§ 1367.3. — 1367.3. (Amended by Stats. 2025, Ch. 105, Sec. 19.)

California § 1367.3.

• Jurisdiction: California
• Code HSC: Health and Safety Code - HSC
• Div. 2.: DIVISION 2. LICENSING PROVISIONS
• Ch. 2.2.: CHAPTER 2.2. Health Care Service Plans
• Art. 5.: ARTICLE 5. Standards

Text

(a)
Every health care service plan that covers hospital, medical, or surgical expenses on a group basis shall offer benefits for the comprehensive preventive care of children. This section shall apply to children 17 and 18 years of age, except as provided in subparagraph (D) of paragraph (2) of subdivision (b). Every plan shall communicate the availability of these benefits to all group contractholders and to all prospective group contractholders with whom they are negotiating. This section shall apply to a plan that, by rule or order of the director, has been exempted from subdivision (i) of Section 1367, insofar as that section and the rules thereunder relate to the provision of the preventive health care services described herein.
(b)
For purposes of this
section, benefits for the comprehensive preventive care of children shall comply with both of the following:
(1)
Be consistent with both of the following:
(A)
The most recent Recommendations for Preventive Pediatric Health Care, as adopted by the American Academy of Pediatrics.
(B)
The Recommended Childhood Immunization Schedule/United States, jointly adopted as of January 1, 2025, by the American Academy of Pediatrics, the Advisory Committee on Immunization Practices, and the American Academy of Family
Physicians. Immunizations subject to this subparagraph may be modified or supplemented by the State Department of Public Health pursuant to Section 120164.
(2)
Provide for the following:
(A)
Periodic health evaluations.
(B)
Immunizations.
(C)
Laboratory services in connection with periodic health evaluations.
(D)
Screening for blood lead levels in children of any age who are at risk for lead poisoning, as determined by a physician and surgeon affiliated with the plan, if the screening is prescribed by a health care provider affiliated with the plan.
(c)
For purposes of this section,
a health care provider is any of the following:
(1)
A person licensed to practice medicine pursuant to Article 3 (commencing with Section 2050) of Chapter 5 of Division 2 of the Business and Professions Code.
(2)
A nurse practitioner licensed to practice pursuant to Article 8 (commencing with Section 2834) of Chapter 6 of Division 2 of the Business and Professions Code.
(3)
A physician assistant licensed to practice pursuant to Article 3 (commencing with Section 3513) of Chapter 7.7 of Division 2 of the Business and Professions Code.

Legislative History

Amended by Stats. 2025, Ch. 105, Sec. 19. (AB 144) Effective September 17, 2025.