Health care coverage: fertility preservation.

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 requires every health care service plan contract to provide enrollees with basic health care services, except as specified. Existing law defines basic health care services to include, among other things, physician services and hospital inpatient and ambulatory care services. Existing law requires specified group health care service plan contracts issued, amended, or renewed on or after January 1, 1990, to offer coverage for the treatment of infertility, as defined, except in vitro fertilization. This bill would clarify that, when a covered treatment may cause iatrogenic infertility to an enrollee, standard fertility preservation services are a basic health care service and are not within the scope of coverage for infertility treatment, as described above. The bill would state that these provisions are declaratory of existing law. The bill would state that these provisions do not apply to Medi-Cal managed care health care service plan contracts or any entity that contracts with the State Department of Health Care Services to deliver health care services pursuant to the Medi-Cal program.