Bill > AB536

This bill expands mandatory health insurance coverage for colorectal cancer screenings by requiring health care service plans and health insurance policies to provide coverage without cost sharing for colorectal cancer screening tests that meet one of three conditions: (1) are approved by the FDA and meet Centers for Medicare and Medicaid Services (CMS) coverage requirements, (2) are FDA-approved and included in the most recent American Cancer Society guidelines, or (3) are assigned a grade of A or B by the United States Preventive Services Task Force (USPSTF). The bill also mandates that any required follow-up colonoscopy for a positive screening result be covered without cost sharing, regardless of the screening test's method or origin. Previously, the law only required coverage for screenings with USPSTF grades of A or B. The legislation applies to health care service plans and health insurance policies issued, amended, or renewed on or after January 1, 2022, and allows insurers to still impose cost-sharing requirements for out-of-network providers. This change aims to provide more comprehensive and accessible colorectal cancer screening options for patients by broadening the range of covered screening methods.

Budget and Finance, Health and Social Services

https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202520260AB536