Official Summary Text
AB 1906, as amended, Aguiar-Curry.
Cervical cancer screening.
Health care coverage: home test kits.
Existing
(1) 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, and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2002, to provide coverage for an annual cervical cancer screening test upon the referral of the patient’s
health care provider.
Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services and under which health care services are provided to low-income individuals pursuant to a schedule of benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. An annual cervical cancer test for screening or diagnostic purposes, upon the referral of a patient’s physician, is a covered benefit under the Medi-Cal program to the extent required or permitted by federal law.
This bill would require a health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2027, to provide coverage without cost sharing for an annual cervical cancer screening home test kit upon the referral of the patient’s health care provider. Because a willful violation of the bill’s requirements relative to health care service
plans would be a crime, the bill would impose a state-mandated local program. The bill would also include cervical cancer home test kits, upon the referral of a patient’s health care provider, as a covered benefit under the Medi-Cal program on or after January 1, 2027, without cost sharing, to the extent required or permitted by federal law.
(2) Under existing law, the Medi-Cal program administers the Family Planning, Access, Care, and Treatment (Family PACT) Program within the State Department of Health Care Services to provide comprehensive clinical family planning services to a person with a family income at or below 200% of the federal poverty level. Existing law authorizes the department to provide reimbursement for sexually transmitted disease-related services as part of the Family PACT Program. Existing law establishes within the department the State-Only
Family Planning Program to provide comprehensive clinical family planning services to any individual who is a resident of the state, has a family income at or below 200% of the federal poverty level, has no other health coverage, except as described, and is not otherwise eligible for Medi-Cal services without a share of cost. Existing law includes in the benefits for Medi-Cal, the Family PACT Program, and the State-Only Family Planning Program home test kits for sexually transmitted diseases and the laboratory testing required to process those kits that are deemed medically necessary or appropriate and are ordered directly by a health care provider or furnished through a standing order for patient use based on clinical guidelines and individual patient health needs, contingent upon the addition of billing codes specific to home test kits in the Current Procedural Terminology or Healthcare Common Procedure Coding System.
This bill would remove the above-described
requirements related to the addition of billing codes for the above-described programs.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.