AB3245:v96#DOCUMENTBill Start
Enrolled
September 03, 2024
|
Passed
IN
Senate
August 28, 2024
|
Passed
IN
Assembly
August 29, 2024
|
Amended
IN
Senate
June 10, 2024
|
Amended
IN
Assembly
April 25, 2024
|
|
CALIFORNIA LEGISLATURE—
2023–2024 REGULAR SESSION
Assembly Bill
No. 3245
Introduced by Assembly Member Joe Patterson
|
February 16, 2024 |
An act to amend Section 1367.668 of the Health and Safety Code, and to amend Section 10123.207 of the Insurance Code, relating to health care coverage.
LEGISLATIVE COUNSEL'S DIGEST
AB 3245, Joe Patterson.
Coverage for colorectal cancer screening.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law generally requires a health care service plan contract or a health insurance policy issued, amended, or renewed on or after January 1, 2022, to provide coverage without cost sharing for a colorectal cancer screening test assigned either a grade of A or a grade of B by the United States Preventive Services Task Force and for a required colonoscopy for a positive result on a test with those grades.
This bill would additionally require that coverage if the screening test is assigned either a grade of A or a grade of B, or equivalent, in accordance with the most current
recommendations established by another accredited or certified guideline agency approved by the California Health and Human Services Agency.
Digest Key
Vote:
MAJORITY
Appropriation:
NO
Fiscal Committee:
NO
Local Program:
NO
Bill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 1367.668 of the Health and Safety Code is amended to read:1367.668.
(a) Every health care service plan contract, except a specialized health care service plan contract, that is issued, amended, or renewed on or after January 1, 2022, shall provide coverage without any cost sharing for a colorectal cancer screening test assigned either a grade of A or a grade of B, or equivalent, by the United States Preventive Services Task Force or in accordance with the most current recommendations established by another accredited or certified guideline agency approved by the California Health and Human Services Agency. The required colonoscopy for a positive result on a test or procedure, other than a colonoscopy, that is a colorectal cancer screening examination or laboratory test assigned either a grade of A or a grade of B, or equivalent by the United States Preventive Services Task Force or in
accordance with the most current recommendations established by another accredited or certified guideline agency approved by the California Health and Human Services Agency shall also be provided without any cost sharing.(b) This section does not preclude a health care service plan that has coverage for out-of-network benefits from imposing cost-sharing requirements for the items or services described in this section that are delivered by an out-of-network provider.
SEC. 2.
Section 10123.207 of the Insurance Code is amended to read:10123.207.
(a) Every health insurance policy, except a specialized health insurance policy, that is issued, amended, or renewed on or after January 1, 2022, shall provide coverage without cost sharing for a colorectal cancer screening test assigned either a grade of A or a grade of B, or equivalent, by the United States Preventive Services Task Force or in accordance with the most current recommendations established by another accredited or certified guideline agency approved by the California Health and Human Services Agency. The required colonoscopy for a positive result on a test or procedure, other than a colonoscopy, that is a colorectal cancer screening examination or laboratory test assigned either a grade of A or a grade of B, or equivalent by the United States Preventive Services Task Force or in accordance with the most
current recommendations established by another accredited or certified guideline agency approved by the California Health and Human Services Agency shall also be provided without any cost sharing.(b) This section does not preclude a health insurer that has a network of providers from imposing cost-sharing requirements for the items or services described in this section that are delivered by an out-of-network provider.