AB 88 Summary:
AB 88 prohibits health plans from basing medical necessity denials on whether the admission for mental health services was voluntary or involuntary, WIC 5150 hold CA Legislator * or on the method of transportation of the patient to the health facility.
See below about mandate to cover Severe Mental Illness!
This bill also requires plans that offer mental health services (Individual & Families * Medi-Cal * Employer Groups) to have information on their website that will assist enrollees in accessing mental health services. SB 1553 §1368.015, §1367.015Health & Safety Code Blue Cross / Anthem Mental Health Procedures
See also, our webpage on ACA/Obamacare mandates of Mental Health as an Essential benefit.
Insurance Code §10144.5
(a) Every policy of disability (health) insurance that covers hospital, medical, or surgical expenses in this state* … shall provide coverage for the diagnosis and medically necessary treatment of severe mental illnesses of a person of any age, and of serious emotional disturbances of a child, … under the same terms and conditions applied to other medical conditions,
(b) These benefits shall include the following:
(c) The terms and conditions applied to the benefits required by this section that shall be applied equally to all benefits under the disability (Health, Medical) insurance policy shall include, but not be limited to, the following:
(1) has one or more mental disorders as identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, other than a primary substance use disorder or developmental disorder, that result in behavior inappropriate to the child’s age according to expected developmental norms, and …
CA Insurance Commissioner letter to All Health Insurance Companies to comply with SB 855 to provide coverage for medically necessary treatment of mental health and substance use disorders, as defined, under the same terms and conditions applied to other medical conditions.
So, one must compare AB 88, with the
Medicare & You - Mental Health
Medicare & Mental Illness # 11358 2 pages
Our webpage on EOC Evidence of Coverage - Plain English, even if they are 2 to 300 pages
Mental Health Videos
- Mental Health Video - updates on Mental Health Parity - Mental Health must be covered the same as physical health
- Video Medicare-covered benefits for mental health.
- PBS Bedlam VIDEO In an effort to get to the bottom of the current mental health crisis in the U.S., psychiatrist and documentarian Kenneth Paul Rosenberg M.D. chronicles personal, poignant stories of those suffering from mental illness, including his own family, to bring to light this epidemic and possible solutions. Shot over the course of five years, Bedlam takes viewers inside Los Angeles County’s overwhelmed and vastly under-resourced psych ER, a nearby jail warehousing thousands of psychiatric patients, and the homes — and homeless encampments — of people affected by severe mental illness, where silence and shame often worsen the suffering. See Trailer Available till October 30th
- Sharp Health Care - Mental Health Videos - Play List
- Mental Health Insurance Coverage: Get the Whole Picture
See our Main Webpage on Mental Health
Consumer Resources & Links
insurance coverage for behavioral and mental health. http://on.apa.org/parity-law.
Bazelon Center Paper on Health Reform & Mental Health
Aetna on Mental Health
Insurance Gender Nondiscrimination Act (IGNA), also known as AB 1586, prohibits health plans from denying medically necessary health care to transgender individuals insure me kevin.com
California Mental Health Parity Act requires Blue Shield to provide medically necessary treatment for people suffering from severe mental illnesses, including anorexia and bulimia.
The case involved Blue Shield’s denial of residential treatment for the plaintiffs’ eating disorders. Blue Shield argued that all the Parity Act required was equality of treatment between mental and physical illnesses and, since its policy did not cover residential treatment for physical illnesses, it did not have to provide residential treatment for severe mental illnesses.
“This decision confirms that residential treatment is one of the most effective treatments for eating disorders, and must be available to California insureds who need this treatment,” * Class Action Lawsuit * Casetext.com * kantor law.net
California mental health care parity law, requiring health insurance policies to cover treatment for mental illness on same terms and conditions applied to other medical conditions, applied to health plan beneficiary who did not live in or seek medical care in California, even assuming that parity law applied to policies written to cover expenses incurred in California, inasmuch as plan was written to provide benefits to California beneficiaries, and did not limit its application on basis of where individual beneficiaries lived or sought medical care. Thompkins v. BC Life and Health Ins. Co., C.D.Cal.2006, 414 F.Supp.2d 953
• Click Advanced search and select “Mental Health Caregivers” or “Mental Health or
Substance Abuse Facilities”
• Enter your city and state or zip code, and click Find now Blue Shield.com *
Child Pages & Related in the Mental Health Section
- SSI – Supplemental Security Benefits
Historical Pre X and Underwriting pre ACA/Obamacare
- Federal Parity
- Individual Therapy
- CA Mental Health Parity AB 88 (1999)
- Resources – Mental Health
- Blame – Your fault or being scapegoated?
- Co Dependency
- FSP Full Service Partnership
- Lanterman – LPS – Conservatorship
- Laura’s Law – Court Mandated Mental Health Treatment
- Organizing, Hoarding, & Cluttering