BILL NUMBER: AB 73 AMENDED
BILL TEXT
AMENDED IN SENATE JUNE 30, 2016
AMENDED IN ASSEMBLY JANUARY 5, 2016
AMENDED IN ASSEMBLY MAY 4, 2015
AMENDED IN ASSEMBLY MARCH 16, 2015
INTRODUCED BY Assembly Member Waldron
DECEMBER 18, 2014
An act to add Section 14133.06 to the Welfare and
Institutions Code, relating to Medi-Cal. amend Section
1710.2 of the Civil Code, relating to real property, and declaring
the urgency thereof, to take effect immediately.
LEGISLATIVE COUNSEL'S DIGEST
AB 73, as amended, Waldron. Patient Access to Prescribed
Antiretroviral Drugs for HIV/AIDS Treatment Act. Real
property: disclosure.
Existing law requires certain disclosures to be made upon the
transfer of residential property and prescribes the manner and form
of the disclosures. Existing law provides that no cause of action
arises against a real property owner or agent, or any agent of a
transferee of real property, for the failure to disclose to the
transferee the occurrence of an occupant's death upon the real
property, as specified, or that an occupant of that property had or
died from Human T-Lymphotropic Virus Type
III/Lymphadenopathy-Associated Virus. Existing law declares the
Legislature's intent to occupy the field of regulation of disclosure
related to deaths occuring upon real property and of AIDS in
situations affecting the transfer of real property or any estate or
interest in real property.
This bill would delete the prohibition against a cause of action
arising for failure to disclose that an occupant of that property had
or died from this virus. The bill would also delete the reference to
AIDS from the declaration of legislative intent.
This bill would declare that it is to take effect immediately as
an urgency statute.
Existing law establishes the Medi-Cal program, administered by the
State Department of Health Care Services, under which qualified
low-income individuals receive health care services. The Medi-Cal
program is, in part, governed and funded by federal Medicaid Program
provisions. Existing law specifies the benefits provided pursuant to
the program, including the purchase of prescribed drugs that are
covered subject to utilization controls. Utilization controls include
a requirement that the treatment provider obtain prior authorization
for providing medical treatment, as specified.
This bill, to the extent permitted by federal law, would provide
that if medically necessary antiretroviral drugs used in the
treatment of HIV/AIDS is prescribed by a Medi-Cal beneficiary's
treating provider for that purpose, and coverage for that prescribed
drug is denied by a Medi-Cal managed care plan in which the
beneficiary is enrolled, that denial shall be reviewed in accordance
with the bill. This bill would provide that if the treating provider
demonstrates, consistent with federal law, that in his or her
reasonable, professional judgment, the drug is medically necessary
and consistent with the federal Food and Drug Administration's
labeling and use rules and regulations, as specified, the beneficiary
would be entitled to an automatic urgent appeal, as defined.
Vote: majority 2/3 . Appropriation:
no. Fiscal committee: yes no .
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1710.2 of the Civil
Code is amended to read:
1710.2. (a) No cause of action arises against an owner of real
property or his or her agent, or any agent of a transferee of real
property, for the failure to disclose to the transferee the
occurrence of an occupant's death upon the real property or the
manner of death where the death has occurred more than three years
prior to the date the transferee offers to purchase, lease, or rent
the real property, or that an occupant of that property was
afflicted with, or died from, Human T-Lymphotropic Virus Type
III/Lymphadenopathy-Associated Virus. property.
As used in this section, "agent" includes any person licensed
pursuant to Part 1 (commencing with Section 10000) of Division 4 of
the Business and Professions Code. As used in this section,
"transferee" includes a purchaser, lessee, or renter of real
property.
(b) It is the intention of the Legislature to occupy the field of
regulation of disclosure related to deaths occurring upon real
property and of AIDS in situations affecting the
transfer of real property or any estate or interest in real property.
(c) This section shall not be construed to alter the law relating
to disclosure pertaining to any other physical or mental condition or
disease, and this section shall not relieve any owner or agent of
any obligation to disclose the physical condition of the premises.
(d) Nothing in this section shall be construed to immunize an
owner or his or her agent from making an intentional
misrepresentation in response to a direct inquiry from a transferee
or a prospective transferee of real property, concerning deaths on
the real property.
SEC. 2. This act is an urgency statute necessary
for the immediate preservation of the public peace, health, or safety
within the meaning of Article IV of the Constitution and shall go
into immediate effect. The facts constituting the necessity are:
AIDS patients and the AIDS community require a change in state law
to protect them from discrimination in real property transactions
that may otherwise impose severe emotional distress.
SECTION 1. This act shall be known, and may be
cited as, the Patient Access to Prescribed Antiretroviral Drugs for
HIV/AIDS Treatment Act.
SEC. 2. Section 14133.06 is added to the
Welfare and Institutions Code, to read:
14133.06. (a) It is the intent of the Legislature in enacting
this section that a Medi-Cal beneficiary shall have prompt access to
medically necessary antiretroviral drugs for use in the treatment of
HIV/AIDS that have been approved by the federal Food and Drug
Administration for that purpose, including drugs that are not on the
formulary of a Medi-Cal managed care plan or that are subject to
prior authorization.
(b) To the extent permitted by federal law, if a drug used in the
treatment of HIV/AIDS as described in subdivision (a) is prescribed
by a Medi-Cal beneficiary's treating provider for the treatment of
HIV/AIDS, and coverage for that prescribed drug is denied by a
Medi-Cal managed care plan in which the beneficiary is enrolled, that
denial shall be reviewed in accordance with this section.
(c) (1) The denial by a Medi-Cal managed care plan of a drug
prescribed for the treatment of HIV/AIDS and approved by the federal
Food and Drug Administration for use in the treatment of HIV/AIDS is
subject to the urgent appeal process described in paragraph (2) if
the treating provider demonstrates, consistent with federal law, that
in his or her reasonable, professional judgment, the drug is
medically necessary and consistent with the federal Food and Drug
Administration's labeling and use rules and regulations, as supported
in at least one of the official compendia identified in Section 1927
(g)(1)(B)(i) of the federal Social Security Act (42 U.S.C. Sec.
1396r-8(g)(1)(B)(i)), and the drug is not on the formulary for the
Medi-Cal managed care plan.
(2) In a case in which a plan denies coverage for a drug
prescribed for the treatment of HIV/AIDS and approved by the federal
Food and Drug Administration for use in the treatment of HIV/AIDS,
the beneficiary shall be entitled to an urgent appeal in accordance
with paragraph (1). For purposes of this section, "urgent appeal"
means an appeal in which the beneficiary, or treatment provider with
the consent of the beneficiary, requests an appeal either orally or
in writing. An urgent appeal shall be resolved by the plan within 24
hours after the plan receives the request. The 24-hour period
specified in this paragraph shall be in addition to any time
prescribed by federal law.