Bill Text: CA AB2581 | 2021-2022 | Regular Session | Introduced

California Assembly Bill 2581 (Prior Session Legislation)

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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-Introduced.html

CALIFORNIA LEGISLATURE— 2021–2022 REGULAR SESSION

Assembly Bill

No. 2581

Introduced by Assembly Member Salas

February 18, 2022

An act to add Section 1374.196 to the Health and Safety Code, relating to health care coverage.

LEGISLATIVE COUNSEL'S DIGEST

AB 2581, as introduced, Salas. Health care service plans: 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 requires a health care service plan contract 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 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 networks, to assess and verify the qualifications of a health care provider within 45 days after receiving a completed provider credentialing application. The bill would authorize an applicant to make a written request for a temporary credential if the health care service plan has not approved or denied the completed application within 45 days of receipt, and would require the health care service plan to issue the temporary credential, unless the applicant has reported a history of malpractice, substance abuse or mental health issues, or disciplinary action on their 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.

Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YES

The people of the State of California do enact as follows:

SECTION 1.

Section 1374.196 is added to the Health and Safety Code, to read:

1374.196.

(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 45 days after receiving a completed provider credentialing application. Upon receipt of the application, the health care service plan shall notify the applicant within five business days, to verify receipt and inform the applicant whether the application is complete.

(1) If the health care service plan has not approved or denied a completed provider credentialing application within 45 days of receipt, the applicant may make a written request for a temporary credential, provided that the applicant has a valid license or other required professional certification to provide the health care services to which the credential would apply. Within five business days after receiving the applicant’s written request, the health care service plan shall issue the applicant a temporary credential, subject to paragraph (2).

(2) The health care service plan shall not issue a temporary credential pursuant to paragraph (1) if the applicant has reported on the application a history of medical malpractice claims, a history of substance abuse or mental health issues, or a history of disciplinary action. The temporary credential shall be effective upon issuance, and shall remain in effect until the provider’s credentialing application is approved or denied by the health care services plan.

(b) For the purposes of this section, “mental health and substance use disorder” and “health care provider” shall have the same meanings as defined in Section 1374.72.

SEC. 2.

No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.