BILL NUMBER: SB 158 INTRODUCED
BILL TEXT
INTRODUCED BY Senator Wiggins
FEBRUARY 12, 2009
An act to amend Section 1367.66 of the Health and Safety Code, and
to amend Section 10123.18 of the Insurance Code, relating to health
care coverage.
LEGISLATIVE COUNSEL'S DIGEST
SB 158, as introduced, Wiggins. Health care coverage: human
papillomavirus vaccination.
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 also provides for the
regulation of health insurers by the Department of Insurance. Under
existing law, health care service plan contracts and health insurance
policies that include coverage for the treatment or surgery of
cervical cancer are deemed to provide coverage for an annual cervical
cancer screening test, upon the referral of specified persons.
This bill would require those plan contracts and insurance
policies to also provide coverage for the human papillomavirus
vaccination, as specified.
Because a willful violation of the bill's requirements by a health
care service plan would be a crime, the bill would impose a
state-mandated local program.
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 1367.66 of the Health and Safety Code is
amended to read:
1367.66. (a) Every individual or group
health care service plan contract, except for a specialized health
care service plan, that is issued, amended, or renewed, on or after
January 1, 2002, and that includes coverage for treatment or surgery
of cervical cancer shall also be deemed to provide coverage for an
annual cervical cancer screening test upon the referral of the
patient's physician and surgeon, a nurse practitioner, or certified
nurse midwife, providing care to the patient and operating within the
scope of practice otherwise permitted for the licensee.
The coverage for an annual cervical cancer screening test provided
pursuant to this section shall include the conventional Pap test, a
human papillomavirus screening test that is approved by the federal
Food and Drug Administration, and the option of any cervical cancer
screening test approved by the federal Food and Drug Administration,
upon the referral of the patient's health care provider.
(b) Every individual or group health care service plan contract,
except for a specialized health care service plan contract, that is
issued, amended, or renewed on or after January 1, 2010, and that
includes coverage for treatment or surgery of cervical cancer shall
also be deemed to provide coverage for a human papillomavirus
vaccination upon the referral of the patient's physician and surgeon,
a nurse practitioner, or certified nurse midwife, providing care to
the patient and operating within the scope of practice otherwise
permitted for the licensee.
Nothing
(c) Nothing in this section shall
be construed to establish a new mandated benefit or to prevent
application of deductible or copayment provisions in an existing plan
contract. The Legislature intends in this section to provide that
cervical cancer screening services are deemed to be covered if the
plan contract includes coverage for cervical cancer treatment or
surgery.
SEC. 2. Section 10123.18 of the Insurance Code is amended to read:
10123.18. (a) Every individual or group policy of health
insurance that provides coverage for hospital, medical, or
surgical benefits, that is issued, amended, or renewed, on
or after January 1, 2002, and that includes coverage for treatment or
surgery of cervical cancer shall also be deemed to provide coverage,
upon the referral of a patient's physician and surgeon, a nurse
practitioner, or a certified nurse midwife, providing care to the
patient and operating within the scope of practice otherwise
permitted for the licensee, for an annual cervical cancer screening
test.
The coverage for an annual cervical cancer screening test provided
pursuant to this section shall include the conventional Pap test, a
human papillomavirus screening test that is approved by the federal
Food and Drug Administration, and the option of any cervical cancer
screening test approved by the federal Food and Drug Administration,
upon the referral of the patient's health care provider.
(b) Every individual or group policy of health insurance that is
issued, amended, or renewed, on or after January 1, 2010, and that
includes coverage for treatment or surgery of cervical cancer shall
also be deemed to provide coverage for a human papillomavirus
vaccination upon the referral of a patient's physician and surgeon, a
nurse practitioner, or a certified nurse midwife, providing care to
the patient and operating within the scope of practice otherwise
permitted for the licensee, for an annual cervical cancer screening
test.
Nothing
(c) Nothing in this section shall
be construed to require an individual or group policy to cover
treatment or surgery for cervical cancer or to prevent application of
deductible or copayment provisions contained in the policy or
certificate, nor shall this section be construed to require that
coverage under an individual or group policy be extended to any other
procedures.
(b)
(d) This section shall not apply to vision only, dental
only, accident only, specified disease, hospital indemnity, Medicare
supplement, CHAMPUS supplement, long-term care, or disability income
insurance. For accident only, hospital indemnity, or specified
disease insurance, coverage for benefits under this section shall
apply only to the extent that the benefits are covered under the
general terms and conditions that apply to all other benefits under
the policy or certificate. Nothing in this section shall be construed
as imposing a new benefit mandate on accident only, hospital
indemnity, or specified disease insurance.
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.