Perinatal health screenings and treatment.

The primary term changed from 'perinatal mental health condition' to 'maternal mental health condition,' and the definition was narrowed to cover conditions occurring during pregnancy or the postpartum period (as defined by ACOG guidelines), removing interpregnancy from the covered timeframes.

Case management and care coordination may be provided by a delegated provider if already provided under the contract as of December 31, 2026 (for plans) or in accordance with Section 10133.65 (for insurers), adding flexibility for existing arrangements.

New exemption added for Medicare supplement policies in the Insurance Code section (Section 10123.867).

New provision states that case management and care coordination does not create a new benefit, and that plans/insurers retain flexibility in care delivery models as long as enrollees receive timely and appropriate followup care consistent with standard of care.

Screening requirements were narrowed: instead of requiring screenings during pregnancy AND the postpartum and perinatal periods, the bill now requires one or more mental health screenings to be conducted during the postpartum period only.

New provision requires health care service plans and insurers to incorporate maternal mental health screening, referral, care coordination, and followup activities into their existing quality improvement and population health management programs, and maintain compliance documentation available to regulators upon request.

Provider obligations under Section 123640 were restructured: practitioners who provide prenatal, postpartum, or perinatal care must ensure screening is offered; if a patient screens positive, the practitioner must ensure clinical evaluation is offered or received; and if a diagnosis is made, the practitioner must offer or provide treatment. The referral option now covers screening, evaluation, diagnosis, and treatment.

Case management and care coordination obligations were limited from applying to all enrollees/insureds during the perinatal period to only those who screen positive for a maternal mental health condition, and must be provided in accordance with the plan's or insurer's existing case management and care coordination programs.

A formal definition of 'case management' was added, describing it as a process in which a health care professional develops and implements a coordinated plan of care integrating medical and psychosocial support services.

Treatment language changed from 'medication and digital therapeutics approved for perinatal mental health by the FDA' to 'outpatient prescription drugs approved for maternal mental health by the FDA,' narrowing the encouraged treatment modalities.

Removed the requirement that health care service plan contracts and health insurance policies issued, amended, or renewed on or after January 1, 2026 must cover at least one FDA-approved medication and at least one FDA-approved digital therapeutic for perinatal mental health. This was a major coverage mandate now eliminated.

Added a new provision (Section 123640(b)) allowing a licensed health care practitioner to satisfy the screening requirement by referring the patient or client to another licensed health care practitioner who is authorized to screen, diagnose, and treat for perinatal mental health conditions. Previously, the practitioner was required to personally screen, diagnose, and treat.

Changed the direct treatment obligation in Section 123640 from requiring practitioners to 'screen, diagnose, and treat' to requiring them to 'diagnose and treat,' with screening now handled separately under subdivision (a) and the new referral option.

Changed screening requirement from a single 'perinatal mental health screening' to 'one or more perinatal mental health screenings,' making explicit that multiple screenings during the perinatal period are expected.

Added a definition of 'health care practitioner' (physician and surgeon, naturopathic doctor, nurse practitioner, physician assistant, nurse midwife, or licensed midwife acting within scope of practice) to both Section 1367.625 (Health and Safety Code) and Section 10123.867 (Insurance Code), where it previously only existed in Section 123640.

Expanded language throughout from 'patient' to 'patient or client' and removed gender-specific reference to 'the mother,' broadening the bill's applicability to different care settings and removing assumptions about who receives perinatal care.

Refined guidelines language to read 'in accordance with applicable clinical guidelines or standards and the standards of care appropriate to the provider's license, training, and scope of practice,' adding 'and the standards of care' as a distinct element alongside clinical guidelines.

The term 'maternal perinatal mental health' is replaced with 'perinatal mental health' throughout the bill. The definition is broadened from a condition occurring during pregnancy or the postpartum period to one occurring during pregnancy, the postpartum period, or the perinatal period.

New scope-of-practice flexibility is added in all three code sections (1367.625, 123640, and 10123.867). Providers may follow guidelines from other recognized professional bodies if ACOG guidelines do not align with their scope of practice. Each section now explicitly states it does not expand or alter a licensed provider's existing scope of practice.

A new subdivision (f) is added to Section 123640 that explicitly protects practitioners by stating the law does not require acting outside the standard of care, does not mandate adherence to guidelines inconsistent with a practitioner's scope of practice, does not limit licensing board disciplinary authority, and does not prevent licensed midwives from referring patients to physicians when a condition exceeds their scope.

The previous specific minimum screening requirements (at least one screening during pregnancy, at least one in the first six weeks postpartum, additional if medically necessary) are removed. They are replaced with a broader requirement to conduct screening according to applicable clinical guidelines appropriate to the provider's license, training, and scope of practice.

The bill's title and digest change from 'maternal perinatal health' to 'perinatal health,' broadening the apparent scope beyond maternal-specific conditions to all perinatal mental health conditions.

Senator Cervantes is added as a co-author and Senator Valladares is listed as a coauthor, indicating expanded legislative sponsorship.

The term 'maternal mental health' is replaced with 'maternal perinatal mental health' throughout the bill. The definition now includes mental health conditions occurring during the perinatal period in addition to pregnancy and postpartum, broadening which conditions are covered.

Section 123640(a) now explicitly includes practitioners who provide 'perinatal' care in the list of covered care types (prenatal, postpartum, perinatal, or interpregnancy), meaning providers of perinatal care are directly subject to the screening obligation.

Health care service plan programs and health insurer programs must now include perinatal mental health screening conducted during pregnancy and during the postpartum and perinatal periods according to clinical guidelines from the American College of Obstetricians and Gynecologists. This is a new mandatory component beyond the existing pregnancy and postpartum screening requirements.

New savings clauses added to both Section 1367.625(f) and Section 10123.867(e) stating that the sections shall not be construed to limit access to additional treatment options for perinatal mental health, protecting patients from having their treatment options narrowed by the new requirements.

Subsections in Section 1367.625 are reorganized: definitions that were in separate subsections (c) and (d) are consolidated into a single subsection (c) with numbered paragraphs, and the Medi-Cal provision is moved from its own standalone subsection into the definitions section.