a general acute care hospital or acute psychiatric hospital to require its medical staff to establish controls to ensure high standards of professional and ethical practice. These controls must include a requirement that all members demonstrate their ability to perform surgical or other procedures competently at original appointment and every three years thereafter. The statute also provides that the Department of Health Care Access and Information “shall not require” these hospitals “to undertake routine reappointments more frequently than every three years.”

These changes align California law with the standards of CMS-approved accreditation organizations, including The Joint Commission and DNV, which already permit reappointment on a three-year cycle.

Moving to a Three-Year Cycle

AB 1199 establishes a permissible maximum reappointment period. It does not require a three-year cycle. Medical Staffs whose Bylaws require reappointment every two years (or more frequently) must continue to follow those Bylaws until they are formally amended through the applicable amendment process. 

A Medical Staff that decides to adopt a three-year cycle should expect to do more than change the reappointment term in its Bylaws. Other Medical Staff and hospital policies, forms, and documents that assume a two-year cycle will also need to be reviewed and updated so that they are consistent with the amended Bylaws.

For example, the reappointment application and attestation questions may ask for updated information from occurrences “in the last two years.” If the cycle becomes three years, those references must be revised to ensure the Medical Staff receives information for the entire period since the practitioner last applied. Options include changing “two years” to “three years,” “since submission of your last application for appointment or reappointment,” or “since your last reappointment.”

What Medical Staffs Should Do Now

Medical Staffs should begin by deciding whether to adopt a three-year cycle. The Medical Staff should consider whether a three-year cycle fits their operational and quality oversight needs. If they decide to proceed, any Bylaws amendment must follow the process required by the existing Bylaws, including Medical Staff vote and governing body approval.

In parallel, Medical Staffs should conduct a review to identify and update all policies, forms, and agreements that reference or assume a two-year cycle, including the reappointment application and attestation language discussed above. Finally, they should plan the transition, addressing timing, communication with members, and any other changes before the new cycle is implemented.