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Latest News   ·   April 28, 2014

DHCS Aims To Remedy Gaps in Mental Health Care Access

  ·   California Healthline   ·  Link to Article

he California Department of Health Care Services is working to address gaps in health coverage for some state residents with mental illnesses, HealthyCal reports.

Background on Coverage Gap

Although provisions in the Affordable Care Act and California's Mental Health Parity Act have improved access to mental health care services in the state, a gap in coverage remains for some individuals.

The ACA requires residents to purchase health coverage, or face a tax penalty. The state parity law requires health insurance companies to cover the treatment of some mental health issues, including:

  • Certain eating disorders;
  • Depression; and
  • Schizophrenia.

However, obstacles to accessing such coverage remain. For instance, some mental health care providers exclusively accept private health insurance, while other providers will only accept patients with Medi-Cal, California's Medicaid program.

In addition, insurers are not required to provide coverage for all mental health issues. For example, insurers must cover anxiety and depression, but they are not required to cover post traumatic stress disorder and other mental health problems.

Details of DHCS Plan

DHCS spokesperson Carol Sloan said the agency is working to provide clarification on mental health coverage to providers and insurers. The department is developing agreements for Medi-Cal beneficiaries and enrollees in other government-funded health plans regarding:

  • Payments;
  • Referrals; and
  • Screening tools.

Sloan noted that the agreements are expected to be finalized by June 30 (Bookwalter, HealthyCal, 4/27).