BILL NUMBER: AB 2345 AMENDED
BILL TEXT
AMENDED IN SENATE AUGUST 17, 2010
AMENDED IN SENATE JULY 15, 2010
AMENDED IN SENATE JUNE 16, 2010
AMENDED IN ASSEMBLY APRIL 22, 2010
AMENDED IN ASSEMBLY APRIL 8, 2010
INTRODUCED BY Assembly Member De La Torre
FEBRUARY 19, 2010
An act to add Section 1367.001 to the Health and Safety Code, and
to add Section 10112.1 to the Insurance Code, relating to health care
coverage.
LEGISLATIVE COUNSEL'S DIGEST
AB 2345, as amended, De La Torre. Health care coverage: preventive
services.
Existing law, the federal Patient Protection and Affordable Care
Act (PPACA), enacts various health care coverage market reforms. With
respect to plan years beginning on and after September 23, 2010, the
act requires health insurance issuers to provide coverage, and not
impose cost-sharing requirements, for certain preventive services.
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 that act a crime. Existing law also provides for the
regulation of health insurers by the Department of Insurance.
This bill would require health care service plan contracts and
health insurance policies issued, amended, renewed, or delivered on
or after September 23, 2010, to provide coverage, and not
impose cost-sharing requirements, for certain comply
with the provisions of PPACA regarding coverage of, and cost-sharing
for, preventive services and any rules or regulations
issued pursuant to those provisions to the extent required under
federal law . Because a willful violation of this requirement
by a health care service plan would be a crime, the bill would impose
a state-mandated local program.
The bill would also state the intent of the Legislature to enact
legislation that would require the Department of Managed Health Care
and the Department of Insurance to post a link on their Internet Web
sites to the Internet Web site of the federal Department of Health
and Human Services where consumers may easily obtain information
about affordable and comprehensive health care coverage options under
PPACA.
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.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1367.001 is added to the Health and
Safety Code, to read:
1367.001. To the extent required by federal law, a group or
individual health care service plan contract issued, amended,
renewed, or delivered on or after September 23, 2010, shall comply
with Section 2713 of the federal Public Health Service Act (42 U.S.C.
Sec. 300gg-13) and any rules or regulations issued under that
section.
SEC. 2. Section 10112.1 is added to the Insurance Code,
to read:
10112.1. To the extent required under federal law, a group or
individual health insurance policy issued, amended, renewed, or
delivered on or after September 23, 2010, shall comply with Section
2713 of the federal Public Health Service Act (42 U.S.C. Sec.
300gg-13) and any rules or regulations issued under that section.
SECTION 1. Section 1367.001 is added to the
Health and Safety Code, to read:
1367.001. (a) (1) Subject to the minimum interval established by
the United States Secretary of Health and Human Services pursuant to
subsection (b) of Section 2713 of the federal Public Health Service
Act, as added by Section 1001 of the federal Patient Protection and
Affordable Care Act (Public Law 111-148), a group or individual
health care service plan contract that is issued, amended, renewed,
or delivered on or after September 23, 2010, shall, at a minimum,
provide coverage for, and shall not impose any cost-sharing
requirements for, all of the following:
(A) Evidence-based items or services that have in effect a rating
of "A" or "B" in the current recommendations of the United States
Preventive Services Task Force.
(B) Immunizations that have in effect a recommendation from the
Advisory Committee on Immunization Practices of the federal Centers
for Disease Control and Prevention with respect to the individual
involved.
(C) With respect to infants, children, and adolescents,
evidence-informed preventive care and screenings provided for in the
comprehensive guidelines supported by the federal Health Resources
and Services Administration.
(D) With respect to women, any additional preventive care and
screenings not described in subparagraph (A) as provided for in the
comprehensive guidelines supported by the federal Health Resources
and Services Administration.
(2) For purposes of this subdivision, the current recommendations
of the United States Preventive Services Task Force regarding breast
cancer screening, mammography, and prevention shall be considered the
most current, other than recommendations issued by the task force in
November of 2009, or within 30 days of that month.
(3) Nothing in this subdivision shall be construed to prohibit a
plan from providing coverage for services in addition to those
recommended by the United States Preventive Services Task Force or to
deny coverage for services that are not recommended by the task
force.
(b) This section shall not apply to Medicare supplement plan
contracts or to coverage offered by specialized health care service
plans, including, but not limited to, ambulance, dental, vision,
behavioral health, chiropractic, and naturopathic.
SEC. 2. Section 10112.1 is added to the
Insurance Code, to read:
10112.1. (a) (1) Subject to the minimum interval established by
the United States Secretary of Health and Human Services pursuant to
subsection (b) of Section 2713 of the federal Public Health Service
Act, as added by Section 1001 of the federal Patient Protection and
Affordable Care Act (Public Law 111-148), a group or individual
health insurance policy that is issued, amended, renewed, or
delivered on or after September 23, 2010, shall, at a minimum,
provide coverage for, and shall not impose any cost-sharing
requirements for, all of the following:
(A) Evidence-based items or services that have in effect a rating
of "A" or "B" in the current recommendations of the United States
Preventive Services Task Force.
(B) Immunizations that have in effect a recommendation from the
Advisory Committee on Immunization Practices of the federal Centers
for Disease Control and Prevention with respect to the individual
involved.
(C) With respect to infants, children, and adolescents,
evidence-informed preventive care and screenings provided for in the
comprehensive guidelines supported by the federal Health Resources
and Services Administration.
(D) With respect to women, any additional preventive care and
screenings not described in subparagraph (A) as provided for in the
comprehensive guidelines supported by the federal Health Resources
and Services Administration.
(2) For purposes of this subdivision, the current recommendations
of the United States Preventive Services Task Force regarding breast
cancer screening, mammography, and prevention shall be considered the
most current, other than recommendations issued by the task force in
November of 2009, or within 30 days of that month.
(3) Nothing in this subdivision shall be construed to prohibit a
health insurer from providing coverage for services in addition to
those recommended by the United States Preventive Services Task Force
or to deny coverage for services that are not recommended by the
task force.
(b) This section shall not apply to specialized health insurance
policies, Medicare supplement policies, CHAMPUS-supplement insurance
policies, TRICARE supplement insurance policies, accident-only
insurance policies, or insurance policies excluded from the
definition of "health insurance" under subdivision (b) of Section
106.
SEC. 3. It is the intent of the Legislature to
enact legislation that would require the Department of Managed Health
Care and the Department of Insurance to post a link on their
respective Internet Web sites to the Internet Web site of the federal
Department of Health and Human Services where consumers may easily
obtain information about affordable and comprehensive health care
coverage options under the federal Patient Protection and Affordable
Care Act (Public Law 111-148).
SEC. 4. SEC. 3. No reimbursement is
required by this act pursuant to Section 6 of Article XIII B of the
California Constitution because the only costs that may be incurred
by a local agency or school district will be incurred because this
act creates a new crime or infraction, eliminates a crime or
infraction, or changes the penalty for a crime or infraction, within
the meaning of Section 17556 of the Government Code, or changes the
definition of a crime within the meaning of Section 6 of Article XIII
B of the California Constitution.