California Assembly Bill AB73 Amended / Bill

 BILL NUMBER: AB 73AMENDED BILL TEXT AMENDED IN SENATE JUNE 30, 2016 AMENDED IN ASSEMBLY JANUARY 5, 2016 AMENDED IN ASSEMBLY MAY 4, 2015 AMENDED IN ASSEMBLY MARCH 16, 2015 INTRODUCED BY Assembly Member Waldron DECEMBER 18, 2014 An act to  add Section 14133.06 to the Welfare and Institutions Code, relating to Medi-Cal.   amend Section 1710.2 of the Civil Code, relating to real property, and declaring the urgency thereof, to take effect immediately.  LEGISLATIVE COUNSEL'S DIGEST AB 73, as amended, Waldron.  Patient Access to Prescribed Antiretroviral Drugs for HIV/AIDS Treatment Act.   Real property: disclosure.   Existing law requires certain disclosures to be made upon the transfer of residential property and prescribes the manner and form of the disclosures. Existing law provides that no cause of action arises against a real property owner or agent, or any agent of a transferee of real property, for the failure to disclose to the transferee the occurrence of an occupant's death upon the real property, as specified, or that an occupant of that property had or died from Human T-Lymphotropic Virus Type III/Lymphadenopathy-Associated Virus. Existing law declares the Legislature's intent to occupy the field of regulation of disclosure related to deaths occuring upon real property and of AIDS in situations affecting the transfer of real property or any estate or interest in real property.   This bill would delete the prohibition against a cause of action arising for failure to disclose that an occupant of that property had or died from this virus. The bill would also delete the reference to AIDS from the declaration of legislative intent.   This bill would declare that it is to take effect immediately as an urgency statute.   Existing law establishes the Medi-Cal program, 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 specifies the benefits provided pursuant to the program, including the purchase of prescribed drugs that are covered subject to utilization controls. Utilization controls include a requirement that the treatment provider obtain prior authorization for providing medical treatment, as specified.   This bill, to the extent permitted by federal law, would provide that if medically necessary antiretroviral drugs used in the treatment of HIV/AIDS is prescribed by a Medi-Cal beneficiary's treating provider for that purpose, and coverage for that prescribed drug is denied by a Medi-Cal managed care plan in which the beneficiary is enrolled, that denial shall be reviewed in accordance with the bill. This bill would provide that if the treating provider demonstrates, consistent with federal law, that in his or her reasonable, professional judgment, the drug is medically necessary and consistent with the federal Food and Drug Administration's labeling and use rules and regulations, as specified, the beneficiary would be entitled to an automatic urgent appeal, as defined.  Vote:  majority   2/3  . Appropriation: no. Fiscal committee:  yes   no  . State-mandated local program: no. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:  SECTION 1.   Section 1710.2 of the   Civil Code   is amended to read:  1710.2. (a) No cause of action arises against an owner of real property or his or her agent, or any agent of a transferee of real property, for the failure to disclose to the transferee the occurrence of an occupant's death upon the real property or the manner of death where the death has occurred more than three years prior to the date the transferee offers to purchase, lease, or rent the real  property, or that an occupant of that property was afflicted with, or died from, Human T-Lymphotropic Virus Type III/Lymphadenopathy-Associated Virus.   property.  As used in this section, "agent" includes any person licensed pursuant to Part 1 (commencing with Section 10000) of Division 4 of the Business and Professions Code. As used in this section, "transferee" includes a purchaser, lessee, or renter of real property. (b) It is the intention of the Legislature to occupy the field of regulation of disclosure related to deaths occurring upon real property  and of AIDS  in situations affecting the transfer of real property or any estate or interest in real property. (c) This section shall not be construed to alter the law relating to disclosure pertaining to any other physical or mental condition or disease, and this section shall not relieve any owner or agent of any obligation to disclose the physical condition of the premises. (d) Nothing in this section shall be construed to immunize an owner or his or her agent from making an intentional misrepresentation in response to a direct inquiry from a transferee or a prospective transferee of real property, concerning deaths on the real property.  SEC. 2.   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:   AIDS patients and the AIDS community require a change in state law to protect them from discrimination in real property transactions that may otherwise impose severe emotional distress.   SECTION 1.   This act shall be known, and may be cited as, the Patient Access to Prescribed Antiretroviral Drugs for HIV/AIDS Treatment Act.   SEC. 2.   Section 14133.06 is added to the Welfare and Institutions Code, to read: 14133.06. (a) It is the intent of the Legislature in enacting this section that a Medi-Cal beneficiary shall have prompt access to medically necessary antiretroviral drugs for use in the treatment of HIV/AIDS that have been approved by the federal Food and Drug Administration for that purpose, including drugs that are not on the formulary of a Medi-Cal managed care plan or that are subject to prior authorization. (b) To the extent permitted by federal law, if a drug used in the treatment of HIV/AIDS as described in subdivision (a) is prescribed by a Medi-Cal beneficiary's treating provider for the treatment of HIV/AIDS, and coverage for that prescribed drug is denied by a Medi-Cal managed care plan in which the beneficiary is enrolled, that denial shall be reviewed in accordance with this section. (c) (1) The denial by a Medi-Cal managed care plan of a drug prescribed for the treatment of HIV/AIDS and approved by the federal Food and Drug Administration for use in the treatment of HIV/AIDS is subject to the urgent appeal process described in paragraph (2) if the treating provider demonstrates, consistent with federal law, that in his or her reasonable, professional judgment, the drug is medically necessary and consistent with the federal Food and Drug Administration's labeling and use rules and regulations, as supported in at least one of the official compendia identified in Section 1927 (g)(1)(B)(i) of the federal Social Security Act (42 U.S.C. Sec. 1396r-8(g)(1)(B)(i)), and the drug is not on the formulary for the Medi-Cal managed care plan. (2) In a case in which a plan denies coverage for a drug prescribed for the treatment of HIV/AIDS and approved by the federal Food and Drug Administration for use in the treatment of HIV/AIDS, the beneficiary shall be entitled to an urgent appeal in accordance with paragraph (1). For purposes of this section, "urgent appeal" means an appeal in which the beneficiary, or treatment provider with the consent of the beneficiary, requests an appeal either orally or in writing. An urgent appeal shall be resolved by the plan within 24 hours after the plan receives the request. The 24-hour period specified in this paragraph shall be in addition to any time prescribed by federal law.