AB 1954 Summary

• Prohibits health care service plans and health insurers from requiring enrollees or insureds to obtain a referral before receiving reproductive and sexual health care services, effective January 1, 2017.

• Defines reproductive and sexual health care services to include services described in Family Code Sections 6925-6928 and Health and Safety Code Section 121020, applying to patients of all ages including minors.

• Allows health plans and insurers to establish reasonable utilization protocols and communication provisions with primary care providers, provided these are no more restrictive than those applied to other specialists with direct access.

• Exempts specialized health plans, Medicare supplement insurance, short-term limited duration insurance, CHAMPUS supplement insurance, TRICARE supplement insurance, hospital indemnity, accident-only, and specified disease insurance from these requirements.

• Specifies no state reimbursement is required for local agencies or school districts under the California Constitution, as costs result from creating new criminal penalties.