BILL NUMBER: AB 1739	AMENDED
	BILL TEXT

	AMENDED IN SENATE  JUNE 2, 2016
	AMENDED IN ASSEMBLY  APRIL 19, 2016
	AMENDED IN ASSEMBLY  MARCH 16, 2016

INTRODUCED BY   Assembly Member Waldron

                        FEBRUARY 1, 2016

   An act to add Section 14133.75 to the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1739, as amended, Waldron. Medi-Cal: allergy testing.
   Existing law provides for the Medi-Cal program, which is
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 provides for a schedule of
benefits under the Medi-Cal program, and authorizes the use of
utilization controls, including prior authorization, that may be
applied to those covered benefits and that are reviewed for, among
other things, medical necessity. Under the Medi-Cal program, a
service is "medically necessary" or a "medical necessity" when it is
reasonable and necessary to protect life, to prevent significant
illness or significant disability, or to alleviate severe pain.
   This bill would require the department to treat serologic-specific
IgE allergy tests and percutaneous skin allergy tests as equivalent
in their  sensitivity and accuracy   clinical
efficacy  for confirming the existence of an allergy in a
patient, and to provide the same standard of coverage for either test
for those individuals with a medical history consistent with
specified conditions. The bill would require the department to update
its provider bulletins, as necessary, to reference the most current
professional literature and guidance related to allergy testing.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 14133.75 is added to the Welfare and
Institutions Code, to read:
   14133.75.  (a) The department shall treat serologic-specific IgE
tests and percutaneous skin tests as equivalent confirmatory tests in
 terms of their sensitivity and accuracy,  
their clinical efficacy,  and shall provide the same standard of
coverage for either test for those individuals with a medical
history consistent with any of the following:
   (1) An inhalant allergy.
   (2) A food allergy.
   (3) Hymenoptera venom allergy or an allergy to stinging insects.
   (4) Allergic bronchopulmonary aspergillosis (ABPA).
   (5) Certain parasitic diseases.
   (6) Allergies to specific drugs.
   (b) The department shall update its provider bulletins, as
necessary, to reference the most current professional literature and
guidance related to allergy testing.