Amended IN Senate September 08, 2023 Amended IN Assembly March 15, 2023 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 365Introduced by Assembly Member Aguiar-CurryFebruary 01, 2023An act to amend Section 14132 of add Section 14132.12 to the Welfare and Institutions Code, relating to Medi-Cal. LEGISLATIVE COUNSEL'S DIGESTAB 365, as amended, Aguiar-Curry. Medi-Cal: diabetes management.Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and 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 sets forth a schedule of benefits under the Medi-Cal program. This bill would add continuous glucose monitors and related supplies required for use with those monitors as a covered benefit under the Medi-Cal program, program for the treatment of diabetes when medically necessary, subject to utilization controls. The bill would require the department, by July 1, 2024, to review and update, review, and update as appropriate, coverage policies for continuous glucose monitors, as specified. The bill would authorize the department to require a manufacturer of a continuous glucose monitor to enter into a rebate agreement with the department. The bill would limit its implementation to the extent that any necessary federal approvals are obtained and federal financial participation is not otherwise jeopardized. available. The bill would make related findings and declarations.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. The Legislature finds and declares all of the following:(a) One in seven adults, or approximately 4 million people, in California have diabetes.(b) In the United States, California has the highest level of new cases of diabetes annually.(c) Diabetes is the seventh leading cause of death in California.(d) Diabetes is the leading cause of cardiovascular disease, adult blindness, kidney failure, and amputation of the lower extremities.SEC. 2. Section 14132.12 is added to the Welfare and Institutions Code, to read:14132.12. (a) (1) Continuous glucose monitors and related supplies required for use with those monitors shall be a covered benefit under the Medi-Cal program for the treatment of diabetes when medically necessary, subject to utilization controls.(2) By July 1, 2024, the department shall review, and update as appropriate, coverage policies for continuous glucose monitors. The department shall consider current evidence-based clinical guidelines and coverage policies of other payers for purposes of this paragraph.(b) The department may require the manufacturer of a continuous glucose monitor to enter into a rebate agreement with the department.(c) This section shall be implemented only to the extent that any necessary federal approvals have been obtained and federal financial participation is available.
Amended IN Senate September 08, 2023 Amended IN Assembly March 15, 2023 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 365Introduced by Assembly Member Aguiar-CurryFebruary 01, 2023An act to amend Section 14132 of add Section 14132.12 to the Welfare and Institutions Code, relating to Medi-Cal. LEGISLATIVE COUNSEL'S DIGESTAB 365, as amended, Aguiar-Curry. Medi-Cal: diabetes management.Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and 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 sets forth a schedule of benefits under the Medi-Cal program. This bill would add continuous glucose monitors and related supplies required for use with those monitors as a covered benefit under the Medi-Cal program, program for the treatment of diabetes when medically necessary, subject to utilization controls. The bill would require the department, by July 1, 2024, to review and update, review, and update as appropriate, coverage policies for continuous glucose monitors, as specified. The bill would authorize the department to require a manufacturer of a continuous glucose monitor to enter into a rebate agreement with the department. The bill would limit its implementation to the extent that any necessary federal approvals are obtained and federal financial participation is not otherwise jeopardized. available. The bill would make related findings and declarations.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO
Amended IN Senate September 08, 2023 Amended IN Assembly March 15, 2023
Amended IN Senate September 08, 2023
Amended IN Assembly March 15, 2023
CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION
Assembly Bill
No. 365
Introduced by Assembly Member Aguiar-CurryFebruary 01, 2023
Introduced by Assembly Member Aguiar-Curry
February 01, 2023
An act to amend Section 14132 of add Section 14132.12 to the Welfare and Institutions Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AB 365, as amended, Aguiar-Curry. Medi-Cal: diabetes management.
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and 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 sets forth a schedule of benefits under the Medi-Cal program. This bill would add continuous glucose monitors and related supplies required for use with those monitors as a covered benefit under the Medi-Cal program, program for the treatment of diabetes when medically necessary, subject to utilization controls. The bill would require the department, by July 1, 2024, to review and update, review, and update as appropriate, coverage policies for continuous glucose monitors, as specified. The bill would authorize the department to require a manufacturer of a continuous glucose monitor to enter into a rebate agreement with the department. The bill would limit its implementation to the extent that any necessary federal approvals are obtained and federal financial participation is not otherwise jeopardized. available. The bill would make related findings and declarations.
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and 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 sets forth a schedule of benefits under the Medi-Cal program.
This bill would add continuous glucose monitors and related supplies required for use with those monitors as a covered benefit under the Medi-Cal program, program for the treatment of diabetes when medically necessary, subject to utilization controls. The bill would require the department, by July 1, 2024, to review and update, review, and update as appropriate, coverage policies for continuous glucose monitors, as specified. The bill would authorize the department to require a manufacturer of a continuous glucose monitor to enter into a rebate agreement with the department. The bill would limit its implementation to the extent that any necessary federal approvals are obtained and federal financial participation is not otherwise jeopardized. available. The bill would make related findings and declarations.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. The Legislature finds and declares all of the following:(a) One in seven adults, or approximately 4 million people, in California have diabetes.(b) In the United States, California has the highest level of new cases of diabetes annually.(c) Diabetes is the seventh leading cause of death in California.(d) Diabetes is the leading cause of cardiovascular disease, adult blindness, kidney failure, and amputation of the lower extremities.SEC. 2. Section 14132.12 is added to the Welfare and Institutions Code, to read:14132.12. (a) (1) Continuous glucose monitors and related supplies required for use with those monitors shall be a covered benefit under the Medi-Cal program for the treatment of diabetes when medically necessary, subject to utilization controls.(2) By July 1, 2024, the department shall review, and update as appropriate, coverage policies for continuous glucose monitors. The department shall consider current evidence-based clinical guidelines and coverage policies of other payers for purposes of this paragraph.(b) The department may require the manufacturer of a continuous glucose monitor to enter into a rebate agreement with the department.(c) This section shall be implemented only to the extent that any necessary federal approvals have been obtained and federal financial participation is available.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. The Legislature finds and declares all of the following:(a) One in seven adults, or approximately 4 million people, in California have diabetes.(b) In the United States, California has the highest level of new cases of diabetes annually.(c) Diabetes is the seventh leading cause of death in California.(d) Diabetes is the leading cause of cardiovascular disease, adult blindness, kidney failure, and amputation of the lower extremities.
SECTION 1. The Legislature finds and declares all of the following:(a) One in seven adults, or approximately 4 million people, in California have diabetes.(b) In the United States, California has the highest level of new cases of diabetes annually.(c) Diabetes is the seventh leading cause of death in California.(d) Diabetes is the leading cause of cardiovascular disease, adult blindness, kidney failure, and amputation of the lower extremities.
SECTION 1. The Legislature finds and declares all of the following:
### SECTION 1.
(a) One in seven adults, or approximately 4 million people, in California have diabetes.
(b) In the United States, California has the highest level of new cases of diabetes annually.
(c) Diabetes is the seventh leading cause of death in California.
(d) Diabetes is the leading cause of cardiovascular disease, adult blindness, kidney failure, and amputation of the lower extremities.
SEC. 2. Section 14132.12 is added to the Welfare and Institutions Code, to read:14132.12. (a) (1) Continuous glucose monitors and related supplies required for use with those monitors shall be a covered benefit under the Medi-Cal program for the treatment of diabetes when medically necessary, subject to utilization controls.(2) By July 1, 2024, the department shall review, and update as appropriate, coverage policies for continuous glucose monitors. The department shall consider current evidence-based clinical guidelines and coverage policies of other payers for purposes of this paragraph.(b) The department may require the manufacturer of a continuous glucose monitor to enter into a rebate agreement with the department.(c) This section shall be implemented only to the extent that any necessary federal approvals have been obtained and federal financial participation is available.
SEC. 2. Section 14132.12 is added to the Welfare and Institutions Code, to read:
### SEC. 2.
14132.12. (a) (1) Continuous glucose monitors and related supplies required for use with those monitors shall be a covered benefit under the Medi-Cal program for the treatment of diabetes when medically necessary, subject to utilization controls.(2) By July 1, 2024, the department shall review, and update as appropriate, coverage policies for continuous glucose monitors. The department shall consider current evidence-based clinical guidelines and coverage policies of other payers for purposes of this paragraph.(b) The department may require the manufacturer of a continuous glucose monitor to enter into a rebate agreement with the department.(c) This section shall be implemented only to the extent that any necessary federal approvals have been obtained and federal financial participation is available.
14132.12. (a) (1) Continuous glucose monitors and related supplies required for use with those monitors shall be a covered benefit under the Medi-Cal program for the treatment of diabetes when medically necessary, subject to utilization controls.(2) By July 1, 2024, the department shall review, and update as appropriate, coverage policies for continuous glucose monitors. The department shall consider current evidence-based clinical guidelines and coverage policies of other payers for purposes of this paragraph.(b) The department may require the manufacturer of a continuous glucose monitor to enter into a rebate agreement with the department.(c) This section shall be implemented only to the extent that any necessary federal approvals have been obtained and federal financial participation is available.
14132.12. (a) (1) Continuous glucose monitors and related supplies required for use with those monitors shall be a covered benefit under the Medi-Cal program for the treatment of diabetes when medically necessary, subject to utilization controls.(2) By July 1, 2024, the department shall review, and update as appropriate, coverage policies for continuous glucose monitors. The department shall consider current evidence-based clinical guidelines and coverage policies of other payers for purposes of this paragraph.(b) The department may require the manufacturer of a continuous glucose monitor to enter into a rebate agreement with the department.(c) This section shall be implemented only to the extent that any necessary federal approvals have been obtained and federal financial participation is available.
14132.12. (a) (1) Continuous glucose monitors and related supplies required for use with those monitors shall be a covered benefit under the Medi-Cal program for the treatment of diabetes when medically necessary, subject to utilization controls.
(2) By July 1, 2024, the department shall review, and update as appropriate, coverage policies for continuous glucose monitors. The department shall consider current evidence-based clinical guidelines and coverage policies of other payers for purposes of this paragraph.
(b) The department may require the manufacturer of a continuous glucose monitor to enter into a rebate agreement with the department.
(c) This section shall be implemented only to the extent that any necessary federal approvals have been obtained and federal financial participation is available.