New legislation places treatment guidelines over financial considerations

CHICAGO — The American Medical Association released a statement praising California’s new mental health reform law, Senate Bill 855, which is designed to keep health insurers and behavioral health management facilities from placing their own financial interests over evidence-based mental health treatment guidelines.

“This law sets a new precedent for all other states to protect patients with a mental illness or substance use disorder,” said Patrice A. Harris, MD, MA, AMA immediate past president and chair of the AMA Opioid Task Force. “Not having to fight insurance companies to use the generally accepted standards of care for our patients will improve treatment and save lives.”

This new law, the AMA pointed out, draws from the case of Wit v. United Behavioral Healthcare, “where a federal court last year issued a scathing rebuke to United Behaviioral Health (UBH) for placing the payer’s financial interests over the safety and well-being of patients from 2011-2017 across four states: Connecticut, Illinois, Rhode Island and Texas.” The class action suit was brought on behalf of patients who were denied coverage by UBH for residential treatment for mental illness and substance abuse disorder, as well as for outpatient treatment.

“Whereas the Wit decision only applied to UBH, the reforms contained in SB 855 will apply to all health insurers in California,” the AMA noted. The bill was signed by Governor Gavin Newsom on Friday, Sept. 25, “after near-unanimous votes in the California Assembly and Senate.”

Senate Bill 855 is set to go into effect Jan. 1, 2021.

John McKenna, Associate Editor, BreakingMED™

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