A bill by Sen. Richard Pan (D-Sacramento) that requires health plans and insurers to cover COVID-19 testing and vaccination without cost sharing or prior authorization requirements provided both in network and out of network took effect Jan. 1.
Senate Bill 510 also set up a similar framework for testing and immunizations for future pandemics.
“I am signing Senate Bill 510 to ensure Californians have timely and equitable access to COVID-19 testing and vaccinations,” Gov. Gavin Newsom said in October. “This bill will ensure uniformity in testing payment and access rules throughout the state.”
Prior to the omicron variant surge, he said California leads the nation in vaccines administered and consistently has the lowest COVID-19 case rate in the country.
“We have made progress in mitigating the spread of COVID-19 by leveraging important public health tools such as testing and vaccination,” Newsom said. “As we look ahead, it is crucial that Californians continue to have timely access to both without having to pay for unexpected out-pocket expenses. To ensure the state is protecting market stability, I am directing the Department of Managed Health Care to issue guidance to address concerns about how the prevailing market rate is determined. This would help prevent price gouging and clarify how a ‘reasonable’ reimbursement amount is calculated for purposes of reimbursing out-of-network providers for COVID-19 testing and vaccine administration.”