MHAC Priority Legislation

MHAC Position: Support

Author: Holden

Date: 04/12/2024

This bill would require a plan or insurer to annually audit and delete inaccurate listings from its provider directories, and would require a provider directory to be 60% accurate on January 1, 2024, with increasing required percentage accuracy benchmarks to be met each year until the directories are 95% accurate on or before January 1, 2027. The bill would subject a plan or insurer to administrative penalties for failure to meet the prescribed benchmarks and for each inaccurate listing in its directories. If a plan or insurer has not financially compensated a provider in the prior year, the bill would require the plan or insurer to delete the provider from its directory beginning July 1, 2024, unless specified criteria applies. The bill would require a plan or insurer to provide information about in-network providers to enrollees and insureds upon request, and would limit the cost-sharing amounts an enrollee or insured is required to pay for services from those providers under specified circumstances. Because a violation of the bill’s requirements by a health care service plan would be a crime, the bill would impose a state-mandated local program.

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MHAC Position: Support

Author: Jackson

Date: 04/12/2024

This bill would require a physician and surgeon, a general acute care hospital, a health care service plan, and a health insurer to provide to each legal guardian of a patient, enrollee, or insured, 10 to 18 years of age, a written or electronic notice regarding the benefits of a behavioral health and wellness screening. The bill would require the providers to provide the notice at least once every 2 years in the preferred method of the legal guardian. Because a violation of the bill’s requirements relative to health care service plans and health facilities would be crimes, the bill would impose a state-mandated local program. This bill would require a Medi-Cal managed care plan to include the above-described notice requirement in their outreach and education plan.

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MHAC Position: Support

Author: Reyes

Date: 04/12/2024

This bill would prohibit a medical service plan and a health insurer from subjecting a naloxone product or another opioid antagonist approved by the United States Food and Drug Administration, or a buprenorphine product or long-acting injectable naltrexone for detoxification or maintenance treatment of a substance use disorder, to prior authorization or step therapy. Because a willful violation of these provisions by a health care service plan would be a crime, this bill would impose a state-mandated local program.

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MHAC Position: Support

Author: Cervantes

Date: 04/12/2024

This bill would require the program to conduct at least one maternal mental health screening during pregnancy, and at least one additional screening during the first 6 months of the postpartum period. Because a willful violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program.

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MHAC Position: Support

Author: Bonta

Date: 04/12/2024

This bill would, instead, require certain boards that regulate healing arts licensees or registrants to collect workforce data from their respective licensees or registrants, and would require that data to be required at the time of electronic license or registration renewal, as specified. The bill would, instead, require a licensee or registrant to provide the specified workforce data as a condition for license or registration renewal and would delete the provision that specifies that a licensee or registrant shall not be subject to discipline for not providing that information.

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MHAC Position: Support

Author: Boerner

Date: 04/12/2024

This bill, until January 1, 2029, and upon appropriation by the Legislature for these purposes, would require the Department of Housing and Community Development to establish the Unicorn Homes Transitional Housing for Homeless LGBTQ+ Youth Program, to be administered by local community-based organizations that provide a majority of its services to the LGBTQ+ community. The bill would require the department to fund community-based organizations in up to 5 selected counties that provide transitional housing for LGBTQ+ youth, 18 to 24 years of age, inclusive, experiencing homelessness due to family rejection, with the ultimate goal of reunification with the youth’s original family. The bill would require the community-based organization to place eligible youth with volunteer host families who meet specified criteria, pursuant to the results of a background check, and who are able to provide crisis intervention with a trauma-informed approach, as defined, to their care. The bill would also require the program to comply with the existing core components of Housing First.

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MHAC Position: Support, MHAC Sponsored

Author: Bonta

Date: 04/12/2024

This bill would ratify and approve the Psychology Interjurisdictional Compact, an interstate compact that is operational under its terms, to facilitate the practice of telepsychology and the temporary in-person, face-to-face practice of psychology across state boundaries.Under this bill, the compact would require this state, as a compact state, to recognize the right of a psychologist, licensed in a compact state in conformance with the compact, to practice telepsychology in other compact states in which the psychologist is not licensed, as provided in the compact. Under the bill, the compact would also require this state to recognize the right of a psychologist, licensed in a compact state in conformance with the compact, to practice temporarily in other compact states in which the psychologist is not licensed, as provided in the compact. Under the bill, the compact would require the board to appoint a commissioner to the Psychology Interjurisdictional Compact Commission, a joint body with powers and responsibilities as established by the compact, including rulemaking authority, as prescribed.This bill would require the board to comply with the requirements of the compact and to adopt regulations as necessary to implement the compact. Under the bill, a person without a license granted under existing state law, but holding a privilege to practice under the compact, would not be prohibited from engaging in the practice of psychology or representing themselves to be a psychologist.

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MHAC Position: MHAC Sponsored, Support

Author: Haney

Date: 04/17/2024

This bill would require the department to establish a 3-year pilot program at 2 or more institutions that would provide access to specified mental health therapy for those not classified by the department to receive mental health treatment from the institution. The bill would require communications during therapy sessions, as specified, between the incarcerated person and assigned therapist to be confidential. The bill would require the California Correctional Health Care Services to be the custodian of records for treatment records generated under this pilot program. The bill would require the department to report certain information to the fiscal and appropriate policy committees of the Legislature, from March 1, 2025, to March 1, 2027.

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MHAC Position: Support

Author: Arambula

Date: 04/18/2024

Existing law establishes the Early Psychosis Intervention Plus (EPI Plus) Program to encompass early psychosis and mood disorder detection and intervention. Existing law establishes the Early Psychosis and Mood Disorder Detection and Intervention Fund and makes the moneys in the fund available, upon appropriation, to the Mental Health Services Oversight and Accountability Commission. Existing law authorizes the commission to allocate moneys from that fund to provide grants to create or expand existing capacity for early psychosis and mood disorder detection and intervention services and supports.This bill would require the Mental Health Services Oversight and Accountability Commission to consult with the State Department of Health Care Services and related state departments and entities, create a strategic plan to achieve specific goals, including improving the understanding of psychosis, as specified, and, no later than July 1, 2025, submit that strategic plan to the relevant policy and fiscal committees of the Legislature. The bill would require the State Department of Health Care Services to seek to partner with the University of California to develop a plan to establish a Center for Practice Innovations the Center for Mental Health Wellness and Innovations to, among other things, promote the widespread availability of evidence-based practices to improve behavioral health services. If the center is established, the bill would require the State Department of Health Care Services, no later than July 1, 2025, to submit the plan to create the center to the relevant policy and fiscal committees of the Legislature.

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MHAC Position: Support

Author: Carrillo

Date: 04/18/2024

Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law authorizes the Director of Health Care Services to terminate a contract or impose sanctions if the director finds that a Medi-Cal managed care plan fails to comply with contract requirements, state or federal law or regulations, or the state plan or approved waivers, or for other good cause.Existing law establishes, until January 1, 2026, certain time and distance and appointment time standards for specified Medi-Cal managed care covered services, consistent with federal regulations relating to network adequacy standards, to ensure that those services are available and accessible to enrollees of Medi-Cal managed care plans in a timely manner, as specified.Under this bill, a Medi-Cal managed care plan would be deemed to be not in compliance with the appointment time standards if either (1) fewer than 85% of the network providers had an appointment available within the standards or (2) the department receives information establishing that the plan was unable to deliver timely, available, or accessible health care services to enrollees, as specified. Under the bill, failure to comply with the appointment time standard may result in contract termination or the issuance of sanctions as described above.Existing law requires a Medi-Cal managed care plan to submit a request for alternative access standards if the plan cannot meet the time or distance standards. Under existing law, a plan is not required to submit a previously approved request on an annual basis, unless the plan requires modifications to its request. Existing law requires the plan to submit this previously approved request at least every 3 years for review and approval when the plan is required to demonstrate compliance with time or distance standards.This bill would instead require a plan that has a previously approved alternative access standard to submit a renewal request on an annual basis, explaining which efforts the plan has made in the previous 12 months to mitigate or eliminate circumstances that justify the use of an alternative access standard, as specified. The bill would require the department to consider the reasonableness and effectiveness of the mitigating efforts as part of the renewal decision.Existing law requires a Medi-Cal managed care plan to demonstrate, annually and upon request by the department, how the plan arranged for the delivery of Medi-Cal covered services to Medi-Cal enrollees, with a report measuring compliance, as specified. Existing law requires the department to annually evaluate a plan’s compliance with the standards and to annually publish a report.This bill would, effective for contract periods commencing on or after July 1, 2025, require the plan’s and department’s reports to include certain information and require the department’s evaluation to be performed using a direct testing method, as specified. Under the bill, failure to comply with these provisions may result in contract termination or the issuance of sanctions.Existing law, as part of the federally required external quality review organization (EQRO) review of Medi-Cal managed care plans, requires the EQRO designated by the department to compile certain data, by plan and by county, for the purpose of informing the status of implementation of the above-described standards.This bill would require that the data include, effective for contract periods commencing on or after July 1, 2025, the number of requests for alternative access standards, categorized by new and returning patients, and the number of allowable exceptions for the appointment time standards, categorized by urgent and nonurgent appointment types and by new and returning patients.Under existing law, in lieu of contract termination, the director has the power and authority to require or impose a plan of correction and issue one or more of specified sanctions against a contractor for findings of noncompliance or good cause.This bill would require the department to monitor any plan of correction imposed by the director, with progress reported publicly no less than annually for the duration of the plan of correction.Existing law authorizes the director to impose monetary sanctions based on any of specified circumstances, including, among others, a contractor’s failure to comply with network adequacy standards, failure to submit timely and accurate network provider data, or failure to timely and accurately process grievances or appeals.This bill would set forth definitions for the terms of “timely” and “accurate network provider data.”

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MHAC Position: Support

Author: Holden

Date: 04/18/2024

This bill would require the department to prepare a document, and to post it on the department’s internet website, for the purpose of making available resource information for individuals who are released or discharged by a facility after being detained for evaluation and treatment. Under the bill, the information would relate to potential methods for covering any applicable costs resulting from evaluation and treatment services in a manner that eliminates or reduces any share of cost for the individual. The bill would require the document to contain certain information, including information on how the individual, if uninsured or underinsured, might be able to have the services be covered by any applicable public or private programs. The bill would require the document to include a blank section that each county would be required to use for adding county-specific resource information, as specified. The bill would require a county to post the completed document on the county’s internet website. The bill would require the above-described facilities to provide a copy of that document to a detained individual upon their release or discharge by the facility. By creating new duties for counties relating to the document, the bill would impose a state-mandated local program.

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MHAC Position: Support

Author: Pellerin

Date: 04/18/2024

This bill would instead require the records, books, and papers of a health care service plan and other specified entities to be open to inspection by the director, including through electronic means. The bill would require a plan and other specified entities to furnish in electronic media records, books, and papers that are possessed in electronic media and to conduct a diligent review of records, books, and papers and make every effort to furnish those responsive to the director’s request. The bill would require records, books, and papers to be furnished in a format that is digitally searchable, to the greatest extent feasible. The bill would authorize the director to inspect and copy these records, books, and papers, and to seek relief in an administrative law proceeding if, in the director’s determination, a plan or other specified entity fails to fully or timely respond to a duly authorized request for production of records, books, and papers. Because a willful violation of these requirements would be a crime, the bill would impose a state-mandated local program.

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MHAC Position: Support

Author: Pellerin

Date: 04/18/2024

This bill would require that utilization review decisions be made within 72 hours when an enrollee’s condition is urgent, and would make a determination of urgency by a referring or treating health care provider binding on the health care service plan. If a health care service plan fails to make a utilization review decision within the applicable 72-hour or 30-day timeline, the bill would automatically entitle an enrollee to proceed with a grievance. This bill would require a plan’s grievance system to include expedited review of urgent grievances and would make a determination of urgency by a referring or treating health care provider binding on the health care service plan. The bill would require a plan to communicate its final grievance determination within 72 hours of receipt if urgent and 30 days if nonurgent. If a plan fails to make a utilization review decision within the applicable 72-hour or 30-day timeline, the bill would require a grievance to be automatically resolved in favor of the enrollee. This bill would require the department to provide specified correspondence and documents to an enrollee and their representative, if applicable, if the enrollee has submitted a grievance for review under the Independent Medical Review System. The bill would require the department to provide an enrollee and their representative a reasonable opportunity to respond to communications between the department and the plan or the independent review organization before the grievance is adjudicated. The bill would prohibit the department and its independent medical review organization from engaging in ex parte communication with a plan, enrollee, or their representatives during the grievance process. If a grievance is filed internally with an insurer, this bill would require an insurer to communicate its final grievance determination within 72 hours of receipt if urgent and 30 days if nonurgent. Upon notice from the department to a disability insurer that an insured has submitted a grievance to the department, the bill would require an insurer to respond within 24 hours, if directed by the department, regarding an urgent grievance or within 5 calendar days regarding a nonurgent grievance.This bill would require the department to determine whether or not a grievance is urgent unless the insured’s referring or treating provider has already designated the grievance as urgent. The bill would require the department to provide specified correspondence and documents to an insured and their representative, if applicable, if the insured has submitted a grievance for review under the Independent Medical Review System. The bill would require the department to provide an insured and their representative a reasonable opportunity to respond to communications between the department and the insurer or the independent review organization before the grievance is adjudicated. The bill would prohibit the department and its independent medical review organization from engaging in ex parte communication with an insurer, insured, or their representatives during the grievance process, except as specified.

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MHAC Position: Support

Author: Wiener

Date: 04/18/2024

Under SB 294, denials will be filed automatically as grievances with health plans. Life-threatening/urgent denials and unresolved grievances will then be referred to the IMR process, without burdening consumers to fight for care. This bill will also strengthen SB 855, a mental health parity law which requires plans to provide medically necessary mental health treatment.

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MHAC Position: Support

Author: Menjivar

Date: 04/22/2024

This bill would require the agency, or an entity designated by the agency, on or before July 1, 2025, to create an internet website where the public can access information and resources to support TGI individuals and their families in accessing trans-inclusive health care and other support services in the state, including, but not limited to, a general description of trans-inclusive health care, information on how to access directories of providers providing gender-affirming services, and resources for victims of hate incidents and hate crimes.The bill would require the agency to consult with specified subject matter experts and the Department of Justice in creating the internet website. The bill would also require the agency, in consultation with subject matter experts, to maintain the website and review the available information and resources to ensure the website is current and updated at reasonable intervals, but no less than once every 6 months.

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