Bill Text: CA AB767 | 2019-2020 | Regular Session | Amended
Bill Title: Victim compensation: use of excessive force by a peace officer.
Spectrum: Partisan Bill (Democrat 8-0)
Status: (Engrossed - Dead) 2020-08-20 - In committee: Held under submission. [AB767 Detail]
Download: California-2019-AB767-Amended.html
|
Amended
IN
Assembly
May 16, 2019 |
|
Amended
IN
Assembly
April 30, 2019 |
|
Amended
IN
Assembly
April 09, 2019 |
| Assembly Bill | No. 767 |
| Introduced by Assembly Member Wicks (Principal coauthors: Assembly Members Burke and Low) (Principal coauthor: Senator Stern) |
February 19, 2019 |
LEGISLATIVE COUNSEL'S DIGEST
Existing law, the Knox-Keene Health Care Service Plan Act of 1975 (Knox-Keene Act), provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of its provisions a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law imposes various requirements and restrictions on health care service plans and health insurers, including, among other things, a requirement that every group health care service plan contract or health insurance policy that is issued, amended, or renewed on or after January 1, 1990, offers coverage for the treatment of infertility, except
in vitro fertilization, under those terms and conditions as may be agreed upon between the group subscriber or the group policyholder and the health care service plans or the health insurers. The Knox-Keene Act specifies that a health care service plan that is a health maintenance organization (HMO) is required to provide this coverage to a group contractholder with at least 20 employees. Existing law provides that any employer that is a religious organization or health care service plans and health insurers that are a subsidiary of an entity whose owner or corporate member is a religious organization shall not be required to offer coverage for forms of treatment of infertility in a manner inconsistent with the religious organization’s religious and ethical principles, as specified.
This bill would instead require every large group health care service plan contract, including applicable HMO contracts, or
large group disability insurance policy that
covers hospital, medical, or surgical expenses, issued, amended, or renewed on or after January 1, 2020, to provide coverage for the treatment of infertility, including a maximum of 3 cycles of in vitro fertilization and mature oocyte cryopreservation, to a lifetime maximum benefit of $75,000 paid at contracted rates per enrollee or insured, as applicable. The bill would delete the exemption for religiously affiliated employers, health care
service plans, and health insurance policies from the requirements relating to coverage for the treatment of infertility, thereby imposing these requirements on these employers, plans, and policies that provide coverage for large groups. The bill would also delete the requirement that a health care service plan contract and health insurance policy provide infertility treatment under agreed upon terms that are communicated to all group contractholders and prospective group contractholders. The bill would specifically exclude
Medi-Cal coverage from these provisions. By expanding the duties of health care service plans, the bill would expand the scope of an existing crime, thereby imposing 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:Bill Text
The people of the State of California do enact as follows:
SECTION 1.
It is the intent of the Legislature to consider the inclusion of infertility treatment in the definition of essential health benefits.(a)(1)On and after January 1, 2020, every large group health care service plan contract that is issued, amended, or renewed that covers hospital, medical, or surgical expenses shall provide coverage for the treatment of infertility, including a maximum of three cycles of
in vitro
fertilization and mature oocyte cryopreservation.
(2)A large group health care service plan contract shall limit the coverage required by paragraph (1) to a lifetime maximum benefit of seventy-five thousand dollars ($75,000) paid at contracted rates per enrollee.
(b)This section shall not be construed to deny or restrict in any way any existing right or benefit to coverage and treatment of infertility under an existing law, plan, or policy.
(c)Consistent with Section 1365.5, coverage for the treatment of infertility shall be provided without discrimination on the basis of age, ancestry, color, disability, domestic
partner status, gender, gender expression, gender identity, genetic information, marital status, national origin, race, religion, sex, or sexual orientation. Nothing in this subdivision shall be construed to interfere with the clinical judgment of a physician and surgeon.
(d)The following definitions shall apply for purposes of this section:
(1)“Infertility” means the presence of a demonstrated condition recognized by a licensed physician and surgeon as a cause of infertility.
(2)“In vitro fertilization” means the laboratory medical procedures involving the in vitro fertilization process.
(3)“Large group health care service plan contract” means a group health care service plan contract other than a contract issued to a “small employer,” as defined in Section 1357, 1357.500, or 1357.600.
(4)“Mature oocyte cryopreservation” means the procedures consistent with established medical practices, including laboratory medical procedures, involving ovulation induction, egg retrieval, and freezing of the egg.
(5)“Treatment of infertility” means procedures consistent with established medical practices in the treatment of infertility by a licensed physician and surgeon, including, but not limited to, diagnosis, diagnostic tests, medication, surgery, gamete intrafallopian transfer, and in vitro fertilization.
(e)This section does not apply to a Medi-Cal managed care plan or any entity that enters into a contract with the State Department of Health Care Services pursuant to Chapter 7 (commencing with Section 14000) of, Chapter 8 (commencing with Section 14200) of, or Chapter 8.75 (commencing with Section 14591) of, Part 3 of Division 9 of the Welfare and Institutions
Code.
(a)(1)On and after January 1, 2020, every insurer issuing, renewing, or amending a policy of large group disability insurance that covers hospital, medical, or surgical expenses shall provide coverage of infertility treatment, including a maximum of three cycles of
in vitro fertilization and mature oocyte cryopreservation.
(2)A large group disability insurance policy shall limit the coverage required by paragraph (1) to a lifetime maximum benefit of seventy-five thousand dollars ($75,000) paid at contracted rates per insured.
(b)This section shall not be construed to deny or restrict in any way any existing right or benefit to coverage and treatment of infertility under an existing law, plan, or policy.
(c)This section applies to every disability insurance policy that is issued, amended, or renewed to residents of this state regardless of the situs of the contract.
(d)Consistent with Section 10140, coverage of infertility treatment shall be offered and, if purchased, provided without discrimination on the basis of age, ancestry, color, disability, domestic partner status, gender, gender expression, gender identity, genetic information, marital status, national origin, race, religion, sex, or sexual orientation. Nothing in this subdivision shall be construed to interfere with the clinical judgment of a physician and surgeon.
(e)The following definitions shall apply for purposes of this section:
(1)“Infertility” means the presence of a demonstrated condition recognized by a licensed physician and surgeon as a cause of infertility.
(2)“In vitro fertilization” means the laboratory medical procedures involving the in vitro fertilization process.
(3)“Large group” means a group that is not a “small employer,” as defined in Section 10753.
(4)“Mature oocyte
cryopreservation” means the procedures consistent with established medical practices, including laboratory medical procedures, involving ovulation induction, egg retrieval, and freezing of the egg.
(5)“Coverage of infertility treatment” means procedures consistent with established medical practices in the treatment of infertility by a licensed physician and surgeon, including, but not limited to, diagnosis, diagnostic tests, medication, surgery, gamete intrafallopian transfer, and in vitro fertilization.
(f)This section does not apply to Medi-Cal contracts with the State Department of Health Care Services.
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.
