Section 1368.2 Of Article 5. Standards From California Health And Safety Code >> Division 2. >> Chapter 2.2. >> Article 5.
1368.2
. (a) On and after January 1, 2002, every group health care
service plan contract, except a specialized health care service plan
contract, which is issued, amended, or renewed, shall include a
provision for hospice care.
(b) The hospice care shall at a minimum be equivalent to hospice
care provided by the federal Medicare program pursuant to Title XVIII
of the Social Security Act.
(c) The hospice care provided under this section is not required
to include preliminary services set forth in subdivision (d) of
Section 1749. However, an enrollee who receives those preliminary
services shall remain eligible for coverage of curative treatment by
a health care service plan during the course of preliminary services
and prior to the election of hospice services.
(d) The following are applicable to this section and to paragraph
(7) of subdivision (b) of Section 1345:
(1) The definitions in Section 1746, except for subdivisions (o)
and (p) of that section.
(2) The "federal regulations" which means the regulations adopted
for hospice care under Title XVIII of the Social Security Act in
Title 42 of the Code of Federal Regulations, Chapter IV, Part 418,
except Subparts A, B, G, and H, and any amendments or successor
provisions thereto.
(e) The director no later than January 1, 2001, shall adopt
regulations to implement this section. The regulations shall meet all
of the following requirements:
(1) Be consistent with all material elements of the federal
regulations that are not by their terms applicable only to eligible
Medicare beneficiaries. If there is a conflict between a federal
regulation and any state regulation, other than those adopted
pursuant to this section, the director shall adopt the regulation
that is most favorable for plan subscribers, members or enrollees to
receive hospice care.
(2) Be consistent with any other applicable federal or state laws.
(3) Be consistent with the definitions of Section 1746, except for
subdivisions (o) and (p) of that section.
(f) This section is not applicable to the subscribers, members, or
enrollees of a health care service plan who elect to receive hospice
care under the Medicare program.