Health care coverage: lung cancer.

A new subsection (d) is added to Section 10123.78 of the Insurance Code exempting specialized health insurance policies that cover only dental, mental health, or vision benefits from the lung cancer followup coverage requirement.

Section 10123.78(b) now includes a paragraph (2) providing that if a health insurance policy is a high deductible health plan, it need not waive the deductible, coinsurance, or other cost sharing for lung cancer followup services if doing so would conflict with federal HDHP requirements. Previously this exception applied only to health care service plans under Section 1367.58.

Assembly Member Aguiar-Curry is added as a co-author of the bill.

For health care service plans, the requirement no longer applies only to plans that provide hospital, medical, or surgical expense coverage. Instead, it now applies broadly but explicitly excludes specialized health care service plan contracts.

For health insurance policies under the Insurance Code, the prior requirement that the policy provide hospital, medical, or surgical expense coverage was removed. All health insurance policies issued, amended, or renewed on or after January 1, 2027 are now subject to the lung cancer followup coverage mandate.

A new exception for high deductible health plans (HDHPs) was added. If a health care service plan contract is an HDHP as defined in Section 223(c)(2) of Title 26 of the U.S. Code, it may impose deductibles, coinsurance, or other cost sharing on lung cancer followup coverage unless not doing so would conflict with federal HDHP requirements, including those defining exempt preventive care.

The fiscal note section was reorganized: the state-mandated local program language was moved earlier in the summary. Page numbering changed from 98 to 97. A duplicated word ('including including') was corrected to 'including' in both statutory sections.

The definition of 'followup screening or diagnostic services for lung cancer' in both Section 10123.77(c) and Section 10123.78(c) was changed from a closed list ('including a...') to an open-ended list ('including, but not limited to, a...'), meaning any followup diagnostic service after an abnormal or indeterminate lung cancer test result is now covered, not just the ones specifically named.

A drafting error introduced the word 'including' twice in both amended definitions ('including including, but not limited to').

Page numbers shifted from 99 to 98 and the digest was updated to reflect 'as amended' status.