Today, Governor Brown approved a modified version of Senator Beall’s mental health parity enforcement budget proposal. The action dedicates nearly $2 ½ million dollars to the Department of Insurance (DOI) and Department of Manage Health Care (DMHC) to hire additional staff to enforce mental health parity laws. The additional staff would be paid by fees on insurance plans and have zero impact to the state general fund.
With the passage of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, every state and every health insurance plan must be in compliance with the federal parity law by Jan. 1, 2015, when it becomes fully enforceable. Each year, California falls further behind in our enforcement obligation -- exposing the state to lawsuits and the risk of losing federal funds for non-compliance, a critical issue that Senate Bill 22 (Beall) sought to address last year.
“The state must take additional budget action now to add enforcement staff or face lawsuits later” Beall said.
In June, the California Appellate Court reversed the Superior Court of LA County decision and ruled that the state Mental Health Parity Act requires that all medically necessary services be covered, whether or not they are listed in an evidence of coverage and the listed services in the Act are illustrative, not exclusive. The case was in response to Blue Shield’s position that California’s Mental Health Parity statute did not cover treatment for a woman suffering from anorexia.
As Chair of the Mental Health Caucus and Senate Mental Health Select Committee, Senator Beall fought hard to ensure additional resources for mental health parity enforcement are included in the final budget. He organized a strong coalition of legislators and community partners including California Insurance Commissioner Dave Jones to help make parity enforcement a budget priority.
In response to the coalition’s hard work and on-going meetings with Department of Managed Health Care and Department of Insurance, the Governor’s revised budget released in May included $369,000 for clinical consulting services to help DMHC immediately conduct initial front-end parity compliance reviews beginning with health plans filings in July. For the first time, plans will be required to provide evidence that demonstrates they are compliant with federal and state parity laws. Prior to this, plans self-certified they meet the new federal parity law plans.
“Although the revised budget was a huge step in the right direction, it did not go far enough,” Beall said. “It made no allowances for the hiring and training of employees necessary to research and analyze the new data that will health plans will be providing, data that will be essential for measuring the enforcement of mental health parity.”
Now more than ever we need to ensure people get the benefits they pay for including mental health benefits. Nearly 1.5 million Californians have enrolled into a Covered CA plan during the first open enrollment period. DMHC will be responsible to regulate all Covered CA plans with the exception of one Health Net plan. We must ensure people with private health insurance get the benefits they pay for.
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Disability Rights CA "What is Mental Health Parity?" - Brouchure PDF