In October 2021, Governor Gavin Newsom signed Senator Scott Wiener’s (D-San Francisco) legislation, SB 221, which requires health plans and insurers to provide patients with timely follow-up care for mental health issues and substance use disorders. That law goes into effect today – July 1, 2022.
Previous laws in California required Health Maintenance Organizations (“HMOs”) and insurers to provide initial mental health care for patients within ten business days following enrollment. But, under interpretation of the law, health plans and insurers were not required to provide timely subsequent care for patients after an initial appointment. This loophole meant that those suffering from mental health issues (such as depression, anxiety, schizophrenia) and addiction had to wait months for each subsequent appointment, resulting in inadequate care.
SB 221 establishes clear timely access standards for HMOs that operate under the California Department of Managed Health Care (“DMHC”) and health insurers that fall under the jurisdiction of the California Department of Insurance (“CDI”), requiring them to provide follow-up appointments and other forms of care within ten business days unless a provider believes a longer wait time is appropriate.
With COVID-19 exacerbating an already dire mental health and substance use crisis facing our country, timely access to mental health care is more important than ever. National survey data shows that the rate of anxiety and depression has tripled over the last year, and a recent CDC study found that an astounding one in four people age 18 to 24 has seriously considered suicide in the past 30 days.
Mental health care and substance use disorder treatment are urgent and necessary, and people should have timely access to care before they go into crisis and their situations escalate. SB 221 is a major victory for the movement to ensure mental health is treated as important as physical health.
If you or someone you know is suffering from any other mental illness, and you are being denied benefits by your insurer or access to treatment, please call Kantor & Kantor for a free consultation or use our online contact form.
We understand, and we can help.