Health care coverage: colorectal cancer screening.

Assembly Member Patterson's legislation expands California's requirements for no-cost colorectal cancer screening coverage by health insurers and health care service plans. The measure adds two new qualifying criteria for screening tests: FDA-approved tests that meet Centers for Medicare and Medicaid Services coverage standards, and FDA-approved tests included in current American Cancer Society guidelines. These additions complement existing coverage requirements for tests rated grade A or B by the U.S. Preventive Services Task Force.

The bill maintains the current requirement that follow-up colonoscopies prompted by positive results from qualifying screening tests must also be covered without cost sharing. Health plans and insurers retain the ability to impose cost sharing when covered services are provided outside their networks. The provisions apply to health care service plan contracts and insurance policies issued, amended, or renewed from January 1, 2022, excluding specialized health plans and policies.

The measure amends parallel sections of California's Health and Safety Code and Insurance Code, placing oversight responsibility with the Department of Managed Health Care and Department of Insurance respectively. Health plans and insurers must incorporate these expanded coverage criteria into their policies while maintaining compliance with existing state and federal preventive care requirements.