Today's Law As Amended


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SB-945 Breast and Cervical Cancer Treatment Program.(2017-2018)



As Amends the Law Today


SECTION 1.

 Section 104161 of the Health and Safety Code is amended to read:

104161.
 For the purposes of this article, the following definitions shall apply:
(a)   “Covered conditions” means breast or cervical cancer.
(b)   “Breast cancer” includes primary, recurrent, and metastatic cancers of the breast, including, but not limited to, infiltrating or in situ.
(c)   “Cervical cancer” includes all primary, recurrent, and metastatic cancers of the cervix, including, but not limited to, infiltrating or in situ, as well as cervical dysplasia.
(d)   “Treatment services” means those health care services, goods, supplies, or merchandise medically necessary to treat the covered condition or conditions with which the individual made eligible under this article has been diagnosed.
(e)   “Uninsured” means not covered for breast or cervical cancer treatment services by any of the following:
(1)   No-cost full-scope Medi-Cal.
(2)   Medicare.
(3)   A health care service plan contract or policy of disability insurance.
(4)   Any other form of health care coverage.
(f)   “Underinsured” means either of the following:
(1)   Covered for breast or cervical cancer treatment services by any health care insurance listed in paragraph (2), (3), or (4) of subdivision (e), but the sum of the individual’s insurance deductible, premiums, and expected copayments in the initial 12-month period that breast or cervical cancer treatment services are needed exceeds seven hundred fifty dollars ($750).
(2)   Covered by share-of-cost or limited-scope Medi-Cal, if the individual is not otherwise eligible for treatment services under the Medi-Cal program pursuant to Section 14007.71 of the Welfare and Institutions Code.

SEC. 2.

 Section 104161.1 of the Health and Safety Code is amended to read:

104161.1.
 (a) If an individual is made eligible for treatment services under this article due to a diagnosis of breast cancer, the treatment services shall be provided for the duration of the period of treatment, as long as the individual continues to meet all other eligibility requirements.
(b) If an individual is made eligible for treatment services under this article due to a diagnosis of cervical cancer, the treatment services shall be provided for the duration of the period of treatment, as long as the individual continues to meet all other eligibility requirements.
(c) If an individual is diagnosed with a reoccurrence of breast cancer or cervical cancer, whether at the original cancer site or a different cancer site, the individual shall be eligible for coverage for the duration of the period of treatment, as long as the individual continues to meet all other eligibility requirements.

SEC. 3.

 Section 104162.1 of the Health and Safety Code is amended to read:

104162.1.
 If an individual is underinsured, as defined in subdivision (f) of Section 104161, the State Department of Health Care Services shall be the payer of second resort for treatment services. To the extent necessary for the individual to obtain treatment services under any health care insurance listed in paragraph (2), (3), or (4) of subdivision (e) of Section 104161, the State Department of Health Care Services may do the following:
(a) Pay for the individual’s breast or cervical cancer copayments, premiums, and deductible.
(b) Provide only treatment services not otherwise covered by any health care insurance listed in paragraph (2), (3), or (4) of subdivision (e) of Section 104161.