CA AB1157

Requires health care service plans and health insurance policies to include durable medical equipment, services, and repairs as part of rehabilitative and habilitative services coverage if prescribed or ordered by a licensed health professional.

Defines durable medical equipment as devices designed for repeated use to help individuals acquire, improve, maintain, or learn daily living skills, including replacement devices and necessary services like fittings, design, and adjustment.

Prohibits coverage of durable medical equipment and services from being subject to financial or treatment limitations, including annual caps or restrictions limiting coverage to home-use devices only.

Requires the Secretary of California Health and Human Services to notify the federal Center for Consumer Information and Insurance Oversight that durable medical equipment coverage is necessary to comply with federal nondiscrimination requirements under the Affordable Care Act.

If the federal government overrules California's determination, requires the Secretary to reevaluate the state's essential health benefits benchmark plan and submit a report to the Legislature within one year with recommendations for incorporating durable medical equipment coverage without triggering federal cost-sharing obligations.