Bill Text: CA AB2271 | 2023-2024 | Regular Session | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: St. Rose Hospital.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Vetoed) 2024-09-22 - Vetoed by Governor. [AB2271 Detail]
Download: California-2023-AB2271-Introduced.html
Bill Title: St. Rose Hospital.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Vetoed) 2024-09-22 - Vetoed by Governor. [AB2271 Detail]
Download: California-2023-AB2271-Introduced.html
CALIFORNIA LEGISLATURE—
2023–2024 REGULAR SESSION
Assembly Bill
No. 2271
| Introduced by Assembly Member Ortega (Coauthors: Assembly Members Haney, Stephanie Nguyen, Santiago, and Waldron) (Coauthor: Senator Dodd) |
February 08, 2024 |
An act to add and repeal Section 1374.198 of the Health and Safety Code, to add and repeal Section 10127.22 of the Insurance Code, and to add and repeal Section 14132.37 of the Welfare and Institutions Code, relating to health care coverage.
LEGISLATIVE COUNSEL'S DIGEST
AB 2271, as introduced, Ortega.
Coverage for naloxone hydrochloride.
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. Under existing law, the pharmacist service of furnishing naloxone hydrochloride is a covered Medi-Cal benefit. The Medi-Cal program also covers certain medications to treat opioid use disorders as part of narcotic treatment program services, or as part of medication-assisted treatment services within the Drug Medi-Cal Treatment Program, as specified.
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 sets forth specified coverage requirements for health care service plan contracts and health insurance policies.
Under this bill, prescription or nonprescription naloxone hydrochloride or another drug approved by the FDA for the complete or partial reversal of an opioid overdose would be a covered benefit under the Medi-Cal program. The bill would require a health care service plan contract or health insurance policy, as specified, to include coverage for the same medications under the same conditions. The bill would prohibit a health care service plan contract or health insurance policy from imposing any cost-sharing requirements for that coverage exceeding $10 per package of medication, and would prohibit a high deductible health plan from imposing cost sharing, as specified. Because a willful violation of these provisions by a health care service
plan would be a crime, the bill would impose a state-mandated local program. The bill would make implementation of its provisions contingent on funding from the Naloxone Distribution Project. The bill’s provisions would be inoperative when the state records 500 or fewer opioid deaths in a calendar year, and the bill would repeal these provisions on the following January 1.
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: YESBill Text
The people of the State of California do enact as follows:
SECTION 1.
The Legislature finds and declares all of the following:(a) According to the United States Food and Drug Administration (FDA), naloxone hydrochloride is a medicine that can counter overdose effects when administered timely and that can help to reduce opioid overdose deaths.
(b) In November 2022, the FDA issued a Federal Register notice with a preliminary assessment of the safety and effectiveness of certain naloxone hydrochloride drug products for nonprescription use, in order to facilitate the development and approval of those products, including through a potential switch from prescription status to nonprescription status.
(c) In February 2023, an advisory committee to the FDA voted unanimously in favor of making Narcan, a naloxone hydrochloride nasal spray, available over the counter.
(d) In March 2023, the FDA approved Narcan for nonprescription use.
(e) The FDA has since approved RiVive, another medication for the complete or partial reversal of an opioid overdose for nonprescription use.
(f) The California Overdose Surveillance Dashboard, administered by the State Department of Public Health, contains the following data applicable to the state for 2022:
(1) Thirteen million six hundred forty thousand seven hundred ninety-four prescriptions were written for opioids.
(2) Six thousand nine hundred fifty-nine deaths were documented as relating to an opioid overdose. Of those deaths, 6,095 were documented as relating to a fentanyl overdose.
(3) Twenty-one thousand three hundred sixteen emergency department visits were documented as relating to an opioid overdose.
SEC. 2.
Section 1374.198 is added to the Health and Safety Code, immediately following Section 1374.197, to read:1374.198.
(a) A health care service plan contract that is issued, amended, delivered, or renewed on or after the date that the state reaches at least 1,000 opioid overdose deaths per year, but no earlier than January 1, 2025, shall include coverage for prescription or nonprescription naloxone hydrochloride or another drug approved by the United States Food and Drug Administration (FDA) for the complete or partial reversal of an opioid overdose.(b) A health care service plan contract shall not impose any cost-sharing requirements, including a copayment or deductible, for coverage provided pursuant to this section exceeding ten dollars ($10) per package of naloxone hydrochloride or another drug approved by the FDA for the complete or partial reversal of
an opioid overdose.
(c) If a health care service plan contract is a “high deductible health plan” under the definition set forth in Section 223(c)(2) of Title 26 of the United States Code, the contract shall not impose cost sharing as specified in this section, unless not applying cost sharing would conflict with federal requirements for high deductible health plans.
(d) This section shall only be implemented to the extent that funding for state costs is provided through the Naloxone Distribution Project administered by the State Department of Health Care Services.
(e) This section shall remain in effect only until the state records 500 or fewer opioid overdose deaths in a calendar year, and as of the following January 1 is repealed.
SEC. 3.
Section 10127.22 is added to the Insurance Code, immediately following Section 10127.20, to read:10127.22.
(a) A health insurance policy that is issued, amended, delivered, or renewed on or after the date that the state reaches at least 1,000 opioid overdose deaths per year, but no earlier than January 1, 2025, shall include coverage for prescription or nonprescription naloxone hydrochloride or another drug approved by the United States Food and Drug Administration (FDA) for the complete or partial reversal of an opioid overdose.(b) A health insurer shall not impose any cost-sharing requirements, including a copayment or deductible, for coverage provided pursuant to this section exceeding ten dollars ($10) per package of naloxone hydrochloride or another drug approved by the FDA for the complete or partial reversal of an opioid overdose.
(c) If a health insurance policy is a “high deductible health plan” under the definition set forth in Section 223(c)(2) of Title 26 of the United States Code, the policy shall not impose cost sharing as specified in this section, unless not applying cost sharing would conflict with federal requirements for high deductible health plans.
(d) This section shall only be implemented to the extent that funding for state costs is provided through the Naloxone Distribution Project administered by the State Department of Health Care Services.
(e) This section shall remain in effect only until the state records 500 or fewer opioid overdose deaths in a calendar year, and as of the following January 1 is repealed.
SEC. 4.
Section 14132.37 is added to the Welfare and Institutions Code, immediately following Section 14132.36, to read:14132.37.
(a) Prescription or nonprescription naloxone hydrochloride or another drug approved by the United States Food and Drug Administration for the complete or partial reversal of an opioid overdose shall be a covered benefit under the Medi-Cal program.(b) This section shall only be implemented to the extent that funding is provided through the Naloxone Distribution Project administered by the department.
(c) This section shall remain in effect only until the state records 500 or fewer opioid overdose deaths in a calendar year, and as of the following January 1 is repealed.
