California 2019-2020 Regular Session

California Senate Bill SB746 Compare Versions

OldNewDifferences
1-Amended IN Assembly May 30, 2019 CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Senate Bill No. 746Introduced by Senator Bates(Coauthor: Senator Wilk)February 22, 2019 An act to add Section 1367.667 to the Health and Safety Code, and to add Section 10123.837 to the Insurance Code, relating to health care coverage. LEGISLATIVE COUNSEL'S DIGESTSB 746, as amended, Bates. Health care coverage: anticancer medical devices.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 requires health care service plan contracts and health insurance policies to cover certain medical services for particular types of cancer, including the screening, diagnosis, and treatment of breast cancer, and the screening and diagnosis of prostate cancer, if the contract or policy was issued, amended, or renewed after the applicable date.This bill would require health care service plan contracts and health insurance policies issued, amended, or renewed on or after January 1, 2020, that cover chemotherapy or radiation therapy for the treatment of cancer to also cover anticancer medical devices. The bill would define anticancer medical device as a medical device that has been approved for marketing by the federal Food and Drug Administration or is exempt from that approval, is primarily designed to be used outside of a medical facility, and has been prescribed by an authorized provider upon the providers determination that the device is medically reasonable and necessary for the treatment of the patients cancer. Because a violation of this bills 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: YES Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 1367.667 is added to the Health and Safety Code, immediately following Section 1367.665, to read:1367.667. (a) Every health care service plan contract issued, amended, or renewed in this state on or after January 1, 2020, that provides coverage for chemotherapy or radiation therapy for the treatment of cancer, cancer shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.SEC. 2. Section 10123.837 is added to the Insurance Code, immediately following Section 10123.835, to read:10123.837. (a) Every policy of disability insurance that covers hospital, medical, or surgical expenses health insurance that is issued, amended, or renewed in this state on or after January 1, 2020, and provides coverage for chemotherapy or radiation therapy for the treatment of cancer, cancer shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.SEC. 3. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB 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 XIIIB of the California Constitution.
1+CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Senate Bill No. 746Introduced by Senator Bates(Coauthor: Senator Wilk)February 22, 2019 An act to add Section 1367.667 to the Health and Safety Code, and to add Section 10123.837 to the Insurance Code, relating to health care coverage. LEGISLATIVE COUNSEL'S DIGESTSB 746, as introduced, Bates. Health care coverage: anticancer medical devices.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 requires health care service plan contracts and health insurance policies to cover certain medical services for particular types of cancer, including the screening, diagnosis, and treatment of breast cancer, and the screening and diagnosis of prostate cancer, if the contract or policy was issued, amended, or renewed after the applicable date.This bill would require health care service plan contracts and health insurance policies issued, amended, or renewed on or after January 1, 2020, that cover chemotherapy or radiation therapy for the treatment of cancer to also cover anticancer medical devices. The bill would define anticancer medical device as a medical device that has been approved for marketing by the federal Food and Drug Administration or is exempt from that approval, is primarily designed to be used outside of a medical facility, and has been prescribed by an authorized provider upon the providers determination that the device is medically reasonable and necessary for the treatment of the patients cancer. Because a violation of this bills 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: YES Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 1367.667 is added to the Health and Safety Code, immediately following Section 1367.665, to read:1367.667. (a) Every health care service plan contract issued, amended, or renewed in this state on or after January 1, 2020, that provides coverage for chemotherapy or radiation therapy for the treatment of cancer, shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.SEC. 2. Section 10123.837 is added to the Insurance Code, immediately following Section 10123.835, to read:10123.837. (a) Every policy of disability insurance that covers hospital, medical, or surgical expenses that is issued, amended, or renewed in this state on or after January 1, 2020, and provides coverage for chemotherapy or radiation therapy for the treatment of cancer, shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.SEC. 3. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB 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 XIIIB of the California Constitution.
22
3- Amended IN Assembly May 30, 2019 CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Senate Bill No. 746Introduced by Senator Bates(Coauthor: Senator Wilk)February 22, 2019 An act to add Section 1367.667 to the Health and Safety Code, and to add Section 10123.837 to the Insurance Code, relating to health care coverage. LEGISLATIVE COUNSEL'S DIGESTSB 746, as amended, Bates. Health care coverage: anticancer medical devices.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 requires health care service plan contracts and health insurance policies to cover certain medical services for particular types of cancer, including the screening, diagnosis, and treatment of breast cancer, and the screening and diagnosis of prostate cancer, if the contract or policy was issued, amended, or renewed after the applicable date.This bill would require health care service plan contracts and health insurance policies issued, amended, or renewed on or after January 1, 2020, that cover chemotherapy or radiation therapy for the treatment of cancer to also cover anticancer medical devices. The bill would define anticancer medical device as a medical device that has been approved for marketing by the federal Food and Drug Administration or is exempt from that approval, is primarily designed to be used outside of a medical facility, and has been prescribed by an authorized provider upon the providers determination that the device is medically reasonable and necessary for the treatment of the patients cancer. Because a violation of this bills 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: YES
3+ CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Senate Bill No. 746Introduced by Senator Bates(Coauthor: Senator Wilk)February 22, 2019 An act to add Section 1367.667 to the Health and Safety Code, and to add Section 10123.837 to the Insurance Code, relating to health care coverage. LEGISLATIVE COUNSEL'S DIGESTSB 746, as introduced, Bates. Health care coverage: anticancer medical devices.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 requires health care service plan contracts and health insurance policies to cover certain medical services for particular types of cancer, including the screening, diagnosis, and treatment of breast cancer, and the screening and diagnosis of prostate cancer, if the contract or policy was issued, amended, or renewed after the applicable date.This bill would require health care service plan contracts and health insurance policies issued, amended, or renewed on or after January 1, 2020, that cover chemotherapy or radiation therapy for the treatment of cancer to also cover anticancer medical devices. The bill would define anticancer medical device as a medical device that has been approved for marketing by the federal Food and Drug Administration or is exempt from that approval, is primarily designed to be used outside of a medical facility, and has been prescribed by an authorized provider upon the providers determination that the device is medically reasonable and necessary for the treatment of the patients cancer. Because a violation of this bills 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: YES
44
5- Amended IN Assembly May 30, 2019
65
7-Amended IN Assembly May 30, 2019
6+
7+
88
99 CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION
1010
1111 Senate Bill No. 746
1212
1313 Introduced by Senator Bates(Coauthor: Senator Wilk)February 22, 2019
1414
1515 Introduced by Senator Bates(Coauthor: Senator Wilk)
1616 February 22, 2019
1717
1818 An act to add Section 1367.667 to the Health and Safety Code, and to add Section 10123.837 to the Insurance Code, relating to health care coverage.
1919
2020 LEGISLATIVE COUNSEL'S DIGEST
2121
2222 ## LEGISLATIVE COUNSEL'S DIGEST
2323
24-SB 746, as amended, Bates. Health care coverage: anticancer medical devices.
24+SB 746, as introduced, Bates. Health care coverage: anticancer medical devices.
2525
2626 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 requires health care service plan contracts and health insurance policies to cover certain medical services for particular types of cancer, including the screening, diagnosis, and treatment of breast cancer, and the screening and diagnosis of prostate cancer, if the contract or policy was issued, amended, or renewed after the applicable date.This bill would require health care service plan contracts and health insurance policies issued, amended, or renewed on or after January 1, 2020, that cover chemotherapy or radiation therapy for the treatment of cancer to also cover anticancer medical devices. The bill would define anticancer medical device as a medical device that has been approved for marketing by the federal Food and Drug Administration or is exempt from that approval, is primarily designed to be used outside of a medical facility, and has been prescribed by an authorized provider upon the providers determination that the device is medically reasonable and necessary for the treatment of the patients cancer. Because a violation of this bills 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.
2727
2828 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 requires health care service plan contracts and health insurance policies to cover certain medical services for particular types of cancer, including the screening, diagnosis, and treatment of breast cancer, and the screening and diagnosis of prostate cancer, if the contract or policy was issued, amended, or renewed after the applicable date.
2929
3030 This bill would require health care service plan contracts and health insurance policies issued, amended, or renewed on or after January 1, 2020, that cover chemotherapy or radiation therapy for the treatment of cancer to also cover anticancer medical devices. The bill would define anticancer medical device as a medical device that has been approved for marketing by the federal Food and Drug Administration or is exempt from that approval, is primarily designed to be used outside of a medical facility, and has been prescribed by an authorized provider upon the providers determination that the device is medically reasonable and necessary for the treatment of the patients cancer. Because a violation of this bills provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program.
3131
3232 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.
3333
3434 This bill would provide that no reimbursement is required by this act for a specified reason.
3535
3636 ## Digest Key
3737
3838 ## Bill Text
3939
40-The people of the State of California do enact as follows:SECTION 1. Section 1367.667 is added to the Health and Safety Code, immediately following Section 1367.665, to read:1367.667. (a) Every health care service plan contract issued, amended, or renewed in this state on or after January 1, 2020, that provides coverage for chemotherapy or radiation therapy for the treatment of cancer, cancer shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.SEC. 2. Section 10123.837 is added to the Insurance Code, immediately following Section 10123.835, to read:10123.837. (a) Every policy of disability insurance that covers hospital, medical, or surgical expenses health insurance that is issued, amended, or renewed in this state on or after January 1, 2020, and provides coverage for chemotherapy or radiation therapy for the treatment of cancer, cancer shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.SEC. 3. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB 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 XIIIB of the California Constitution.
40+The people of the State of California do enact as follows:SECTION 1. Section 1367.667 is added to the Health and Safety Code, immediately following Section 1367.665, to read:1367.667. (a) Every health care service plan contract issued, amended, or renewed in this state on or after January 1, 2020, that provides coverage for chemotherapy or radiation therapy for the treatment of cancer, shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.SEC. 2. Section 10123.837 is added to the Insurance Code, immediately following Section 10123.835, to read:10123.837. (a) Every policy of disability insurance that covers hospital, medical, or surgical expenses that is issued, amended, or renewed in this state on or after January 1, 2020, and provides coverage for chemotherapy or radiation therapy for the treatment of cancer, shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.SEC. 3. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB 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 XIIIB of the California Constitution.
4141
4242 The people of the State of California do enact as follows:
4343
4444 ## The people of the State of California do enact as follows:
4545
46-SECTION 1. Section 1367.667 is added to the Health and Safety Code, immediately following Section 1367.665, to read:1367.667. (a) Every health care service plan contract issued, amended, or renewed in this state on or after January 1, 2020, that provides coverage for chemotherapy or radiation therapy for the treatment of cancer, cancer shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
46+SECTION 1. Section 1367.667 is added to the Health and Safety Code, immediately following Section 1367.665, to read:1367.667. (a) Every health care service plan contract issued, amended, or renewed in this state on or after January 1, 2020, that provides coverage for chemotherapy or radiation therapy for the treatment of cancer, shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
4747
4848 SECTION 1. Section 1367.667 is added to the Health and Safety Code, immediately following Section 1367.665, to read:
4949
5050 ### SECTION 1.
5151
52-1367.667. (a) Every health care service plan contract issued, amended, or renewed in this state on or after January 1, 2020, that provides coverage for chemotherapy or radiation therapy for the treatment of cancer, cancer shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
52+1367.667. (a) Every health care service plan contract issued, amended, or renewed in this state on or after January 1, 2020, that provides coverage for chemotherapy or radiation therapy for the treatment of cancer, shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
5353
54-1367.667. (a) Every health care service plan contract issued, amended, or renewed in this state on or after January 1, 2020, that provides coverage for chemotherapy or radiation therapy for the treatment of cancer, cancer shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
54+1367.667. (a) Every health care service plan contract issued, amended, or renewed in this state on or after January 1, 2020, that provides coverage for chemotherapy or radiation therapy for the treatment of cancer, shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
5555
56-1367.667. (a) Every health care service plan contract issued, amended, or renewed in this state on or after January 1, 2020, that provides coverage for chemotherapy or radiation therapy for the treatment of cancer, cancer shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
56+1367.667. (a) Every health care service plan contract issued, amended, or renewed in this state on or after January 1, 2020, that provides coverage for chemotherapy or radiation therapy for the treatment of cancer, shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
5757
5858
5959
60-1367.667. (a) Every health care service plan contract issued, amended, or renewed in this state on or after January 1, 2020, that provides coverage for chemotherapy or radiation therapy for the treatment of cancer, cancer shall also provide coverage for anticancer medical devices.
60+1367.667. (a) Every health care service plan contract issued, amended, or renewed in this state on or after January 1, 2020, that provides coverage for chemotherapy or radiation therapy for the treatment of cancer, shall also provide coverage for anticancer medical devices.
6161
6262 (b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:
6363
6464 (1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.
6565
6666 (2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.
6767
6868 (3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
6969
70-SEC. 2. Section 10123.837 is added to the Insurance Code, immediately following Section 10123.835, to read:10123.837. (a) Every policy of disability insurance that covers hospital, medical, or surgical expenses health insurance that is issued, amended, or renewed in this state on or after January 1, 2020, and provides coverage for chemotherapy or radiation therapy for the treatment of cancer, cancer shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
70+SEC. 2. Section 10123.837 is added to the Insurance Code, immediately following Section 10123.835, to read:10123.837. (a) Every policy of disability insurance that covers hospital, medical, or surgical expenses that is issued, amended, or renewed in this state on or after January 1, 2020, and provides coverage for chemotherapy or radiation therapy for the treatment of cancer, shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
7171
7272 SEC. 2. Section 10123.837 is added to the Insurance Code, immediately following Section 10123.835, to read:
7373
7474 ### SEC. 2.
7575
76-10123.837. (a) Every policy of disability insurance that covers hospital, medical, or surgical expenses health insurance that is issued, amended, or renewed in this state on or after January 1, 2020, and provides coverage for chemotherapy or radiation therapy for the treatment of cancer, cancer shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
76+10123.837. (a) Every policy of disability insurance that covers hospital, medical, or surgical expenses that is issued, amended, or renewed in this state on or after January 1, 2020, and provides coverage for chemotherapy or radiation therapy for the treatment of cancer, shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
7777
78-10123.837. (a) Every policy of disability insurance that covers hospital, medical, or surgical expenses health insurance that is issued, amended, or renewed in this state on or after January 1, 2020, and provides coverage for chemotherapy or radiation therapy for the treatment of cancer, cancer shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
78+10123.837. (a) Every policy of disability insurance that covers hospital, medical, or surgical expenses that is issued, amended, or renewed in this state on or after January 1, 2020, and provides coverage for chemotherapy or radiation therapy for the treatment of cancer, shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
7979
80-10123.837. (a) Every policy of disability insurance that covers hospital, medical, or surgical expenses health insurance that is issued, amended, or renewed in this state on or after January 1, 2020, and provides coverage for chemotherapy or radiation therapy for the treatment of cancer, cancer shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
80+10123.837. (a) Every policy of disability insurance that covers hospital, medical, or surgical expenses that is issued, amended, or renewed in this state on or after January 1, 2020, and provides coverage for chemotherapy or radiation therapy for the treatment of cancer, shall also provide coverage for anticancer medical devices.(b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:(1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.(2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.(3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
8181
8282
8383
84-10123.837. (a) Every policy of disability insurance that covers hospital, medical, or surgical expenses health insurance that is issued, amended, or renewed in this state on or after January 1, 2020, and provides coverage for chemotherapy or radiation therapy for the treatment of cancer, cancer shall also provide coverage for anticancer medical devices.
84+10123.837. (a) Every policy of disability insurance that covers hospital, medical, or surgical expenses that is issued, amended, or renewed in this state on or after January 1, 2020, and provides coverage for chemotherapy or radiation therapy for the treatment of cancer, shall also provide coverage for anticancer medical devices.
8585
8686 (b) For purposes of this section, anticancer medical device means a medical device, including component parts, services, and supplies necessary for the effective use of the device, that meets all of the following criteria:
8787
8888 (1) The device has been cleared or approved for marketing by the federal Food and Drug Administration, if that clearance or approval is required by law.
8989
9090 (2) The device is primarily and substantially designed for use outside of a medical treatment facility, or use for which reimbursement is not ordinarily provided as incident to a providers professional service or as part of a providers fee for service.
9191
9292 (3) The device is prescribed by a provider authorized to prescribe that device for the treatment of cancer, upon a determination by the provider that the device is medically reasonable and necessary for the treatment of the patient.
9393
9494 SEC. 3. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB 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 XIIIB of the California Constitution.
9595
9696 SEC. 3. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB 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 XIIIB of the California Constitution.
9797
9898 SEC. 3. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB 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 XIIIB of the California Constitution.
9999
100100 ### SEC. 3.