AB 3221 (Pellerin) Department of Managed Health Care: review of records – Support

March 26, 2024

The Honorable Mia Bonta
Chair, Assembly Health Committee
1020 N Street, Room 390
Sacramento, CA 95814

Re: AB 3221 (Pellerin) – SUPPORT

Dear Chair Bonta:

Mental Health America of California (MHAC) is writing to express our support of AB 3221 (Pellerin) which will allow the Department of Managed Health Care (DMHC) to take enforcement action more swiftly and more efficiently when health plans violate the law.

Too often, people with mental health challenges don’t receive the behavioral health care they need, and that they have paid for, in the timely and appropriate manner they are entitled to under the law. California has been at the forefront of passing groundbreaking behavioral health parity (SB 855) and timely access laws (SB 221), which could alleviate this crisis if the Department of Managed Health Care were empowered to take faster, stronger, and more efficient action.

As stated in my testimony before the Senate Select Committee on Mental Health and Addition in August 2022, I have firsthand experience as a family member and employer with care that is frequently delayed seven or more months and often only after incorporating the assistance of DMHC.

Under The Knox-Keene Health Care Service Plan of 1975, health care service plans are required to keep their books, records and papers open to inspection by the DMHC director.  DMHC is required to conduct periodic on site medical surveys, publicly report results, and issue final reports after public review. They must also conduct follow-up reviews to evaluate a health plan’s efforts to correct deficiencies. But several of the provisions are outdated, ineffective, or both. Records are not provided electronically, which delays and costs the department, and penalties are not required for failure to provide full records in a timely manner. Additionally, when DMHC seeks approval for actions on behalf of consumers, they are required to go to Superior Court, which is overburdened and less efficient than Administrative law judges.

AB 3221 will allow DMHC to request that health plan records be furnished electronically, making those records faster to receive and easier to review. It will allow DMHC to seek relief on patients’ behalf through an administrative hearing rather than the slower and more burdensome Superior Court hearing process, and empower DMHC’s director to take disciplinary action when a health plan fails to respond to a request for records fully or in a timely manner.

These common-sense changes will allow DMHC to take important enforcement actions more quickly and efficiently, improving compliance with the groundbreaking behavioral health parity and timely access laws California recently enacted.

For all of these reasons, Mental Health America of California supports AB 3221 (Pellerin), and we respectfully request an “AYE” vote.

Sincerely,

Heidi L. Strunk
Chief Executive Officer