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<ns0:Id>20250AB__190699INT</ns0:Id>
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<ns0:ActionText>INTRODUCED</ns0:ActionText>
<ns0:ActionDate>2026-02-12</ns0:ActionDate>
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<ns0:SessionYear>2025</ns0:SessionYear>
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<ns0:AuthorText authorType="LEAD_AUTHOR">Introduced by Assembly Member Aguiar-Curry</ns0:AuthorText>
<ns0:Authors>
<ns0:Legislator>
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<ns0:House>ASSEMBLY</ns0:House>
<ns0:Name>Aguiar-Curry</ns0:Name>
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<ns0:Title> An act to amend Section 1367.66 of the Health and Safety Code, to amend Section 10123.18 of the Insurance Code, and to amend Section 14132.17 of the Welfare and Institutions Code, relating to health care coverage. </ns0:Title>
<ns0:RelatingClause>health care coverage</ns0:RelatingClause>
<ns0:GeneralSubject>
<ns0:Subject>Cervical cancer screening.</ns0:Subject>
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<html:p>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 provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2002, to provide coverage for an annual cervical cancer screening test upon the referral of the patient’s health care provider.</html:p>
<html:p>Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services and under which health care services are provided to low-income individuals pursuant to a schedule of benefits. The Medi-Cal program is, in part, governed and
funded by federal Medicaid program provisions. An annual cervical cancer test for screening or diagnostic purposes, upon the referral of a patient’s physician, is a covered benefit under the Medi-Cal program to the extent required or permitted by federal law.</html:p>
<html:p>This bill would require a health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2027, to provide coverage without cost sharing for an annual cervical cancer screening home test kit upon the referral of the patient’s health care provider. 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. The bill would also include cervical cancer home test kits, upon the referral of a patient’s health care provider, as a covered benefit under the Medi-Cal program on or after January 1, 2027, without cost sharing, to the extent required or permitted by
federal law.</html:p>
<html:p>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.</html:p>
<html:p>This bill would provide that no reimbursement is required by this act for a specified reason.</html:p>
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<ns0:Preamble>The people of the State of California do enact as follows:</ns0:Preamble>
<ns0:BillSection id="id_43608FDD-71F8-4376-99A5-B2C92F3E987C">
<ns0:Num>SECTION 1.</ns0:Num>
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Section 1367.66 of the
<ns0:DocName>Health and Safety Code</ns0:DocName>
is amended to read:
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<ns0:Num>1367.66.</ns0:Num>
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(a)
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(1)
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A individual or group health care service plan contract, except for a specialized health care service plan, issued, amended, or renewed on or after January 1, 2002, shall provide coverage for an annual cervical cancer screening test upon the referral of the patient’s physician and surgeon, a nurse practitioner, or a certified nurse-midwife, providing care to the patient and operating within the scope of practice otherwise permitted for the licensee.
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(2)
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A
health care service plan contract, except for a specialized health care service plan, issued, amended, or renewed on or after January 1, 2027, shall provide coverage for an annual cervical cancer screening home test kit upon the referral of the patient’s health care provider. A health care service plan contract shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided pursuant to this paragraph.
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(3)
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The coverage for an annual cervical cancer screening test provided pursuant to this
subdivision shall include the conventional Pap test, a human papillomavirus screening test that is approved by the United States Food and Drug Administration (FDA), and the option of any cervical cancer screening test approved by the FDA, upon the referral of the patient’s health care provider.
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<html:p>
(4)
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This subdivision does not establish a new mandated benefit or prevent application of deductible or copayment provisions in an existing plan contract. The Legislature intends in this section to provide that cervical cancer screening services are deemed to be covered if the plan contract includes coverage for cervical cancer treatment or
surgery.
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<html:p>
(b)
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A health care service plan contract, except for a specialized health care service plan, issued, amended, or renewed on or after January 1, 2024, shall provide coverage for the human papillomavirus vaccine for enrollees for whom the vaccine is approved by the FDA. A health care service plan contract shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided pursuant to this subdivision.
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<ns0:Num>SEC. 2.</ns0:Num>
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Section 10123.18 of the
<ns0:DocName>Insurance Code</ns0:DocName>
is amended to read:
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<ns0:Num>10123.18.</ns0:Num>
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<html:p>
(a)
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(1)
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A disability insurance policy issued, amended, or renewed on or after January 1, 2024, and that provides coverage for hospital, medical, or surgical benefits shall provide coverage, upon the referral of a patient’s physician and surgeon, a nurse practitioner, or a certified nurse-midwife, providing care to the patient and operating within the scope of practice otherwise permitted for the licensee, for an annual cervical cancer screening test.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
A disability insurance policy issued, amended, or renewed on or after January 1, 2027, shall provide
coverage for an annual cervical cancer screening home test kit upon the referral of a patient’s health care provider. A health insurance policy shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided pursuant to this paragraph.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
The coverage for an annual cervical cancer screening test provided pursuant to this subdivision shall include the conventional Pap test, a human papillomavirus
screening test that is approved by the United States Food and Drug Administration (FDA) and the option of any cervical cancer screening test approved by the FDA, upon the referral of the patient’s health care provider.
</html:p>
<html:p>
(4)
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This subdivision does not require an individual or group policy to cover treatment or surgery for cervical cancer or to prevent application of deductible or copayment provisions contained in the policy or certificate, and does not require that coverage under an individual or group policy be extended to any other procedures.
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<html:p>
(b)
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A disability insurance policy issued, amended, or renewed on
or after January 1, 2024, that provides coverage for hospital, medical, or surgical benefits shall provide coverage for the human papillomavirus vaccine for insureds for whom the vaccine is approved by the FDA. The policy shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided pursuant to this subdivision.
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(c)
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This section shall not apply to vision-only, dental-only, accident-only, specified disease, hospital indemnity, Medicare supplement, CHAMPUS supplement, long-term care, or disability income insurance. For accident-only, hospital indemnity, or specified disease insurance, coverage for benefits under this section shall apply only to the extent that the benefits are covered under the general terms and conditions that apply to all other benefits under the policy or certificate. This section does not impose a new benefit mandate on accident-only, hospital indemnity, or specified
disease insurance.
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<ns0:Num>SEC. 3.</ns0:Num>
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Section 14132.17 of the
<ns0:DocName>Welfare and Institutions Code</ns0:DocName>
is amended to read:
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<ns0:Num>14132.17.</ns0:Num>
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<html:p>
(a)
<html:span class="EnSpace"/>
Annual cervical cancer tests for screening or diagnostic purposes, upon the referral of a patient’s physician, is a covered benefit under this chapter, on or after January 1, 1991, to the extent required or permitted by federal law.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
Annual cervical cancer home test kits for screening or diagnostic purposes, upon the referral of a patient’s health care provider, is a covered benefit under this chapter, on or after January 1, 2027, to the
extent required or permitted by federal law.
</html:p>
<html:p>
(2)
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A Medi-Cal beneficiary is not subject to any cost sharing, including, but not limited to, a share of cost or spend down of excess income as described in Section 14054 for the benefit described in this subdivision.
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<html:p>
(3)
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This subdivision applies to both the fee-for-service delivery system and the managed care delivery system under the Medi-Cal program.
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<ns0:Num>SEC. 4.</ns0:Num>
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<html:p>
No reimbursement is required by this act pursuant to Section 6 of Article XIII
<html:span class="ThinSpace"/>
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
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B of the California Constitution.
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