Today's Law As Amended


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SB-746 Health care coverage: anticancer medical devices.(2019-2020)



As Amends the Law Today


SECTION 1.

 Section 1367.667 is added to the Health and Safety Code, immediately following Section 1367.665, to read:

1367.667.
 (a) Every health care service plan contract issued, amended, or renewed in this state on or after January 1, 2020, that provides coverage for chemotherapy or radiation therapy for the treatment of cancer shall also provide coverage for anticancer medical devices.
(b) For purposes of this section, “anticancer medical device” means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:
(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.
(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a provider’s professional service or as part of a provider’s fee for service.
(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.

SEC. 2.

 Section 10123.837 is added to the Insurance Code, immediately following Section 10123.835, to read:

10123.837.
 (a) Every policy of health insurance that is issued, amended, or renewed in this state on or after January 1, 2020, and provides coverage for chemotherapy or radiation therapy for the treatment of cancer shall also provide coverage for anticancer medical devices.
(b) For purposes of this section, “anticancer medical device” means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:
(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.
(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a provider’s professional service or as part of a provider’s fee for service.
(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
SEC. 3.
 No reimbursement is required by this act pursuant to Section 6 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 Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.