Qualified youth drop-in center health care coverage.
- Expands mental health coverage to include services at youth drop-in centers for patients 25 and younger.
- Requires health plans to reimburse providers without prior authorization or cost sharing.
- Establishes a statewide fee schedule and provider network for behavioral health services.
- Creates a dedicated fund to cover administrative costs through fees charged to health plans.
Senator Allen's mental health coverage legislation would require California health insurers and Medi-Cal plans to cover mental health and substance use disorder treatment provided at qualified youth drop-in centers for individuals age 25 and younger. The bill expands existing requirements for coverage of these services at school sites.
The legislation defines qualified youth drop-in centers as facilities providing behavioral or primary health services to youth ages 12-25 that received Children and Youth Behavioral Health Initiative funding by 2025 or obtained local educational agency approval. These centers must have capacity to provide services outside school hours.
Under the bill, health plans cannot require prior authorization for covered services at drop-in centers and must reimburse providers at the higher of their contracted rate or the state's fee-for-service schedule. Services would be exempt from copayments, coinsurance, deductibles and other cost-sharing. The Department of Health Care Services would develop and maintain a statewide fee schedule and provider network for these services.
The measure tasks the department with establishing an administration fund supported by fees on participating health plans to cover implementation costs. Implementation requires federal approval to maintain Medi-Cal funding. The provisions would apply to health plan contracts and insurance policies issued, amended or renewed starting January 2024.
This bill was recently introduced. Email the authors to let them know what you think about it.
Introduced By
 Shannon GroveR Senator | Committee Member |  Not Contacted | |
 Benjamin AllenD Senator | Bill Author | Not Contacted | |
 Scott WienerD Senator | Committee Member | Not Contacted | |
 Tim GraysonD Senator | Committee Member | Not Contacted | |
 Monique LimonD Senator | Committee Member | Not Contacted |
- Expands mental health coverage to include services at youth drop-in centers for patients 25 and younger.
- Requires health plans to reimburse providers without prior authorization or cost sharing.
- Establishes a statewide fee schedule and provider network for behavioral health services.
- Creates a dedicated fund to cover administrative costs through fees charged to health plans.
This bill was recently introduced. Email the authors to let them know what you think about it.
Introduced By
Senator Allen's mental health coverage legislation would require California health insurers and Medi-Cal plans to cover mental health and substance use disorder treatment provided at qualified youth drop-in centers for individuals age 25 and younger. The bill expands existing requirements for coverage of these services at school sites.
The legislation defines qualified youth drop-in centers as facilities providing behavioral or primary health services to youth ages 12-25 that received Children and Youth Behavioral Health Initiative funding by 2025 or obtained local educational agency approval. These centers must have capacity to provide services outside school hours.
Under the bill, health plans cannot require prior authorization for covered services at drop-in centers and must reimburse providers at the higher of their contracted rate or the state's fee-for-service schedule. Services would be exempt from copayments, coinsurance, deductibles and other cost-sharing. The Department of Health Care Services would develop and maintain a statewide fee schedule and provider network for these services.
The measure tasks the department with establishing an administration fund supported by fees on participating health plans to cover implementation costs. Implementation requires federal approval to maintain Medi-Cal funding. The provisions would apply to health plan contracts and insurance policies issued, amended or renewed starting January 2024.
Shannon GroveR Senator | Committee Member | Not Contacted | |
Benjamin AllenD Senator | Bill Author | Not Contacted | |
Scott WienerD Senator | Committee Member | Not Contacted | |
Tim GraysonD Senator | Committee Member | Not Contacted | |
Monique LimonD Senator | Committee Member | Not Contacted |