January 10, 2019 - SACRAMENTO - Yesterday, Senate President pro Tempore Toni Atkins (D-San Diego), along with Sen. Mike McGuire (D-Healdsburg), 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.”
Source: Senate President pro Tempore Toni Atkins