MedicaidCoverageMedium impact
25-366 New Law Expands Protections for Survivors of Rape and Sexual Assault
Health Net·CA · Emergency Medicine, OB-GYN, Psychiatry +3 more·Prior Authorization
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Summary
Effective July 1, 2025, Health Net/CalViva Health will cover emergency room care and follow-up medical treatment for rape and sexual assault survivors with no member cost share. Claims must be billed with specific diagnosis codes to identify services provided for rape or sexual assault treatment.
Action Required
By July 1, 2025: Billing team must update systems to recognize and correctly bill services for rape and sexual assault survivors using the specified ICD-10 diagnosis codes. Update billing software to ensure claims include appropriate diagnosis codes for emergency room care, follow-up treatments, and mental health services. Train staff on proper coding requirements and ensure prescriptions include relevant diagnosis codes for covered services.