Bill Text: CA AB1739 | 2015-2016 | Regular Session | Enrolled

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Bill Title: Medi-Cal: allergy testing.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Vetoed) 2016-09-21 - Vetoed by Governor. [AB1739 Detail]

Download: California-2015-AB1739-Enrolled.html

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BILL NUMBER: AB 1739	ENROLLED
	BILL TEXT

	PASSED THE SENATE  AUGUST 18, 2016
	PASSED THE ASSEMBLY  AUGUST 23, 2016
	AMENDED IN SENATE  AUGUST 2, 2016
	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, 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 standard of coverage and medical
necessity for allergy tests to be consistent with specified consensus
standards and recommendations and peer-reviewed medical literature
pertaining to the utilization of modern serologic-specific IgE tests.
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.


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 standard of coverage and medical necessity for
allergy tests shall be consistent with consensus standards and
recommendations in clinical guidelines from the National Institutes
of Health, Clinical and Laboratory Standards Institute, and the most
current peer-reviewed medical literature pertaining to the
utilization of modern serologic-specific IgE tests.
   (b) The department shall update its provider bulletins, as
necessary, to reference the most current professional literature and
guidance related to allergy testing.