In summary
“Everyone has been denied some kind of care,” said a California mental health lawyer. Now, legislative behavior is pushing new bills related to health coverage.
Residents of frustrated California have long complained that they cannot achieve their health plans for the most essential mental health treatment.
These days, state lawmakers seem to be hearing them – and are trying to act.
This session introduced a bill will require health plans for more cough Data on coverage refusalAnd punish those who often refuse claims.
Will require plans for another Wait at least 28 days After approving a patient to go to the treatment center for the use of a substance, he should re -evaluate whether the patient can stay there or not.
One -third of health plans will prohibit the need Permission before this Treatment for the use of mental health and material before the patient was established in a hospital.
The list continues.
Four years after state leaders make historic legislation to improve mental health and the use of material, Paul is still deeply unhappy with the people they are receiving. Last year, a California survey found that more than 80 % of respondents wanted governor and legislature Increasing access to mental health treatment.
“Everyone has been denied some kind of care,” said John Dribaginger, a senior lawyer for the Mental Health Advocate Organization, said. “No one likes it. If you are not, you know someone who has it.”
Under the Senate’s Budget and Financial Review Committee’s February supervision, Scott WinnerDemocratic San Francisco’s state senator who authored the 2020 coverage law, called the process through which consumers can Appeals refusal The state’s Department of Health care “burden, vague and timely demand.”
In light of the federal efforts to dismiss workers and remove data from government websites, he said, “Leading California is more important than ever.”
It is still pretty in the process that it can be said because of any kind of factors in the proposed legislation, including federal financial uncertainty, opposition to the health plan and disagreement with those who advocate for the best approach.
Last year, a handful of bills designed to keep health projects accountable ended late in the legislative process. Supporters estimates cost estimates for their death.
But some of these lawmakers and supporters say that last December, Brian Thomson, 26, was shot dead by the chief executive officer of the United Healthcare. The murder has led to the end of public frustration and has become a cultural flashpoint.
At a February surveillance hearing, the director of the Managed Healthcare Department, Mary Watanab, looks open for plans to provide more information about coverage refusal.
“We are actually trying to understand the obstacles that consumers face to navigate the health system,” he said.
California Association of Health Plans spokesman Mary Allen Grant said in an email that it is premature to submit the comment, because the Industry Association has not yet taken a formal position on individual bills. He provided a reality sheet about the importance of advance permission to make health care safe, high quality and more affordable.
There are some high bills trying to deal with this problem:
More transparency about the denial
Would like to see Winner Too much transparency From commercial health projects. In their Senate Bill 363, the state will require plans to report granted data on how many times they refuse treatment. This bill applies not only to mental health, but to deny all kinds of medical care.
The state also has its appeals for consumers, known as the Independent Medical Review. Winner’s bill will also impose a fine on the projects if the state will eliminate the refusal of their coverage for more than half a time.
Weirs have admitted that health plans have proved some of their other bills “opponents”. But they call the pressure “long -term” for maximum accountability. Since he has made legislation, he said, how many people have stopped him on the streets of San Francisco to share his personal nightmares about refusing coverage.
“It is touching the nerve,” he said.
To protect the first 28 days
Assembly Bill 669 Continuying to use substances to continue planning to prevent a patient’s eligibility will prevent them from approval for at least 28 days.
Matt Henny, A Democratic State Assembly from San Francisco, which authored the bill, says his interest in the bill has been influenced by the story of Ryan Matlok. Metalok, a young man whose story was presented in columnists last fall, died after deciding to hide his residential treatment after his health plan. The project was initially decided that Matlok did not need to stay at the treatment facility when he spent only three days there. Metalic’s mother, Christine Dogti, is testifying by the legislature.
Honey says 12 other states already have similar laws.
“It is sad and mindful that the insurance company can deny someone that they need and their physician says they need it, but the insurance company’s job ‘doctor’ has been denied that he never spoke to the patient, and it was wrong.”
Bill patronizing organizations include California Consortium of Addiction programs and professionals, the California Establishment Health Association, Advocate for Addiction Treatment, and a new path (parents of drug treatment and healing).
No advance permission for patients’ mental health
Cleaning Mental Health Protection Act, AB 384, will stop health plans Required in advance permission Care of patients for the treatment of mental health and material. It also prevents plans for any medical care that is considered necessary during the establishment of these patients.
Demon ConnealiA Democratic State Assembly, a San Rafael, says he has modeled a similar, successful legislative bill in Illinois.
“Often advance permission is delayed in the situation where every other count is,” he said.
The California State Association of Psychiatrist and California Health Association are supporting the bill.
Describes ‘medically necessary’
Health plans are needed to cover medical health and mental health care. But what does the medical need? A bill of Democratic Frecheno State Assembly Member Jokin ArmablaAB 980, will Specify “medically necessary” Legally recommended medical care means that is reasonable and fits with the standards set by the medical community. The bill also details the losses whose projects can be held responsible if such care is not provided.
Health -related health visit after forest fire
With the elimination of the entire palaces of the state, it is clear that some people in destructive communities will need health treatment. A bill of Democratic State Assembly Member John Harbidin Passadina and from Robert Revis From Selenis, AB -1032 will need health insurance to pay entries from a disaster zone. 12 visits with a licensed behavior health provider During the year after the forest fire program.
