California Legislation

This resolution lays out statistics regarding MHo Lays out MH/SUD statistics, Milliman statistics, and Wit decision. The Legislature calls for Department Managed Health Care, Department of Insurance, Department of Health Care Services, and the Attorney General to use full powers of their office to ensure parity compliance. The Legislature also calls on all coverage to be consistent with generally accepted standards of care and for changes to state law to be made as necessary.

This bill amends Section 14006.18 of the Welfare and Institutions code to extend Medi-Cal postpartum care for up to one year beginning on the last day of the pregnancy for an eligible individual who is diagnosed with a maternal mental health condition.

This bill amends California Statutes by adding a section HSC 1374.77 and WIC 10144.41 to require health insurers to submit an annual report to the Department of Managed Health Care or the Department of Insurance certifying compliance with state and federal mental health parity laws. The report shall include an analysis certifying that medical necessity criteria and NQTLs are in compliance with parity. This applies to: large group health care service plan contracts; every health care service plan contract issued, amended, or renewed on or after July 1, 2000, that provides hospital, medical, or surgical coverage; large group health insurance policy; individual or small group health insurance policy; and every policy of disability insurance that covers hospital, medical, or surgical expenses.

Furthermore, this amendment requires the departments to review insurer reports submitted to ensure compliance, The reports and the results of the reviews must be available upon request and be posted to the  departments’ website. Finally, this provision requires the departments to report to the Legislature the information obtained through the reports, the results of the review of the reports, and all other activities taken to enforce state and federal mental health parity laws.

Additionally, the bill adds a section HSC 1374.78 and WIC 10144.42. This provision is directed towards plans or policies, as listed above, that provides prescription drug benefits for the treatment of SUD. Such plans are prohibited plans from imposing any prior authorization requirements or any step therapy requirements on drugs approved by the FDA to treat SUD. They also are prohibited from excluding of coverage of any drugs approved by the FDA to treat SUD and any associated counseling or wraparound services on the grounds that those medications and services were court ordered. Finally, these plans are required to place all prescription medications approved by the FDA for the treatment of SUD on the lowest tier of the drug formulary

Among other things, this bill amends LAB 884 by adding a section to require that emergency ambulance employees who request mental health treatment for critical incident stress management or PTSD to receive in-person treatment from a qualified professional who is trained in the areas of critical incident stress management or PTSD.
Notes: Under existing law, every emergency ambulance employee is entitled to employer-paid mental health services through an EAP. Existing law requires the EAP coverage to provide up to 10 mental health treatments per issue, per calendar year.

This bill would amend WIC section 14045 by adding a new section to require the State Department of Health Care Services to establish a statewide peer, parent, transition-age, and family support specialist certification program, as a part of the state’ s comprehensive mental health and substance use disorder delivery system and the Medi-Cal program. The bill would include 4 certification categories: adult peer support specialist, transition-age youth peer support specialist, family peer support specialist, and parent peer support specialist. This bill would require Medi-Cal reimbursement for peer support specialist services to be implemented only if, and to the extent that, federal financial participation is available and the department obtains all necessary federal approvals. The Department of Health Care Services (DHCS) would be responsible for developing the certification program.

Section 1 of A.B. 2861 amends the California Welfare and Institutions Code by adding §14132.731 as a new section to require, upon federal approval, licensed practitioners of the healing arts and certified substance use disorder counselors to be eligible for MediCal reimbursement for covered outpatient counseling services provided through Telehealth for substance use disorder patients.

Section 1 of S.B.1125 amends the California Welfare and Institutions Code §14132.100 to authorize reimbursement through Medi-Cal for a maximum of two visits to health care providers taking place on the same day at a single location if after the first visit, the patient needs additional care or has a mental health or dental care visit.

This bill tried to amend parity law within the state Insurance Code to give the Insurance Commissioner power to levy a $2,500 fine per patient per day on insurers for violating state parity law.

This bill tried to amend parity laws within the Health and Safety Code and the Insurance Code to require all plans to submit reports to either DMHC or CDI certifying their compliance with the Federal Parity Law and the state parity law. These reports would have included surveys of consumers and providers.

This bill tried to add provisions in the state parity law for increased coverage of pervasive developmental disorders or autism beyond what was already established in the state law. It also included specific language specifying that plans would not have to provide benefits exceeding those required by the essential health benefits of the ACA.

This bill tried to amend the state parity law so that most behavioral health conditions would be covered instead of the “severe mental illnesses” currently covered. It tried to include all conditions in the DSM -IV except for a list of exceptions. It is an adaptation of bills introduced in previous legislative sessions.

This bill tried to amend the state parity law so that most behavioral health conditions would be covered instead of the “severe mental illnesses” currently covered. It sought to include all conditions in the DSM -IV except for a list of exceptions. It is an adaptation of bill introduced in previous legislative session.

This bill tried to amend the state parity law so that most behavioral health conditions would be covered instead of the “severe mental illnesses” currently covered. It sought to include all conditions in the DSM-IV.