California families continue to face challenges in accessing mental health treatment, despite a law signed by Gov. Gavin Newsom four years ago. An investigation by CalMatters has revealed that the system for appealing mental health denials is still broken, with many people not appealing treatment denials to their health plans and those who do often being denied again.
Regulators lack data to track doctors’ decisions and are not routinely authorized to require health plans and insurers to submit information on denial rates. When regulators do intervene, they overwhelmingly side with patients. Unfortunately, one family’s experience highlights the tragic consequences of these challenges, as their son died shortly after his insurance plan declined to continue covering his addiction treatment.
State lawmakers have been monitoring the situation, with Sen. Scott Wiener introducing a bill to address denials of mental health treatment for children and young people. However, the bill was held in committee, highlighting the ongoing issues in the system.
While treatment decisions can be complex, the importance of accessing mental health care cannot be understated. Advocates continue to fight for better access to treatment and are pushing for reforms to ensure that all Californians can receive the care they need. For more information on how to handle denial of coverage, readers are encouraged to consult a guide for steps to take in such situations.
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Photo credit calmatters.org