Health care coverage: tobacco cessation.

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 also provides for the regulation of health insurers by the Department of Insurance. Existing law requires health care service plan contracts and health insurance policies to provide coverage, and not impose cost-sharing requirements, for certain preventive services, including evidence-based items or services with a rating of "A" or "B" in the current recommendations of the United States Preventive Services Task Force, as specified. This bill would require health care service plan contracts and health insurance policies issued, amended, renewed, or delivered on or after January 1, 2013, to provide coverage for 2 courses of treatment in a 12-month period for tobacco cessation preventive services rated "A" or "B" by the United States Preventive Services Task Force, and would prohibit plans and insurers from charging a copayment, coinsurance, or deductible for those services. The bill would also prohibit a plan or insurer from requiring enrollees or insureds to enter counseling in order to receive tobacco cessation medications or from imposing prior authorization or stepped-care requirements on tobacco cessation treatments. Because a willful violation of the bill's provisions relative to health care service plans would be a crime, the bill would impose a state-mandated local program. 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.