AB 210 – Maternity Services Coverage – on Governor’s Desk!

BILL NUMBER: AB 210     ENROLLED

BILL TEXT

PASSED THE SENATE
SEPTEMBER 2, 2011

PASSED THE
ASSEMBLY  SEPTEMBER 7, 2011

AMENDED IN SENATE
SEPTEMBER 1, 2011

AMENDED IN SENATE
AUGUST 15, 2011

AMENDED IN SENATE
JULY 12, 2011

AMENDED IN SENATE
JUNE 29, 2011

AMENDED IN
ASSEMBLY  JUNE 1, 2011

AMENDED IN
ASSEMBLY  MAY 27, 2011

AMENDED IN
ASSEMBLY  APRIL 4, 2011

INTRODUCED BY   Assembly Member Roger
Hernández

(Coauthors: Assembly Members Alejo, Ammiano,
Blumenfield, Carter,

Huffman, Bonnie Lowenthal, and Williams)
JANUARY 31, 2011

An act to add Section 10123.866 to the Insurance Code, relating to

maternity services.

LEGISLATIVE COUNSEL’S
DIGEST

AB 210, Roger Hernández. Maternity
services.

Existing law provides for the regulation
of health insurers by the

Department of Insurance. Under existing law, a health
insurer that

provides maternity coverage may not restrict inpatient
hospital

benefits, as specified, and is required to provide
notice of the

maternity services coverage.

This bill, commencing July 1, 2012, would
require every group

health insurance policy to provide coverage for
maternity services

for all insureds covered under the policy.

This bill would become operative only if
SB 222 is also enacted.

THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS
FOLLOWS:

SECTION 1.  The Legislature finds and
declares the following:

(a) In actual practice, health care
service plans have been

required by the Knox-Keene Health Care Service Plan
Act of 1975

(Chapter 2.2 (commencing with Section 1340) of
Division 2 of the

Health and Safety Code) to provide maternity services
as a basic

health care benefit.

(b) At the same time, existing law does
not require health

insurers to provide designated basic health care
services and,

therefore, health insurers are not required to provide
coverage for

maternity services.

(c) Therefore, it is essential to clarify
that all health care

coverage made available to California consumers,
whether issued by

health care service plans regulated by the Department
of Managed

Health Care or by health insurers regulated by the
Department of

Insurance, must include maternity services.

SEC. 2.  Section 10123.866 is added to the
Insurance Code, to read:

10123.866.  (a) Commencing no later
than July 1, 2012, every group

health insurance policy shall provide coverage for
maternity

services for all insureds covered under the policy.

(b) For purposes of this section,
“maternity services” include

prenatal care, ambulatory care maternity services,
involuntary

complications of pregnancy, neonatal care, and
inpatient hospital

maternity care, including labor and delivery and
postpartum care.

This definition of “maternity services”
shall remain in effect until

such time as federal regulations and guidance issued
pursuant to the

federal Patient Protection and Affordable Care Act
(Public Law

111-148) define the scope of benefits to be provided
under the

maternity benefit requirement of that act, after which
time the

definition of that term under the federal act and
associated

regulations and guidance shall apply for purposes of
this section.

(c) This section shall not apply to
specialized health insurance,

Medicare supplement insurance, short-term limited
duration health

insurance, CHAMPUS-supplement insurance, or TRI-CARE
supplement

insurance, or to hospital indemnity, accident-only, or
specified

disease insurance.

SEC. 3.  This act shall become operative
only if Senate Bill 222 of

the 2011-12 Regular Session is also enacted and takes
effect.

Thanks to Kimberly Wong for sharing this news!

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