Health care coverage: mental health and substance use disorders: inpatient admissions.

Assembly Member Connolly's California Mental Health Protection Act proposes to eliminate prior authorization requirements for inpatient mental health and substance use disorder treatments across California's health care system. The legislation affects health care service plans, insurance policies, and the Medi-Cal program for services provided after January 1, 2027.

The bill removes prior authorization requirements in two key areas: initial admission to 24-hour inpatient care facilities and subsequent medically necessary treatments during those stays. These provisions apply to mental health disorders, substance use disorders, and co-occurring conditions, as determined by a physician. Covered facilities include general acute care hospitals, psychiatric hospitals, chemical dependency recovery centers, and psychiatric residential treatment facilities.

For enforcement, the Department of Managed Health Care and Insurance Commissioner may impose administrative or civil penalties on non-compliant plans and insurers. The Department of Health Care Services holds authority to terminate contracts or sanction Medi-Cal entities that violate these requirements. The Medi-Cal provisions require federal approval and financial participation before implementation. The bill establishes uniform definitions of covered inpatient settings across all three regulatory frameworks to ensure consistent application.