10123.833.
(a) Every health insurance policy that is issued, amended, or renewed on or after January 1, 2020, that provides hospital, medical, or surgical coverage, excluding specialized health insurance policies, shall permit an HIV specialist to be an eligible primary care provider, if the provider requests primary care provider status and meets the health insurer’s eligibility criteria for all specialists seeking primary care provider status.(b) For purposes of this section, “primary care provider” means a physician or a nonphysician medical practitioner, as each term is defined in Section 14254 of the Welfare and Institutions Code, who has the responsibility for providing initial and primary care to patients, for maintaining the continuity of patient care, and for initiating referral for specialist care. This means providing care for the majority of health care problems, including, but not limited to, preventive services, acute and chronic conditions, and psychosocial issues.
(c) For purposes of this section, “HIV specialist” means a physician, physician assistant, or a nurse practitioner who meets the criteria for an HIV specialist as published by the American Academy of HIV Medicine or the HIV Medicine Association, or who is contracted to provide outpatient medical care under the federal Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of 1990 (Public Law 101-381).
(d) This section does not include an HIV specialist as a primary care physician for the purposes of the department’s network adequacy requirements.
(e) This section does not apply to a health insurance policy that does not require an insured to obtain a referral from the primary care physician prior to seeking covered health care services from a specialist.
(f) This section does not require a health insurance policy to include provisions to pay an HIV specialist providing primary care services more than the policy would pay any other primary care provider for providing primary care services.