SECTION 1. Section 56.05 of the Civil Code is amended to read:56.05. For purposes of this part:(n) “Sensitive services” means all health care services related to mental or behavioral health, sexual and reproductive health, sexually transmitted infections, substance use disorder, gender affirming care, and intimate partner violence, and includes services described in Sections 6924, 6925, 6926, 6927, 6928, 6929, and 6930 of the Family Code, and Sections 121020 and 124260 of the Health and Safety Code, obtained by a patient at or above the minimum age specified for consenting to the service specified in the section.

Coverage

Health Net covers emergency room care and follow-up medical treatment without any member cost share for members who have suffered rape or sexual assault.

Members may obtain any of the following services for rape or sexual assault without any member cost share from the start of treatment (members enrolled in a high deductible health plan (HDHP) are subject to plan deductible):

• Emergency room care.
• Follow-up treatments, including any medical or surgical services for the diagnosis, prevention or treatment of medical conditions arising from an instance of rape or sexual assault.
• Mental health treatments.
• Out-of-network services if medically necessary care is not available within the member’s network.

How to bill for services

Providers may use standard diagnosis codes recognized by Health Net that pertain to rape or sexual assault following Billing and Submission requirements. Health Net requires that the ICD-10 Dx code is visible on the face of the paper-based prescription when pharmacist is filling the prescription. For electronic scripts, providers are responsible for determining where to place this information, based on their Electronic Medical Record (EMR) system.

If you have questions on how or where to place the Dx code, please contact your EMR vendor for information. Please note that any prescriptions given for member care will need to include the relevant diagnosis code(s).