Panel OKs Mental Health Parity Bill

The Assembly Committee on Health this week approved a bill aiming to ensure mental health needs are treated with the same concern as physical conditions by ramping up legislative oversight and enforcement efforts.

Summer recess begins July 3, so the bill likely will remain in Assembly Appropriations until the Legislature reconvenes in August.

 SB 22 by Sen. Jim Beall (D-San Jose) would require health plans and health insurers to submit annual reports to the Department of Managed Health Care and the California Department of Insurance, respectively, to certify they are complying with state and federal mental health parity laws.

The Beall bill also would require DMHC and CDI to publish a report on their websites of any access or quality of care issues they find, and the agencies would need to hold public hearings on report findings. At present, state officials must conduct a survey to determine whether insurers’ health delivery systems are in compliance with mental health parity laws every three years, rather than every year.

“SB 22 strengthens California’s enforcement of the state mental health parity laws by measuring health insurers’ compliance with reliable, in-depth and clear data,” Beall said. “The current enforcement system is a complaint-driven process. It places the burden on the person who may very well be struggling with a mental health or substance abuse disorder, and asks this person to voluntarily file a complaint.”

Beall said a more proactive and timely enforcement process is required.

“California has passed some of the strongest mental health and substance abuse parity laws in the nation,” staffers wrote in a bill analysis. But, the analysis said, “statutes are sabotaged by a weak enforcement system.”

A staff report found mental health patients endured longer waits for patient appointments, denials by insurance companies to provide care and insufficient numbers of providers. All of that can dissuade mental health patients from getting treatment.

Only 60% of people with mental illnesses and 10% of people with substance abuse disorders have timely access to treatment, the report said.

Health insurance companies voiced opposition to the bill Tuesday, noting that there are already laws on the books that ensure compliance with health parity laws.

“We unfortunately do oppose the bill,” said Nick Louizos, director of legislative affairs for the California Association of Health Plans. “We view it as one more bureaucratic requirement that our plans would have to comply with in the face of many of the compliance issues that are required under the Affordable Care Act.”

Randall Hagar, government affairs director for the California Psychiatric Association, disagreed.

“It’s not enough really to have medical surveys every three years,” Hagar said. “We need to do better in terms of data. One of the issues that we’ve dealt with forever is that people with mental illnesses, for whatever reasons, don’t tend to complain — they don’t tend to appeal.”

SB 22 “will really help us enforce the parity laws in the state and address issues such as access and quality of care,” Hagar added.

Assembly member Richard Pan (D-Sacramento), chair of the Assembly health committee and a pediatrician, said he has seen firsthand in his practice why laws like SB 22 are important.

“I think that there are some unique challenges to access for people with mental health [issues],” Pan said. “I, as a physician taking care of people with mental health problems, understand that even with parity and coverage, patients can still have challenges with access. We want to make sure they have access in the end.”

Under current law, Medi-Cal managed care plans are exempt from the parity requirement.

SB 22 now goes to the Assembly Committee on Appropriations. The measure has a one-time price tag of about $350,000 for DMHC and CDI administrative costs, and potential ongoing costs of $270,000 for enforcement activities.