Today's Law As Amended


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SB-22 Health care coverage: mental health parity.(2013-2014)



As Amends the Law Today


SECTION 1.

 Section 1374.18 is added to the Health and Safety Code, to read:

1374.18.
 (a) This section shall apply to every health care service plan that provides hospital, medical, or surgical coverage or any specialized mental health care service plan that contracts with a health care service plan to provide mental health services.
(b) On and after October 1, 2014, every plan described in subdivision (a) shall submit an annual report to the department certifying compliance with Section 1374.72 and the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (Public Law 110-343), hereafter referred to as the MHPAEA, its implementing regulations, and all related federal guidance. The annual report shall be a public record made available upon request and shall be published on the department’s Internet Web site. The department may hold public hearings on the reports at its discretion.
(c) As part of the report, the plan described in subdivision (a) shall conduct both of the following:
(1) A survey of enrollees to collect responses pertaining to enrollee experiences with mental health and substance use care.
(2) A survey of providers to collect responses pertaining to provider experiences with providing mental health and substance use care.
(d) On or before July 1, 2014, the department shall collaborate with the Department of Insurance and consult with experts and stakeholders to create standards for the form and content of information to be reported pursuant to subdivision (b). These standards shall ensure that data reported, including the results of surveys conducted pursuant to subdivision (c), are standardized and intercomparable. For the creation of standards for certifying compliance with MHPAEA, the department shall consider national mental health parity compliance standards, including, but not limited to, the standards P-MHP-1, P-MHP-2, and P-MHP-3 of the American Accreditation HealthCare Commission (URAC) Health Plan Accreditation Guide, Version 7, or any subsequent versions.
(e) On or before January 1, 2020, the department shall report to the Legislature on the information obtained through the annual reports in subdivision (b). The report shall include a summary of any regulatory actions taken as a result of information gathered through the reports.
(f) A report submitted to the department pursuant to this section shall not include any information that may individually identify enrollees, including, but not limited to, medical record numbers, names, and addresses.
(g) This section shall not apply to contracts entered into pursuant to Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing with Section 14200) of Part 3 of Division 9 of the Welfare and Institutions Code, between the State Department of Health Care Services and a health care service plan for enrolled Medi-Cal beneficiaries.

SEC. 2.

 Section 10144.53 is added to the Insurance Code, to read:

10144.53.
 (a) On and after October 1, 2014, every health insurer shall submit a consolidated annual report to the Department of Insurance certifying that each of its health insurance policies comply with Section 10144.5 and the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (Public Law 110-343), hereafter referred to as the MHPAEA, its implementing regulations, and all related federal guidance. The annual report shall be a public record made available upon request and shall be published on the department’s Internet Web site. The department may hold public hearings on the reports at its discretion.
(b) As part of the report, an insurer shall conduct both of the following:
(1) A survey of insureds to collect responses pertaining to insured’s experiences with mental health and substance use care.
(2) A survey of providers to collect responses pertaining to provider experiences with providing mental health and substance use care.
(c) On or before July 1, 2014, the department shall collaborate with the Department of Managed Health Care and consult with experts and stakeholders to create standards for the form and content of information to be reported pursuant to subdivision (a). These standards shall ensure that data reported, including the results of surveys conducted pursuant to subdivision (b), are standardized and intercomparable. For the creation of standards for certifying compliance with MHPAEA, the department shall consider national mental health parity compliance standards, including, but not limited to, the standards P-MHP-1, P-MHP-2, and P-MHP-3 of the American Accreditation HealthCare Commission (URAC) Health Plan Accreditation Guide, Version 7, or any subsequent versions.
(d) On or before January 1, 2020, the department shall report to the Legislature on the information obtained through the annual reports in subdivision (a). The report shall include a summary of any regulatory actions taken as a result of information gathered through the reports.
(e) A report submitted to the department pursuant to this section shall not include any information that may individually identify insureds, including, but not limited to, medical record numbers, names, and addresses.
(f) This section shall not apply to policies or health benefit plans issued pursuant to Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing with Section 14200) of Part 3 of Division 9 of the Welfare and Institutions Code, between the State Department of Health Care Services and an insurance policy or health benefit plan for enrolled Medi-Cal beneficiaries.
SEC. 3.
 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.