Bill Text: CA SB600 | 2019-2020 | Regular Session | Amended
Bill Title: Health care coverage: fertility preservation.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Passed) 2019-10-12 - Chaptered by Secretary of State. Chapter 853, Statutes of 2019. [SB600 Detail]
Download: California-2019-SB600-Amended.html
|
Amended
IN
Assembly
September 05, 2019 |
|
Amended
IN
Senate
April 30, 2019 |
| Introduced by Senator Portantino |
February 22, 2019 |
LEGISLATIVE COUNSEL'S DIGEST
This bill would clarify that an individual or group health care service plan contract or health insurance policy that covers hospital, medical, or surgical expenses includes coverage for standard fertility preservation services when a
medically necessary treatment may cause iatrogenic infertility to an enrollee or insured. The bill would state that these provisions are declaratory of existing law.
Existing law provides for 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 provides for a schedule of benefits under the Medi-Cal program, which includes comprehensive perinatal services, subject to utilization controls.
This bill would add to the schedule of benefits standard fertility preservation services when a medically necessary treatment may cause iatrogenic infertility to a beneficiary.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NOBill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 1374.551 is added to the Health and Safety Code, to read:(a)A health care service plan contract that covers hospital, medical, or surgical expenses includes coverage for medically necessary expenses for standard fertility preservation services when a medically necessary treatment may directly or indirectly cause iatrogenic infertility to an enrollee.
1374.551.
(a) When a covered treatment may directly or indirectly cause iatrogenic infertility, standard fertility preservation services are a basic health care service, as defined in subdivision (b) of Section 1345, and are not within the scope of coverage for the treatment of infertility for the purposes of Section 1374.55.
(c)This section applies to a health care service plan contract with the State Department of Health Care Services pursuant to the Medi-Cal program (Chapter 7 (commencing with Section 14000) of Part 3 of the Welfare and Institutions Code).
(a)An individual or group health insurance policy that covers hospital, medical, or surgical expenses includes coverage for medically necessary expenses for standard fertility preservation services when a medically necessary treatment may directly or indirectly cause iatrogenic infertility to an insured.
(b)For purposes of this section, the following definitions apply:
(1)“Iatrogenic infertility” means an
impairment of fertility caused directly or indirectly by surgery, chemotherapy, radiation, or other medical treatment.
(2)Medical treatment that “may directly or indirectly cause iatrogenic infertility” means medical treatment with a possible side effect of impaired fertility, as established by the American Society of Clinical Oncology or the American Society for Reproductive Medicine.
(3)“Standard fertility preservation services” means procedures consistent with the established
medical practices and professional guidelines published by the American Society of Clinical Oncology or the American Society for Reproductive Medicine.
(a)Medically necessary expenses for standard fertility preservation services are covered under this chapter when a medically necessary treatment may directly or indirectly cause iatrogenic infertility to a beneficiary.
(b)For purposes of this section, the following definitions apply:
(1)“Iatrogenic infertility” means an impairment of fertility caused directly or indirectly by surgery, chemotherapy, radiation, or other medical treatment.
(2)Medical treatment that “may directly or indirectly cause iatrogenic infertility” means medical treatment with a possible side effect of impaired fertility, as established
by the American Society of Clinical Oncology or the American Society for Reproductive Medicine.
(3)“Standard fertility preservation services” means procedures consistent with the established medical practices and professional guidelines published by the American Society of Clinical Oncology or the American Society for Reproductive Medicine.
