Bill Text: CA AB2581 | 2021-2022 | Regular Session | Chaptered
Bill Title: Health care coverage: mental health and substance use disorders: provider credentials.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Passed) 2022-09-25 - Chaptered by Secretary of State - Chapter 533, Statutes of 2022. [AB2581 Detail]
Download: California-2021-AB2581-Chaptered.html
Assembly Bill
No. 2581
CHAPTER 533
An act to add Section 1374.197 to the Health and Safety Code, and to add Section 10144.56 to the Insurance Code, relating to health care coverage.
[
Approved by
Governor
September 25, 2022.
Filed with
Secretary of State
September 25, 2022.
]
LEGISLATIVE COUNSEL'S DIGEST
AB 2581, Salas.
Health care coverage: mental health and substance use disorders: provider credentials.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of the act a crime. Existing law also provides for the regulation of disability insurers by the Department of Insurance. Existing law requires a health care service plan contract or disability insurance policy issued, amended, or renewed on or after January 1, 2021, that provides hospital, medical, or surgical coverage to provide coverage for medically necessary treatment of mental health and substance use disorders, under the same terms and conditions applied to other medical conditions, as specified.
For provider contracts issued, amended, or renewed on and after January 1, 2023, this bill would require a health care service plan or
disability insurer that provides coverage for mental health and substance use disorders and credentials health care providers of those services for the health care service plan’s or disability insurer’s networks, to assess and verify the qualifications of a health care provider within 60 days after receiving a completed provider credentialing application. Because a violation of the bill’s requirements by a health care service plan would be a crime, the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YESBill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 1374.197 is added to the Health and Safety Code, to read:1374.197.
(a) For provider contracts issued, amended, or renewed on and after January 1, 2023, a health care service plan that provides coverage for mental health and substance use disorders and that credentials health care providers of those services for its networks shall assess and verify the qualifications of a health care provider within 60 days after receiving a completed provider credentialing application. Upon receipt of the application by the credentialing department, the health care service plan shall notify the applicant within seven business days, to verify receipt and inform the applicant whether the application is complete. The 60-day timeline shall apply only to the credentialing process and does not include contracting completion.(b) For the purposes of this section, “mental health and substance use disorder” and “health care provider” have the same meanings as defined in Section 1374.72.
SEC. 2.
Section 10144.56 is added to the Insurance Code, to read:10144.56.
(a) For provider contracts issued, amended, or renewed on and after January 1, 2023, a disability insurer that provides coverage for mental health and substance use disorders and that credentials health care providers of those services for its networks shall assess and verify the qualifications of a health care provider within 60 days after receiving a completed provider credentialing application. Upon receipt of the application by the credentialing department, the disability insurer shall notify the applicant within seven business days, to verify receipt and inform the applicant whether the application is complete. The 60-day timeline shall apply only to the credentialing process and does not include contracting completion.(b) For the purposes of this section, “mental health and substance use disorder” and “health care provider” have the same meanings as defined in Section 10144.5.
