NUHW is sponsoring two mental health equity bills
NUHW is helping make 2024 a monumental year in the fight for mental health equity.
In January, we worked with allies in the State Assembly to pass Assembly Bill 236, authored by Chris Holden, that would put an end to Ghost Networks by requiring health plans to maintain accurate lists of in-network providers.
Now, NUHW is sponsoring two bills, authored by Assemblymember Gail Pellerin of Santa Cruz, that would help state regulators better enforce recent mental health parity laws and help patients advocate for their rights.
AB 3221 and AB 3260 would build upon NUHW’s recent legislative victories. The bills were introduced in February just months after Kaiser Permanente entered into a $200 million settlement agreement with state authorities after investigations showed that Kaiser routinely denied its members access to timely care and failed to resolve nearly one-third of patient grievaces within the required 30-day timeframe.
“We have a real opportunity to build on our accomplishments and help patients access the care they’re entitled to receive,” NUHW President Sal Rosselli said. “NUHW members have helped elevate the movement for mental health equity, especially following our 2022 strike in Northern California, and the legislature is ready to really start protecting patients and holding health plans accountable.”
AB 3221 would help the Department of Managed Health Care better enforce state law by removing roadblocks that have made it difficult for the agency to conduct effective investigations. The bill would allow the agency to:
- Request health plan records in a searchable digital format, allowing for faster receipt and review of records.
- Take disciplinary action when health plans fail to respond to records fully or in a timely manner.
- Seek relief on behalf of consumers through administrative hearings rather than through the slower Superior Court hearing process that is currently required.
AB 3260 would empower patients seeking mental health care to fight for their rights and win grievances when their health plan denies them appropriate care. The law:
- Prohibits health plans and disability insurers from overriding a provider’s determination that a patient (consumer) requires urgent care.
- Allows consumers to file grievances immediately if their health plans or disability insurers fail to respond to their claims within the time period and in the manner required under state law.
- Requires health plans and disability insurers to automatically resolve grievances in favor of the consumer if they don’t respond within the legally-required timeframe of 72 hours for urgent cases and 30 days for non-urgent cases.
- Increases transparency and expands due process rights for consumers who file complaints with state regulators over improper denials or lack of access to care.
AB 236, the Ghost Network Bill, which is now in the State Senate, aims to put an end to “ghost networks,” by requiring health plans to audit their own provider directories based on standards set by the Department of Managed Health Care. Health plans would be required to achieve 80 percent accuracy by 2026 and 95 percent accuracy by 2028. Plans that fail to meet accuracy benchmarks would be fined.