Assembly Bill No. 350 (Introduced by Assembly Member Ramos on January 29, 2025) 

This assembly bill was introduced by Assembly Member Ramos on January 29, 2025. This is an act to add Section 1367.73 to the Health and Safety Code, to add Section 10120.45 to the Insurance Code, and to amend Section 14132 of the Welfare and Institutions Code, relating to health care coverage.

This bill would require a health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2026, that provides coverage for the application of fluoride varnish as a pediatric oral care benefit to provide coverage without cost sharing for the application of fluoride varnish as medically necessary regardless of whether the service is billed as a dental benefit or as a medical benefit. If this coverage requirement creates an obligation for the state to defray costs for an individual, the bill would not require coverage unless there is an appropriation for this purpose, as specified. Because a willful violation of this provision by a health care service plan would be a crime, the bill would impose a state-mandated local program.

This bill would make the application of fluoride or other appropriate fluoride treatment, as defined by the department, a covered benefit under the Medi-Cal program for children under 21 years of age. The bill would require the State Department of Health Care Services to establish and promulgate a policy for on or before January 1, 2027, that specifies this covered benefit includes the application of fluoride varnish, as specified, and that allows reimbursement in certain circumstances.