AB 72

Bill Subjects

Abstract

Existing law requires a health care service plan, that is not a health maintenance organization or is not a plan that enters exclusively into specialized health care service plan contracts, and a health insurer issuing policies on a groupwide basis, to offer acupuncture coverage under those terms and conditions as may be agreed upon by the parties. Existing law provides that a plan or insurer is not required to offer "that Coverage as" part of a contract or policy covering public employees. A willful violation of the laws regulating health care service plans is a crime. This bill would instead require every health care service plan, except a plan that enters exclusively into contracts that are accident-only, specified disease, hospital indemnity, Medicare supplement, or specialized health care service plan contracts, and every health insurer issuing policies on a groupwide basis, except for policies that are accident-only, specified disease, hospital indemnity, Medicare supplement, or specialized health insurance policies, to provide acupuncture coverage under those terms and conditions as may be agreed upon by the parties. Because a violation of this bill's requirements with respect to a health care service plan would be a crime, this bill would impose a state-mandated local program by creating a new crime. Existing law authorizing a disability insurance policy to provide payment for acupuncture services requires that the disability insurance policy or contract expressly include acupuncture as a benefit in order for a licensed or certified acupuncturist to be paid or reimbursed under the policy for his or her services. This bill would delete the requirement conditioning the payment and reimbursement of a certified or licensed acupuncturist, for his or her services, on the express inclusion of acupuncture as a benefit in a disability insurance policy or contract. This bill would also make technical and conforming changes. 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.