April 11, 2025
California Department of Insurance
Attn: Stesha Hodges, Assistant Chief Counsel, Kayte Fisher, Attorney V
Health Equity and Access Office
300 Capitol Mall, Suite 1700
Sacramento, CA 95814
Via email <CDIRegulations@insurance.ca.gov>
Re: Mental Health and Substance Use Disorder Coverage Requirements, Article 15.2 (commencing with section 2652.1) of Subchapter 3 of Chapter 5 of Title 10 of the California Code of Regulations, pursuant to the authority granted by Insurance Code sections 10144.4, 10144.5, 10144.51, 10144.52, 10144.53, and 10144.57
We thank the California Department of Insurance for its ongoing progress towards finalizing its Mental Health and Substance Use Disorder Parity in Health Insurance Rulemaking (REG-2021-00008), to implement Senate Bill 855 (Wiener, Chapter 151, 2020) and Assembly Bill 988 (Bauer-Kahan, Chapter 747, 2022). We are grateful for the Department’s continued engagement with us on numerous issues related to implementation of the law and its drafted regulations. The Department’s proposed Rule lessens the possibility that disability insurers will exploit ambiguities to inappropriately limit insureds’ access to mental health and substance use disorder (MHSUD) care.
We encourage this comprehensive Rulemaking to be finalized as soon as possible and offer support for the Department’s April 3, 2025 additions to its drafted Rulemaking dated May 24, 2024. Specifically, we are supportive of the following key additions, as currently drafted:
- Network adequacy monitoring. We support the Department’s added clarity as to what an insurer needs to do once someone has requested assistance identifying a health care provider including by adding that if an insurer cannot identify more than three in-network providers, that it must refer the person to those three and notify the Department of the service requested, type of provider, and location. This is an important mechanism for ensuring the Department has proactive insight into possible weakening parts of networks that could lead to or show existing network inadequacies. We applaud the Department for this forward-thinking change which we believe will protect insureds.
- Defining coordinated specialty care. Providing a definition of Coordinated Specialty Care makes it much harder for insurers to deny or partially deny medically necessary services for individuals experiencing first and early episodes of psychosis. We applaud the Department’s further defining of these life-saving but seldom reimbursed services.
We encourage the swift promulgation of comprehensive regulations. Once promulgated, we encourage the Department to issue notices, bulletins, and/or general opinion letters regarding particular areas of enforcement concern. Our organizations stand ready to assist you in the identification of MH/SUD access issues and comprehensive implementation of the Rule in any way we can.
If you have any questions, please contact Lauren Finke (lauren@thekennedyforum.org). For matters requiring physical or printed communication, please send to 1121 L Street, Sacramento, California 95814 suite #300.
Sincerely,
Adrienne Shilton
California Alliance of Child and Family Services
Robb Layne
California Association of Alcohol and Drug Program Executives, Inc
Joy Alafia
California Association of Marriage and Family Therapists
Chad Costello
California Association of Social Rehabilitation Agencies
Carli Stelzer
California Behavioral Health Association
Tyler Rinde
California Psychological Association
Paul Yoder
California State Association of Psychiatrists
Danny Thirakul
California Youth Empowerment Network
Alison Ivie
REDC Consortium
Eating Disorders Coalition for Research, Policy, & Action
Karen Fessel
Mental Health & Autism Insurance Project
Heidi Strunk
Mental Health America of California
Héctor Hernández-Delgado
National Health Law Program
Benjamin Eichert
NUHW
Samia H. Rafeedie
Occupational Therapy Association of California
Randall Hagar
Psychiatric Physicians Alliance of California
Tara Gamboa-Eastman
Steinberg Institute
Lauren Finke
The Kennedy Forum
CC:
Ricardo Lara, Stesha Hodges, Kayte Fisher, Department of Insurance
Senator Scott Wiener
Assemblymember Bauer-Kahan
