Section 1367.45 Of Article 5. Standards From California Health And Safety Code >> Division 2. >> Chapter 2.2. >> Article 5.
1367.45
. (a) Every individual or group health care service plan
contract that is issued, amended, or renewed on or after January 1,
2002, that covers hospital, medical, or surgery expenses shall
provide coverage for a vaccine for acquired immune deficiency
syndrome (AIDS) that is approved for marketing by the federal Food
and Drug Administration and that is recommended by the United States
Public Health Service.
(b) This section may not be construed to require a health care
service plan to provide coverage for any clinical trials relating to
an AIDS vaccine or for any AIDS vaccine that has been approved by the
federal Food and Drug Administration in the form of an
investigational new drug application.
(c) A health care service plan that contracts directly with an
individual provider or provider organization may not delegate the
risk adjusted treatment cost of providing services under this section
unless the requirements of Section 1375.5 are met.
(d) Nothing in this section is to be construed in any manner to
limit or impede a health care service plan's power or responsibility
to negotiate the most cost-effective price for vaccine purchases.
(e) Nothing in this section shall be construed to deny or restrict
in any way the department's authority to ensure plan compliance with
this chapter when a plan provides coverage for prescription drugs.