California Law Aims to Boost Behavioral Health Pay Parity

California recently passed a law requiring health plans to follow a more expansive definition of behavioral health reimbursement parity starting in 2021. Experts say that plans will have to spend more on behavioral health care than they did before, as payers’ utilization management practices will have to follow a more generous standard for medical necessity.

The new law, which passed the California Assembly as S.B. 855 on Sept. 23, expands the requirements of existing behavioral health parity statutes to require that plans reimburse all “medically necessary” behavioral health treatment, including substance use disorder treatment. The law also includes a provision that requires plans to limit cost sharing to in-network levels for members who are only able to access out-of-network providers.

© 2021 MMIT

Peter Johnson

Peter has been a reporter for nearly a decade. Before joining AIS Health, Peter covered a wide variety of topics in his hometown of Seattle, where he continues to live. Peter’s work has appeared in publications including The Atlantic and The Stranger. Peter attended Colby College.

Related Posts
October 22

With COVID Testing Set to Surge, Insurers Fret About Costs

READ MORE‘Dance-Partners.jpg
October 22

Could Payers, Plan Sponsors Pick Retail ‘Dance Partners?’

READ MORE‘Virtual-First-Health-Plan-Fray.jpg
October 22

UnitedHealthcare, Cigna Join ‘Virtual-First’ Health Plan Fray

Read More


Sign up for publications to get unmatched business intelligence delivered to your inbox.

subscribe today