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SB-1213 Health care programs: cancer.(2023-2024)



Current Version: 09/04/24 - Enrolled

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SB1213:v95#DOCUMENT

Enrolled  September 04, 2024
Passed  IN  Senate  August 30, 2024
Passed  IN  Assembly  August 28, 2024
Amended  IN  Assembly  August 19, 2024
Amended  IN  Senate  April 08, 2024
Amended  IN  Senate  March 21, 2024

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Senate Bill
No. 1213


Introduced by Senator Atkins
(Principal coauthor: Senator Portantino)
(Coauthor: Senator Rubio)

February 15, 2024


An act to amend Sections 104150 and 104162 of the Health and Safety Code, relating to health care programs.


LEGISLATIVE COUNSEL'S DIGEST


SB 1213, Atkins. Health care programs: cancer.
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 provides that an individual is eligible to receive treatment services if, among other things, the individual has a family income at or below 200% of the federal poverty level as determined by the provider performing the screening and diagnosis.
This bill would provide that, commencing no later than July 1, 2026, an individual is eligible to receive treatment services if the individual has a family income at or below 250% of the federal poverty level as determined by the provider performing the screening and diagnosis.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 Section 104150 of the Health and Safety Code is amended to read:

104150.
 (a) (1) (A) A provider or an entity that participates in the grant made to the department by the federal Centers for Disease Control and Prevention breast and cervical cancer early detection program established under Title XV of the federal Public Health Service Act (42 U.S.C. Sec. 300k et seq.) in accordance with requirements of Section 1504 of that act (42 U.S.C. Sec. 300n) may only render screening services under the grant to an individual if the provider or entity determines that the individual’s family income does not exceed 200 percent of the federal poverty level.
(B) Commencing no later than July 1, 2026, a provider or an entity described in subparagraph (A) may render screening services under the grant if the provider or entity determines that the individual’s family income does not exceed 250 percent of the federal poverty level.
(2) Providers, or the enrolling entity, shall make available to all applicants and beneficiaries, before or concurrent with enrollment, information on the manner in which to apply for insurance affordability programs, in a manner determined by the State Department of Health Care Services. The information shall include the manner in which applications can be submitted for insurance affordability programs, information about the open enrollment periods for the California Health Benefit Exchange, and the continuous enrollment aspect of the Medi-Cal program.
(b) (1) The department shall provide for breast cancer and cervical cancer screening services under the grant at the level of funding budgeted from state and other resources during the fiscal year in which the Legislature has appropriated funds to the department for this purpose. These screening services shall not be deemed to be an entitlement.
(2) The following individuals shall be eligible for breast cancer screening and diagnostic services pursuant to this section if they meet all other eligibility requirements:
(A) An individual of any age who is symptomatic.
(B) An individual whose age is within the age range for routine breast cancer screening, as recommended by the United States Preventive Services Task Force, subject to any federal action relating to breast cancer screening that overrides those recommendations.
(3) For purposes of this section, “symptomatic” means an individual presenting with an abnormality or change in the look or feel of the breast, including, but not limited to, a lump, a hard knot, thickening or swelling of the breast tissue, a change in the color, size, or shape of the breast, or any discharge from the nipple.
(c) To implement the federal breast and cervical cancer early detection program specified in this section, the department may contract, to the extent permitted by Section 19130 of the Government Code, with public and private entities, or utilize existing health care service provider enrollment and payment mechanisms, including the Medi-Cal program’s fiscal intermediary. However, the Medi-Cal program’s fiscal intermediary shall only be utilized if services provided under the program are specifically identified and reimbursed in a manner that does not claim federal financial reimbursement. Any contracts with, and the utilization of, the Medi-Cal program’s fiscal intermediary shall not be subject to Chapter 3 (commencing with Section 12100) of Part 2 of Division 2 of the Public Contract Code. Contracts to implement the federal breast and cervical cancer early detection program entered into by the department with entities other than the Medi-Cal program’s fiscal intermediary shall not be subject to Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code.
(d) The department shall enter into an interagency agreement with the State Department of Health Care Services to transfer that portion of the grant made to the department by the federal Centers for Disease Control and Prevention breast and cervical cancer early detection program established under Title XV of the federal Public Health Service Act (42 U.S.C. Sec. 300k et seq.) to the State Department of Health Care Services. The department shall have no other liability to the State Department of Health Care Services under this article.

SEC. 2.

 Section 104162 of the Health and Safety Code is amended to read:

104162.
 An individual shall be eligible to receive treatment services pursuant to this article provided that all of the following criteria are met:
(a) The individual is a resident of California.
(b) The individual is uninsured or underinsured.
(c) The individual, who meets the income standards described in subdivision (d), was screened for breast or cervical cancer by a provider or entity participating in the Centers for Disease Control and Prevention breast and cervical cancer early detection program established under Title XV of the Public Health Service Act (42 U.S.C. Sec. 300k et seq.) in accordance with requirements of Section 1504 of that act (42 U.S.C. Sec. 300n) and needs treatment for breast or cervical cancer.
(d) (1) As determined by the provider performing the screening and diagnosis, the individual has family income at or below 200 percent of the federal poverty level.
(2) Commencing no later than July 1, 2026, as determined by the provider described in paragraph (1), the individual has family income at or below 250 percent of the federal poverty level.
(e) The individual has filed a completed application for eligibility for treatment services under the Medi-Cal program pursuant to Section 14007.71 of the Welfare and Institutions Code, and has been found ineligible for benefits under that section.