California AB980 mandates health insurers to cover medically necessary treatment for physical conditions and diseases.

California AB980 requires health insurers to cover medically necessary treatment for physical conditions and diseases. This includes basic health care services, intermediate services, and prescription drugs. The bill mandates that insurers base medical necessity determinations on current generally accepted standards of care. It also requires insurers to provide education programs for staff and ensure interrater reliability testing. Insurers must arrange coverage for medically necessary out-of-network services if in-network services are unavailable.

California AB980 mandates health insurers to cover medically necessary treatment for physical conditions and diseases.

California AB980 requires health insurers to cover medically necessary treatment for physical conditions and diseases. This includes basic health care services, intermediate services, and prescription drugs. The bill mandates that insurers base medical necessity determinations on current generally accepted standards of care. It also requires insurers to provide education programs for staff and ensure interrater reliability testing. Insurers must arrange coverage for medically necessary out-of-network services if in-network services are unavailable.