Health
SACRAMENTO – Senate President pro Tempore Toni Atkins (D-San Diego), along with Sen. Mike McGuire (D-Healdsburg), has introduced SB 66, legislation with bipartisan support that allows community health centers to bill Medi-Cal for two visits if a patient is provided mental-health services on the same day they receive other medical services.
Currently, if a patient receives treatment through Medi-Cal at a community health center from both a medical provider and a mental health specialist on the same day, the Department of Health Care Services will reimburse the center for only one visit.
A patient must seek mental-health treatment on a subsequent day in order for that treatment to be reimbursed as a second visit.
“A substantial number of patients seen in a primary care setting have an active psychiatric condition,” Atkins said. “Seamlessly transitioning patients from primary care to an onsite mental health specialist on the same day is a proven way to ensure that patient receives needed care and follows through with treatment. This efficient transition is even more important for disadvantaged patients for whom taking time off work and arranging transportation to and from a health center can be extraordinarily difficult.”
The existing financial deterrent for integrated care for mental health patients in California community clinics does not exist for similar health services.
For instance, California allows clinics to bill for two separate Medi-Cal visits if a patient sees both a primary care provider and a dental care provider on the same day.
In addition, the federal Medicare program already allows for same-day billing of mental health and primary care services, and more than 35 state Medicaid programs already make use of this reimbursement mechanism.
“Thousands of rural Californians utilize community health centers as their primary health care home, and this bill will ensure all residents are able to access critical mental health care services on the same day they receive other medical services, which is exactly the way integrated health care should work,” said McGuire, joint author of the SB 66. “Pro Tem Atkins has been a statewide leader on increasing access to health care services, and I’m grateful to partner with her on this critical legislation.”
“California should be a national leader when it comes to promoting a fully integrated approach to health care, encompassing both brain and body,” said Maggie Merritt, executive director of the Steinberg Institute, a Sacramento-based nonprofit dedicated to advancing sound policy on issues of brain health. “And a key aspect of promoting integrated care is knocking down financial barriers for providers. This legislation does exactly that. It’s good for patients and good for California.”
“Senate Bill 66 will improve access to care for all Californians,” said Carmela Castellano Garcia, president and CEO of CaliforniaHealth+ Advocates. “California’s community health centers, which serve nearly 7 million people, provide a full spectrum of care to California’s most vulnerable communities. Right now, California is one of only a handful of states that does not allow health centers to provide and bill for mental and physical health visits on the same day. We are grateful for Senate President pro Tem Toni Atkins’ strong leadership and dedication to providing timely access to behavioral health services for all of our communities.”
Currently, if a patient receives treatment through Medi-Cal at a community health center from both a medical provider and a mental health specialist on the same day, the Department of Health Care Services will reimburse the center for only one visit.
A patient must seek mental-health treatment on a subsequent day in order for that treatment to be reimbursed as a second visit.
“A substantial number of patients seen in a primary care setting have an active psychiatric condition,” Atkins said. “Seamlessly transitioning patients from primary care to an onsite mental health specialist on the same day is a proven way to ensure that patient receives needed care and follows through with treatment. This efficient transition is even more important for disadvantaged patients for whom taking time off work and arranging transportation to and from a health center can be extraordinarily difficult.”
The existing financial deterrent for integrated care for mental health patients in California community clinics does not exist for similar health services.
For instance, California allows clinics to bill for two separate Medi-Cal visits if a patient sees both a primary care provider and a dental care provider on the same day.
In addition, the federal Medicare program already allows for same-day billing of mental health and primary care services, and more than 35 state Medicaid programs already make use of this reimbursement mechanism.
“Thousands of rural Californians utilize community health centers as their primary health care home, and this bill will ensure all residents are able to access critical mental health care services on the same day they receive other medical services, which is exactly the way integrated health care should work,” said McGuire, joint author of the SB 66. “Pro Tem Atkins has been a statewide leader on increasing access to health care services, and I’m grateful to partner with her on this critical legislation.”
“California should be a national leader when it comes to promoting a fully integrated approach to health care, encompassing both brain and body,” said Maggie Merritt, executive director of the Steinberg Institute, a Sacramento-based nonprofit dedicated to advancing sound policy on issues of brain health. “And a key aspect of promoting integrated care is knocking down financial barriers for providers. This legislation does exactly that. It’s good for patients and good for California.”
“Senate Bill 66 will improve access to care for all Californians,” said Carmela Castellano Garcia, president and CEO of CaliforniaHealth+ Advocates. “California’s community health centers, which serve nearly 7 million people, provide a full spectrum of care to California’s most vulnerable communities. Right now, California is one of only a handful of states that does not allow health centers to provide and bill for mental and physical health visits on the same day. We are grateful for Senate President pro Tem Toni Atkins’ strong leadership and dedication to providing timely access to behavioral health services for all of our communities.”
- Details
- Written by: Elizabeth Larson
SACRAMENTO – Covered California is launching a final statewide enrollment tour to get the word out that the current open-enrollment period ends Jan. 15.
For those interested in enrolling in a quality health insurance plan, next week’s deadline will mark the last opportunity for many to get coverage for all of 2019.
This year’s deadline is shorter than in previous years, when open enrollment ran through the end of January.
“Covered California knows that many consumers are deadline driven and often wait until the final few days to sign up for health insurance,” said Covered California Executive Director Peter V. Lee. “We want to make sure they know that this year’s deadline is earlier than it has been in the past, and they must take action in the next week in order to get the peace of mind and protection they deserve in 2019.”
California is one of six marketplaces across the nation still enrolling consumers through open enrollment, accounting for a quarter of the United States population.
California’s Jan. 15 deadline is due to a state law that established that open enrollment would run from Oct. 15 through Jan. 15 each year.
Open enrollment is the one time of the year when consumers can sign up for coverage without needing to meet any conditions.
“Do not wait until the last minute, or let this deadline go past, without checking your options,” Lee said. “In only a few minutes at coveredca.com, you can see which plans are available in your area and whether you qualify for financial help to bring the price of coverage within reach.”
Covered California’s announcement comes one day after Gov. Gavin Newsom announced, as his first official act, that he will focus on making health care more affordable.
“We applaud Gov. Newsom for building on the strong foundation of the Affordable Care Act in his first official action,” Lee said. “At a time of ongoing uncertainty in Washington, the governor is not only embracing policies that will lower the cost of coverage for millions in the individual market, but he is also offering increased help to those who are struggling with rising costs.”
The governor proposes to make health care more affordable and restore the individual shared responsibility provision, which was repealed by the federal government in 2019, as part of his goal to continue toward universal coverage.
“Gov. Newsom’s proposals mark concrete and meaningful steps to lower health care costs for millions and increase enrollment,” Lee said. “We look forward to action from Sacramento in the weeks and months ahead, but today the action is happening in local communities across California where individuals can embrace this reminder from the governor of the importance of coverage and sign up through Jan. 15.”
The majority of uninsured Californians who are eligible for financial help either do not know or mistakenly think they do not qualify.
Nearly nine out of 10 Covered California consumers receive financial help. The average Covered California enrollee pays about $5 per day for coverage, but many pay far less.
One out of every three Covered California consumers who receive financial help can purchase a Silver plan — which provides the best overall value — for $50 or less per month. Nearly three out of five of these consumers can get a Silver plan for $100 or less per month.
Consumers can easily find out if they are eligible for financial help and see which plans are available in their area by entering their ZIP code, household income and the ages of those who need coverage into Covered California’s Shop and Compare Tool.
As of Dec. 31, more than 238,000 consumers had signed up and selected a plan during the current open-enrollment period, which remains in line with projections that there would be decline in enrollment due to recent federal policies and ongoing confusion sowed at the national level. In addition, Covered California previously announced that roughly 1.2 million existing consumers had renewed their coverage for 2019.
Those interested in learning more about their coverage options should go to www.CoveredCA.com, where they can get help to enroll.
They can explore their options and find out if they qualify for financial help by using the Shop and Compare Tool.
They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/ and searching among 700 storefronts statewide or 16,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages.
In addition, consumers can reach the Covered California service center by calling 800-300-1506.
For those interested in enrolling in a quality health insurance plan, next week’s deadline will mark the last opportunity for many to get coverage for all of 2019.
This year’s deadline is shorter than in previous years, when open enrollment ran through the end of January.
“Covered California knows that many consumers are deadline driven and often wait until the final few days to sign up for health insurance,” said Covered California Executive Director Peter V. Lee. “We want to make sure they know that this year’s deadline is earlier than it has been in the past, and they must take action in the next week in order to get the peace of mind and protection they deserve in 2019.”
California is one of six marketplaces across the nation still enrolling consumers through open enrollment, accounting for a quarter of the United States population.
California’s Jan. 15 deadline is due to a state law that established that open enrollment would run from Oct. 15 through Jan. 15 each year.
Open enrollment is the one time of the year when consumers can sign up for coverage without needing to meet any conditions.
“Do not wait until the last minute, or let this deadline go past, without checking your options,” Lee said. “In only a few minutes at coveredca.com, you can see which plans are available in your area and whether you qualify for financial help to bring the price of coverage within reach.”
Covered California’s announcement comes one day after Gov. Gavin Newsom announced, as his first official act, that he will focus on making health care more affordable.
“We applaud Gov. Newsom for building on the strong foundation of the Affordable Care Act in his first official action,” Lee said. “At a time of ongoing uncertainty in Washington, the governor is not only embracing policies that will lower the cost of coverage for millions in the individual market, but he is also offering increased help to those who are struggling with rising costs.”
The governor proposes to make health care more affordable and restore the individual shared responsibility provision, which was repealed by the federal government in 2019, as part of his goal to continue toward universal coverage.
“Gov. Newsom’s proposals mark concrete and meaningful steps to lower health care costs for millions and increase enrollment,” Lee said. “We look forward to action from Sacramento in the weeks and months ahead, but today the action is happening in local communities across California where individuals can embrace this reminder from the governor of the importance of coverage and sign up through Jan. 15.”
The majority of uninsured Californians who are eligible for financial help either do not know or mistakenly think they do not qualify.
Nearly nine out of 10 Covered California consumers receive financial help. The average Covered California enrollee pays about $5 per day for coverage, but many pay far less.
One out of every three Covered California consumers who receive financial help can purchase a Silver plan — which provides the best overall value — for $50 or less per month. Nearly three out of five of these consumers can get a Silver plan for $100 or less per month.
Consumers can easily find out if they are eligible for financial help and see which plans are available in their area by entering their ZIP code, household income and the ages of those who need coverage into Covered California’s Shop and Compare Tool.
As of Dec. 31, more than 238,000 consumers had signed up and selected a plan during the current open-enrollment period, which remains in line with projections that there would be decline in enrollment due to recent federal policies and ongoing confusion sowed at the national level. In addition, Covered California previously announced that roughly 1.2 million existing consumers had renewed their coverage for 2019.
Those interested in learning more about their coverage options should go to www.CoveredCA.com, where they can get help to enroll.
They can explore their options and find out if they qualify for financial help by using the Shop and Compare Tool.
They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/ and searching among 700 storefronts statewide or 16,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages.
In addition, consumers can reach the Covered California service center by calling 800-300-1506.
- Details
- Written by: Covered California
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