California Senate Bill SB799 Latest Draft

 BILL NUMBER: SB 799AMENDED BILL TEXT AMENDED IN SENATE MAY 8, 2013 AMENDED IN SENATE APRIL 1, 2013 INTRODUCED BY Senator Calderon FEBRUARY 22, 2013 An act to add Section 1367.667 to, and to add Article 4 (commencing with Section 104201) to Chapter 2 of Part 1 of Division 103 of, the Health and Safety Code, and to add Section 10123.22 to the Insurance Code, relating to health care coverage  , and declaring the ur   gency thereof, to take effect immediately  . LEGISLATIVE COUNSEL'S DIGEST SB 799, as amended, Calderon. Health care coverage: colorectal cancer: genetic testing and screening. 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. Existing law requires individual and group health care service plan contracts and health insurance policies to provide coverage for all generally medically accepted cancer screening tests and requires those contracts and policies to also provide coverage for the treatment of breast cancer. Existing law requires an individual or small group health care service plan contract or insurance policy issued, amended, or renewed on or after January 1, 2014, to, at a minimum, include coverage for essential health benefits, which includes preventive services, pursuant to the federal Patient Protection and Affordable Care Act. This bill would require a health care service plan contract or a health insurance policy, except as specified, that is issued, amended, or renewed on or after January 1, 2014, to provide coverage for genetic testing for hereditary nonpolyposis colorectal cancer (HNPCC) and  screening   annual screenings  for colorectal cancer under specified circumstances. Because a willful violation of the bill's requirements relative to health care service plans would be a crime, the bill would impose a state-mandated local program. This bill would also require a physician and surgeon who makes a diagnosis that a patient has colorectal cancer to provide the patient with specified information. 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.  This bill would declare that it is to take effect immediately as an urgency statute.  Vote:  majority   2/3  . Appropriation: no. Fiscal committee: yes. State-mandated local program: yes. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 1367.667 is added to the Health and Safety Code, to read: 1367.667. Every health care service plan contract, except a specialized health care service plan contract, that is issued, amended, or renewed on or after January 1, 2014, shall provide coverage for all of the following: (a) Genetic testing for hereditary nonpolyposis colorectal cancer (HNPCC) for an enrollee who is under 50 years of age and has been diagnosed with colorectal cancer. (b) Genetic testing for HNPCC for an enrollee who is the child or sibling of an individual who has been diagnosed with colorectal cancer and has tested positive for the gene mutation for HNPCC. (c)  Frequent   Annual  screenings, including colonoscopies, for an enrollee who has tested positive for the gene mutation for HNPCC, and is the child or sibling of an individual who has been diagnosed with colorectal cancer and has tested positive for the gene mutation for HNPCC. SEC. 2. Article 4 (commencing with Section 104201) is added to Chapter 2 of Part 1 of Division 103 of the Health and Safety Code, to read: Article 4. Colorectal Cancer 104201. If a physician and surgeon makes a diagnosis that a patient has colorectal cancer, the physician and surgeon shall recommend that the patient be tested for the genetic mutation for hereditary nonpolyposis colorectal cancer (HNPCC). The physician and surgeon shall also inform the patient that genetic testing for HNPCC may be covered by the patient's health care coverage, and that genetic testing and screening for his or her children or siblings may be covered by the children's or siblings' health care coverage if the patient tests positive for the HNPCC gene mutation. SEC. 3. Section 10123.22 is added to the Insurance Code, to read: 10123.22. Every health insurance policy, except a specialized health insurance policy, that is issued, amended, or renewed on or after January 1, 2014, shall provide coverage for all of the following: (a) Genetic testing for hereditary nonpolyposis colorectal cancer (HNPCC) for an insured who is under 50 years of age and has been diagnosed with colorectal cancer. (b) Genetic testing for HNPCC for an insured who is the child or sibling of an individual who has been diagnosed with colorectal cancer and has tested positive for the gene mutation for HNPCC. (c)  Frequent   Annual  screenings, including colonoscopies, for an insured who has tested positive for the gene mutation for HNPCC, and is the child or sibling of an individual who has been diagnosed with colorectal cancer and has tested positive for the gene mutation for HNPCC. SEC. 4. 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.  SEC. 5.   This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the Constitution and shall go into immediate effect. The facts constituting the necessity are:   In order to protect the health of all Californians at the earliest possible time, it is necessary that this act take effect immediately.