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

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Date Published: 01/29/2018 09:00 PM
SB945:v99#DOCUMENT


CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Senate Bill No. 945


Introduced by Senator Atkins
(Principal coauthor: Senator Pan)
(Principal coauthors: Assembly Members Arambula, Burke, Cristina Garcia, and Rubio)

January 29, 2018


An act to amend Sections 104161, 104161.1, and 104162.1 of the Health and Safety Code, relating to cancer.


LEGISLATIVE COUNSEL'S DIGEST


SB 945, as introduced, Atkins. Breast and Cervical Cancer Treatment Program.
Existing law requires the State Department of Health Care Services to perform various health functions, including providing breast and cervical cancer screening and treatment for low-income individuals. Existing law defines “period of coverage” as beginning when an individual is made eligible for a covered condition and not to exceed 18 or 24 months, respectively, for a diagnosis of breast cancer or a diagnosis of cervical cancer.
This bill would delete that definition and, instead, provide that the treatment services be provided for the duration of the period of treatment for an individual made eligible for treatment due to a diagnosis of breast cancer or cervical cancer, as long as the individual continues to meet all other eligibility requirements. The bill would make conforming changes to a provision relating to an individual who is diagnosed with a reoccurrence of breast cancer or cervical cancer. The bill would also make technical, nonsubstantive changes to related provisions.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


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) “Period of coverage” means the period of time beginning when an individual is made eligible under this article for a covered condition and shall not exceed the period of time the individual’s eligibility for treatment services for a covered condition concludes, as described in Section 104161.1.

(e)

(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.

(f)

(e)  “Uninsured” means not covered for breast or cervical cancer treatment services by any of the following:
(1)  No cost full scope 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.

(g)

(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 (f), (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 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) When If an individual is made eligible for treatment services under this article due to a diagnosis of breast cancer, the period of coverage shall not exceed 18 months of treatment. After 18 months, the individual’s eligibility for treatment services for the cancer condition that made this individual eligible concludes. 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) When If an individual is made eligible for treatment services under this article due to a diagnosis of cervical cancer, the period of coverage shall not exceed 24 months of treatment. After 24 months, the individual’s eligibility for treatment services for the cancer condition that made this individual eligible concludes. 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, and meets all other applicable eligibility requirements, the individual shall be eligible for an additional period of treatment coverage, as described in subdivision (a) or (b), respectively. 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.
 When If an individual is underinsured, as defined in subdivision (g) (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 (f) (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 (f) (e) of Section 104161.