Bill Text: CA AB2640 | 2019-2020 | Regular Session | Introduced
Bill Title: Health care coverage: genetic biomarker testing.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2020-03-02 - Referred to Com. on HEALTH. [AB2640 Detail]
Download: California-2019-AB2640-Introduced.html
CALIFORNIA LEGISLATURE—
2019–2020 REGULAR SESSION
Assembly Bill
No. 2640
Introduced by Assembly Member Gonzalez |
February 20, 2020 |
An act to amend Section 1367.665 of the Health and Safety Code, and to amend Section 10123.20 of the Insurance Code, relating to health care coverage.
LEGISLATIVE COUNSEL'S DIGEST
AB 2640, as introduced, Gonzalez.
Health care coverage: genetic biomarker testing.
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 provides for the regulation of health insurers by the Department of Insurance. Existing law requires an individual or group health care service plan contract or health insurance policy issued, amended, delivered, or renewed on or after July 1, 2000, to provide coverage for all generally medically accepted cancer screening tests.
This bill would prohibit an individual or group health care service plan contract or health insurance policy issued, amended, delivered, or renewed on or after January 1, 2021, from requiring prior authorization for genetic biomarker testing for an enrollee or insured with metastatic
or advanced stage 3 or 4 cancer. Because a willful violation of these provisions 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.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YESBill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 1367.665 of the Health and Safety Code is amended to read:1367.665.
(b) An individual or group health care service plan contract, except for a specialized health care service plan contract, that is issued, amended, delivered, or renewed on or after January 1, 2021, shall not require prior authorization for genetic biomarker testing for an enrollee with metastatic or advanced stage 3 or 4 cancer.
SEC. 2.
Section 10123.20 of the Insurance Code is amended to read:10123.20.
(a)(b) An individual or group health insurance policy that is issued, amended, delivered, or renewed on or after January 1, 2021, shall not require prior authorization for genetic biomarker testing for an insured with metastatic or advanced stage 3 or 4 cancer.
(b)
(c) This section shall does
not apply to vision-only, dental-only, accident-only, specified disease, hospital indemnity, Medicare supplement, long-term care, or disability income insurance, except that for accident-only, specified disease, or hospital indemnity insurance, coverage for benefits under this section shall apply to the extent that the benefits are covered under the general terms and conditions that apply to all other benefits under the policy or contract. Nothing in this section shall be construed as imposing This section does not impose a new benefit mandate on accident-only, specified disease, or hospital indemnity insurance.