SB 278: Health data: HIV test results. - California

06/19/25 - Amended Assembly → 07/17/25 - Amended Assembly · 4 edits · Jul 17, 2025

MODERATE

The July 17 amendment to SB 278 makes two substantive changes to Section 120985: it conditions the disclosure of identifiable HIV test results to DHCS staff and Medi-Cal managed care plans on the opt-out mechanism being implemented first, and it adds a new provision authorizing de-identified HIV test results to flow from managed care plans back to DHCS staff for quality improvement purposes. The bill title also contains what appears to be a drafting error (redundant reference to Section 120985).

Scope change

The bill's scope was narrowed in practice by adding a precondition: identifiable HIV data disclosure to DHCS and managed care plans under Section 120985 now cannot occur until the opt-out mechanism is implemented (by December 31, 2026). A new de-identified data pathway from managed care plans to DHCS was added, slightly expanding the types of authorized disclosures.

REQUIREMENT

Section 120985(a)(2)(A) now specifies that the disclosure of identifiable HIV test results applies to 'a Medi-Cal beneficiary' and adds the condition 'once the opt-out mechanism described in subparagraph (C) is implemented.' This means identifiable data cannot be shared with DHCS or managed care plans until the opt-out process is operational, adding a privacy safeguard not present in the prior version.

SCOPE

New Section 120985(a)(2)(B) authorizes Medi-Cal managed care plans to disclose HIV test results that do NOT identify or provide identifying characteristics of the test subjects to State Department of Health Care Services staff, for the purpose of administering quality improvement programs. This creates a new de-identified data flow from managed care plans back to DHCS.

TECHNICAL

The opt-out mechanism provision was renumbered from subparagraph (B) to subparagraph (C) to accommodate the new de-identified disclosure provision inserted as (B).

The bill title changed from 'An act to amend Sections 120985 and 121025 of the Health and Safety Code' to 'An act to amend Sections 120985 and 121025 Section 120985 of the Health and Safety Code,' which appears to be a drafting error introducing a redundant reference.

10/13/25 - Chaptered → SB278 · 1 edit

MINOR

No substantive policy changes occurred between these two versions. The diff reflects only a change in presentation format: the bill text moved from a traditional chaptered document layout (with page numbers and centered headers) to a web-based display format that includes navigation menus, search tools, and links to related bill pages. The underlying statutory language of Section 120985 is identical in both versions.

TECHNICAL

The document was reformatted from a traditional chaptered legislative document (with page numbers, centered title blocks, and 'AUTHENTICATED ELECTRONIC LEGAL MATERIAL' header) into a web page layout that includes site navigation, quick search fields, version history links, and share/track options. No words of the actual statute were added, removed, or altered.

07/17/25 - Amended Assembly → 09/02/25 - Amended Assembly · 5 edits · Sep 2, 2025

MODERATE

The September 2025 amendment significantly narrows SB 278 by removing the entire second section that would have amended Health and Safety Code Section 121025, eliminating the pathway for state public health agency HIV surveillance staff to disclose patient information to DHCS and Medi-Cal plans. The remaining bill now relies solely on healthcare providers disclosing HIV test results directly to Medi-Cal managed care plans. Additionally, external quality review organizations were added as a new recipient of disclosed HIV test results, and the disclosure actor was clarified as 'a provider of health care.'

Scope change

The bill's scope was substantially reduced. It no longer creates a public health records disclosure pathway (Section 121025) for sharing HIV information with DHCS and Medi-Cal plans. The only remaining pathway is direct disclosure by healthcare providers to Medi-Cal managed care plans under Section 120985, plus a new pathway to external quality review organizations.

SCOPE

The entire amendment to Health and Safety Code Section 121025 was deleted. This removed the authorization for state public health agency HIV surveillance staff to disclose personally identifying information in public health records to DHCS staff, who could then pass it to Medi-Cal managed care plans, the patient, or their provider for care coordination and quality improvement purposes.

External quality review organizations contracted by DHCS to conduct external quality reviews of Medi-Cal managed care plans were added as a new authorized recipient of HIV test results that identify a Medi-Cal beneficiary.

REQUIREMENT

The disclosure actor was clarified: the old version used passive voice ('may be disclosed'), while the new version specifies 'may be disclosed by a provider of health care,' making it explicit that the healthcare provider is the one sharing the results with the managed care plan.

ELIGIBILITY

The opt-out mechanism scope was narrowed. Previously, beneficiaries could opt out of disclosure to both DHCS staff and the Medi-Cal managed care plan. Now the opt-out only covers disclosure to the Medi-Cal managed care plan, since DHCS staff are no longer a direct recipient under this section.

TECHNICAL

The statutory carve-out was expanded from 'Notwithstanding Section 120980' to 'Notwithstanding Section 120980 and 121010,' adding an additional section that the disclosure authority overrides.

09/02/25 - Amended Assembly → 09/12/25 - Enrolled · 2 edits · Sep 12, 2025

MINOR

The enrolled version of SB 278 removes the opt-out mechanism that previously allowed Medi-Cal beneficiaries to refuse disclosure of their HIV test results to their assigned managed care plan. The amended assembly version required the Department of Health Care Services to develop an opt-out process by December 31, 2026, and conditioned disclosure on that mechanism being implemented. The enrolled version authorizes disclosure unconditionally, meaning beneficiaries will have no way to prevent their HIV test results from being shared with their managed care plan for quality improvement purposes.

Scope change

The scope of who can be subject to HIV test result disclosure to managed care plans expanded from beneficiaries who have not opted out (once the opt-out mechanism is implemented) to all Medi-Cal beneficiaries unconditionally. The removal of the opt-out means there is no longer a carve-out for individuals who wish to keep their HIV status confidential from their plan.

ELIGIBILITY

Removed the requirement that the State Department of Health Care Services develop an opt-out mechanism (in consultation with the State Department of Public Health) by which Medi-Cal beneficiaries could refuse disclosure of their HIV test results to their assigned managed care plan. The December 31, 2026 implementation deadline is also eliminated.

REQUIREMENT

Removed the condition that disclosure to managed care plans would only occur 'once the opt-out mechanism described in subparagraph (C) is implemented.' Disclosure is now authorized without any such precondition, meaning it can take effect immediately upon the bill's approval.

09/12/25 - Enrolled → 10/13/25 - Chaptered · 3 edits · Oct 13, 2025

MINOR

This diff reflects the transition of SB 278 from its enrolled version to its final chaptered form as Chapter 748, approved by the Governor on October 13, 2025. No substantive policy changes were made; all differences are formatting and administrative (header, page numbers, approval signature line). The statutory text amending Health and Safety Code Section 120985 regarding HIV test result disclosure to Medi-Cal managed care plans is identical in both versions.

TECHNICAL

Header changed from enrolled bill format (Senate/Assembly passage dates, Governor receipt line) to chaptered law format (STATE OF CALIFORNIA, AUTHENTICATED, CHAPTER 748, approval date October 13, 2025).

Page numbers changed from 93 to 92 and page header format changed from 'SB 278' to 'Ch. 748'.

Approval line changed from a blank date field to the Governor's initial 'O' with the October 13, 2025 date.

03/17/25 - Amended Senate → 03/28/25 - Amended Senate · 4 edits · Mar 28, 2025

MODERATE

The March 28 amendment to SB 278 narrows which public health staff can initiate disclosure of HIV records to the State Department of Health Care Services and Medi-Cal managed care plans, limiting that authority to HIV surveillance staff only (previously it also included HIV prevention staff, AIDS Drug Assistance Program staff, and care services staff). The amendment also adds coauthors from both chambers and fixes several typographical duplications in the text.

SCOPE

Narrowed the category of state public health agency staff authorized to disclose HIV information to DHCS staff (and onward to Medi-Cal managed care plans) from 'HIV surveillance staff, HIV prevention staff, AIDS Drug Assistance Program staff, and care services staff' to only 'HIV surveillance staff.' This is a significant privacy protection that limits who can start the chain of disclosure to the state's health insurance system.

TECHNICAL

Changed 'the beneficiary person is assigned' to 'the person is assigned' in two places (Section 120985(a)(2)(A) and Section 121025(c)(2)(D)(i)), a minor terminology cleanup.

Added coauthors: Senators Cervantes, Laird, Padilla, and Wiener, and Assembly Members Jackson, Lee, Solache, and Ward, indicating broader legislative sponsorship.

Fixed several typographical duplications: 'existing, existing law' to 'existing law,' 'Medi-cal Medi-Cal' to 'Medi-Cal,' and 'programs programs' to 'programs.'

03/28/25 - Amended Senate → 06/19/25 - Amended Assembly · 2 edits · Jun 19, 2025

MINOR

The Assembly amended SB 278 to add a specific deadline requiring that the opt-out mechanism for HIV/AIDS public health record disclosures be implemented no later than December 31, 2026. This deadline was added in two places: in Section 120985 (governing HIV test result disclosures) and Section 121025 (governing confidential public health records). Assembly Member Mark Gonzalez was also added as a coauthor.

TIMELINE

A deadline of December 31, 2026 was added requiring the State Department of Health Care Services to implement the opt-out mechanism that allows Medi-Cal beneficiaries to decline disclosure of their HIV/AIDS public health records to DHCS staff or their Medi-Cal managed care plan. This appears in both Section 120985(a)(2)(B) and Section 121025(c)(2)(D)(ii).

TECHNICAL

Assembly Member Mark Gonzalez was added as a coauthor of the bill.

02/04/25 - Introduced → 03/17/25 - Amended Senate · 5 edits · Mar 17, 2025

MODERATE

The amended version of SB 278 adds an opt-out mechanism allowing Medi-Cal beneficiaries to refuse disclosure of their HIV/AIDS public health records to the State Department of Health Care Services or their managed care plan. It also expands the scope of quality improvement programs to explicitly include value-based payment and healthy behavior incentive programs, and adds clarifying provisions about how the new disclosures interact with existing confidentiality and penalty sections.

ELIGIBILITY

Medi-Cal beneficiaries can now opt out of having their personally identifying HIV/AIDS public health records disclosed to DHCS staff or their Medi-Cal managed care plan. DHCS must develop this opt-out mechanism in consultation with the State Department of Public Health.

SCOPE

Quality improvement programs are now explicitly defined to include value-based payment programs and healthy behavior incentive programs, broadening the types of programs that can receive disclosed HIV data for Medi-Cal beneficiaries.

REQUIREMENT

A new provision states that Section 120985(a) is subject to Sections 120975 and 120980 (existing HIV confidentiality provisions), clarifying that the new disclosures do not override those protections.

ENFORCEMENT

The no-further-disclosure rule in Section 120985(b) now explicitly extends to federal agencies and authorities in other states, unless otherwise required by federal law.

A new clause clarifies that the civil penalty provisions in subdivision (e) of Section 121025 apply to individuals or entities making disclosures under the new DHCS/managed care plan pathway.

Health data: HIV test results.

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