Bill Text: CA SB529 | 2009-2010 | Regular Session | Amended
Bill Title: Health care coverage: FDA approved treatments.
Sponsorship: Partisan Bill (Republican 1)
Status: (Introduced - Dead) 2010-02-01 - Returned to Secretary of Senate pursuant to Joint Rule 56. [SB529 Detail]
Download: California-2009-SB529-Amended.html
BILL NUMBER: SB 529 AMENDED
BILL TEXT
AMENDED IN SENATE APRIL 2, 2009
INTRODUCED BY Senator Wyland
FEBRUARY 27, 2009
An act to amend Section 1344 of add
Section 1367.47 to the Health and Safety Code, and to add
Section 10127.19 to the Insurance Code, relating to health care
service plans coverage .
LEGISLATIVE COUNSEL'S DIGEST
SB 529, as amended, Wyland. Health care service plans.
coverage: FDA approved treatments.
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
authorizes the director of that department to adopt, amend, and
rescind rules, form, and orders that are necessary to carry out the
provisions of the act, as specified. Existing law also
provides for the regulation of health insurers by the Department of
Insurance. Existing law requires health care service plan contracts
and health insurance policies to provide coverage for certain
conditions.
This bill would make technical, nonsubstantive changes to that
provision.
This bill would require a health care service plan contract or a
health insurance policy that provides coverage of a health condition
to also provide coverage for any federal Food and Drug Administration
approved treatment of that condition, as specified.
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 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: no
yes . State-mandated local program: no
yes .
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1367.47 is added to the
Health and Safety Code , to read:
1367.47. (a) A health care service plan contract that provides
coverage of a health condition shall also provide coverage for any
federal Food and Drug Administration approved treatment of that
condition that is prescribed by the enrollee's health care provider.
(b) This section shall not be construed to require a health care
service plan contract to provide coverage for any treatment that has
been approved by the federal Food and Drug Administration in the form
of an investigational new drug application.
(c) For purposes of this section, "treatment" includes, but is not
limited to, drugs and medical devices.
SEC. 2. Section 10127.19 is added to the
Insurance Code , to read:
10127.19. (a) A health insurance policy that provides coverage of
a health condition shall also provide coverage for any federal Food
and Drug Administration approved treatment of that condition that is
prescribed by the insured's health care provider.
(b) This section shall not be construed to require a health
insurance policy to provide coverage for any treatment that has been
approved by the federal Food and Drug Administration in the form of
an investigational new drug application.
(c) For purposes of this section, "treatment" includes, but is not
limited to, drugs and medical devices.
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.
SECTION 1. Section 1344 of the Health and
Safety Code is amended to read:
1344. (a) The director may from time to time adopt, amend, and
rescind any rules, forms, and orders that are necessary to carry out
the provisions of this chapter, including rules governing
applications and reports, and defining any terms, whether or not used
in this chapter, insofar as the definitions are not inconsistent
with the provisions of this chapter. For the purpose of rules and
forms, the director may classify persons and matters within the
director's jurisdiction, and may prescribe different requirements for
different classes. The director may waive any requirement of any
rule or form in situations where in the director's discretion that
requirement is not necessary in the public interest or for the
protection of the public, subscribers, enrollees, or persons or plans
subject to this chapter. The director may adopt rules consistent
with federal regulations and statutes to regulate health care
coverage supplementing Medicare.
(b) The director may honor requests from interested parties for
interpretive opinions.
(c) No provision of this chapter imposing any liability applies to
any act done or omitted in good faith in conformity with any rule,
form, order, or written interpretive opinion of the director, or any
opinion of the Attorney General, notwithstanding that the rule, form,
order, or written interpretive opinion may later be amended or
rescinded or be determined by judicial or other authority to be
invalid for any reason.
