SB 294 (Wiener) Automatic Review of Health Plan Denials – Support

April 5, 2024

The Honorable Scott Wiener
California State Senate
1021 O Street, Suite 8620
Sacramento, CA 95814

RE: Senate Bill 294 (Wiener) – Support

Dear Senator Wiener:

I am pleased to share that Mental Health America of California (MHAC) supports Senate Bill 294 (Wiener), legislation which would ensure health plan denials of care for mental health disorders for youth ages 0-26 are automatically reviewed.

MHAC is a peer-run organization leading the state in behavioral health public policy and advocacy since 1957. The mission of MHAC is to assist and encourage communities, families and individuals to experience hope, wellness and recovery from mental health and substance use disorder issues through voluntary services that are delivered in their local community with compassion and respect for everyone’s dignity and autonomy. Achieving this goal entails implementing automatic reviews of health plan denials and utilizing all available resources and processes to ensure the preferred delivery of care.

Each year, hundreds of thousands of individuals face denied claims, with specific health plans denying claims to millions. For instance, in 2022, Anthem Blue Cross received 5,650,144 claims but denied 1,476,768 of them, representing slightly over 26% of all claims received.[1] Additionally, the Department of Managed Health Care reported that 67.5% of all enrollees that submitted Independent Medical Review requests in 2021 received the service(s) or treatment(s) they requested.[2] These disparities highlight the discrepancy between the number of individuals seeking and able to receive care and those who are consistently denied access to it. SB 294 takes a step forward in improving access to care by ensuring that denials of mental health care for youth are automatically reviewed.

For these reasons, we support Senate Bill 294 (Weiner). If you or your staff have any questions, or if Mental Health America of California can be of any assistance on this or any other behavioral health bill, please do not hesitate to contact me at hstrunk@mhac.org, or our Director of Public Policy, Karen Vicari at kvicari@mhacofca.org.

In Community,

Heidi Strunk
President & CEO
Mental Health America of California


[1] Data on denied claims. California’s Health Benefit Exchange – Insurance Companies – Denied Claims. (n.d.). https://hbex.coveredca.com/insurance-companies/denied-claims/#:~:text=2020%20Total%20Claims%20Denied%3A%201%2C141.&text=Inland%20Empire%20Health%20Plan%3A,is%20available%20to%20report%20yet.

[2] 2022 Department of Managed Health Care Annual Report. (n.d.-b). https://www.dmhc.ca.gov/Portals/0/Docs/DO/2022AR.pdf