California Health and Safety Code

§ 1368.1

HSC § 1368.1 Effective Jan 1, 1995Div. 2 · Ch. 2.2 · Art. 5

Statute text

(a)A plan that denies coverage to an enrollee with a terminal illness, which for the purposes of this section refers to an incurable or irreversible condition that has a high probability of causing death within one year or less, for treatment, services, or supplies deemed experimental, as recommended by a participating plan provider, shall provide to the enrollee within five business days all of the following information:

(1)A statement setting forth the specific medical and scientific reasons for denying coverage.

(2)A description of alternative treatment, services, or supplies covered by the plan, if any. Compliance with this subdivision by a plan shall not be construed to mean that the plan is engaging in the unlawful practice of medicine.

…

Legislative history

Added by Stats. 1994, Ch. 582, Sec. 1. Effective January 1, 1995.