AB 73,
as amended, Waldron. begin deletePatient Access to Prescribed Antiretroviral Drugs for HIV/AIDS Treatment Act. end deletebegin insertReal property: disclosure.end insert
Existing law requires certain disclosures to be made upon the transfer of residential property and prescribes the manner and form of the disclosures. Existing law provides that no cause of action arises against a real property owner or agent, or any agent of a transferee of real property, for the failure to disclose to the transferee the occurrence of an occupant’s death upon the real property, as specified, or that an occupant of that property had or died from Human T-Lymphotropic Virus Type III/Lymphadenopathy-Associated Virus. Existing law declares the Legislature’s intent to occupy the field of regulation of disclosure related to deaths occuring upon real property and of AIDS in situations affecting the transfer of real property or any estate or interest in real property.
end insertbegin insertThis bill would delete the prohibition against a cause of action arising for failure to disclose that an occupant of that property had or died from this virus. The bill would also delete the reference to AIDS from the declaration of legislative intent.
end insertbegin insertThis bill would declare that it is to take effect immediately as an urgency statute.
end insertExisting law establishes the Medi-Cal program, administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. Existing law specifies the benefits provided pursuant to the program, including the purchase of prescribed drugs that are covered subject to utilization controls. Utilization controls include a requirement that the treatment provider obtain prior authorization for providing medical treatment, as specified.
end deleteThis bill, to the extent permitted by federal law, would provide that if medically necessary antiretroviral drugs used in the treatment of HIV/AIDS is prescribed by a Medi-Cal beneficiary’s treating provider for that purpose, and coverage for that prescribed drug is denied by a Medi-Cal managed care plan in which the beneficiary is enrolled, that denial shall be reviewed in accordance with the bill. This bill would provide that if the treating provider demonstrates, consistent with federal law, that in his or her reasonable, professional judgment, the drug is medically necessary and consistent with the federal Food and Drug Administration’s labeling and use rules and regulations, as specified, the beneficiary would be entitled to an automatic urgent appeal, as defined.
end deleteVote: begin deletemajority end deletebegin insert2⁄3end insert.
Appropriation: no.
Fiscal committee: begin deleteyes end deletebegin insertnoend insert.
State-mandated local program: no.
The people of the State of California do enact as follows:
begin insertSection 1710.2 of the end insertbegin insertCivil Codeend insertbegin insert is amended to
2read:end insert
(a) No cause of action arises against an owner of real
4property or his or her agent, or any agent of a transferee of real
5property, for the failure to disclose to the transferee the occurrence
6of an occupant’s death upon the real property or the manner of
P3 1death where the death has occurred more than three years prior to
2the date the transferee offers to purchase, lease, or rent the real
3begin delete property, or that an occupant of that property was afflicted with, begin insert property. end insert As used in this
4or died from, Human T-Lymphotropic Virus Type
5III/Lymphadenopathy-Associated Virus.end delete
6section, “agent” includes any
person licensed pursuant to Part 1
7(commencing with Section 10000) of Division 4 of the Business
8and Professions Code. As used in this section, “transferee” includes
9a purchaser, lessee, or renter of real property.
10(b) It is the intention of the Legislature to occupy the field of
11regulation of disclosure related to deaths occurring upon real
12propertybegin delete and of AIDSend delete in situations affecting the transfer of real
13property or any estate or interest in real property.
14(c) This section shall not be construed to alter the law relating
15to disclosure pertaining to any other physical or mental condition
16or disease, and this section shall not relieve any owner or agent of
17any obligation to disclose the physical condition of the premises.
18(d) Nothing
in this section shall be construed to immunize an
19owner or his or her agent from making an intentional
20misrepresentation in response to a direct inquiry from a transferee
21or a prospective transferee of real property, concerning deaths on
22the real property.
This act is an urgency statute necessary for the
24immediate preservation of the public peace, health, or safety within
25the meaning of Article IV of the Constitution and shall go into
26immediate effect. The facts constituting the necessity are:
27
AIDS patients and the AIDS community require a change in state
28law to protect them from discrimination in real property
29transactions that may otherwise impose severe emotional distress.
This act shall be known, and may be cited as, the
31Patient Access to Prescribed Antiretroviral Drugs for HIV/AIDS
32Treatment Act.
Section 14133.06 is added to the Welfare and
34Institutions Code, to read:
(a) It is the intent of the Legislature in enacting this
36section that a Medi-Cal beneficiary shall have prompt access to
37medically necessary antiretroviral drugs for use in the treatment
38of HIV/AIDS that have been approved by the federal Food and
39Drug Administration for that purpose, including drugs that are not
P4 1on the formulary of a Medi-Cal managed care plan or that are
2subject to prior authorization.
3(b) To the extent permitted by federal law, if a drug used in the
4treatment of HIV/AIDS as described in subdivision (a) is prescribed
5by a Medi-Cal beneficiary’s treating provider for the treatment of
6HIV/AIDS, and coverage for that prescribed drug is denied by a
7Medi-Cal managed care plan in which the beneficiary is enrolled,
8that denial
shall be reviewed in accordance with this section.
9(c) (1) The denial by a Medi-Cal managed care plan of a drug
10prescribed for the treatment of HIV/AIDS and approved by the
11federal Food and Drug Administration for use in the treatment of
12HIV/AIDS is subject to the urgent appeal process described in
13paragraph (2) if the treating provider demonstrates, consistent with
14federal law, that in his or her reasonable, professional judgment,
15the drug is medically necessary and consistent with the federal
16Food and Drug Administration’s labeling and use rules and
17regulations, as supported in at least one of the official compendia
18identified in Section 1927(g)(1)(B)(i) of the federal Social Security
19Act (42 U.S.C. Sec. 1396r-8(g)(1)(B)(i)), and the drug is not on
20the formulary for the Medi-Cal managed care plan.
21(2) In a case in which a plan denies coverage for a drug
22
prescribed for the treatment of HIV/AIDS and approved by the
23federal Food and Drug Administration for use in the treatment of
24HIV/AIDS, the beneficiary shall be entitled to an urgent appeal in
25accordance with paragraph (1). For purposes of this section, “urgent
26appeal” means an appeal in which the beneficiary, or treatment
27provider with the consent of the beneficiary, requests an appeal
28either orally or in writing. An urgent appeal shall be resolved by
29the plan within 24 hours after the plan receives the request. The
3024-hour period specified in this paragraph shall be in addition to
31any time prescribed by federal law.
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