California 2019-2020 Regular Session Status: Enacted 6 D cosponsors

SB 855 — Health coverage: mental health or substance use disorders.

Last action — Chaptered by Secretary of State. Chapter 151, Statutes of 2020.

  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed Senate
  4. ✓
    Passed Assembly
  5. ✓
    To Executive
  6. 6
    Enacted

This bill has been enacted into law. Introduced January 14, 2020. Enacted.

Prognosis

Likely to advance 82% · moderate confidence

Where this bill stands today.

Odds of enactment

High

How often bills like it became law.

  • Enacted

    Current position in the legislative process.

  • 14 sponsors

    1 primary, 13 co-sponsors signed on.

  • Single-party support

    Sponsorship is currently within one party (6 D).

  • Cleared a recorded vote

    Passed 9 recorded votes so far.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

Summary

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of disability insurers by the Department of Insurance. Existing law, known as the California Mental Health Parity Act, requires every health care service plan contract or disability insurance policy issued, amended, or renewed on or after July 1, 2000, that provides hospital, medical, or surgical coverage to provide coverage for the diagnosis and medically necessary treatment of severe mental illnesses of a person of any age, and of serious emotional disturbances of a child under the same terms and conditions applied to other medical conditions, as specified. Existing law requires those benefits to include, among other things, outpatient services, inpatient hospital services, partial hospital services, and prescription drugs, if the plan contract or policy includes coverage for prescription drugs. This bill would revise and recast those provisions, and would instead require a health care service plan contract or disability insurance policy issued, amended, or renewed on or after January 1, 2021, to provide coverage for medically necessary treatment of mental health and substance use disorders, as defined, under the same terms and conditions applied to other medical conditions. The bill would prohibit a health care service plan or disability insurer from limiting benefits or coverage for mental health and substance use disorders to short-term or acute treatment. The bill would revise the covered benefits to include basic health care services, as defined, intermediate services, and prescription drugs. This bill would require a health care service plan or disability insurer that provides hospital, medical, or surgical coverage to base medical necessity determinations and the utilization review criteria the plan or insurer, and any entity acting on the plan's or insurer's behalf, applies to determine the medical necessity of health care services and benefits for the diagnosis, prevention, and treatment of mental health and substance use disorders, on current generally accepted standards of mental health and substance use disorder care. The bill would require the health care service plan or insurer to apply specified clinical criteria and guidelines in conducting utilization review of the covered health care services and benefits and would prohibit the plan or insurer from applying different, additional, or conflicting criteria than the criteria and guidelines in the specified sources. The bill would authorize the Director of the Department of Managed Health Care or the Insurance Commissioner, as applicable, to assess administrative or civil penalties, as specified, for violation of the requirements relating to utilization review. The bill would make any provision in a health care service plan issued, delivered, amended, or renewed on or after January 1, 2021, that reserves discretionary authority to the plan, or an agent of the plan, to determine eligibility for benefits or coverage, interprets the terms of the contract, or provides standards of interpretation or review that are inconsistent with California law, void and unenforceable, as specified. The bill would declare that its provisions are severable. Because a willful violation of these requirements with respect to health care service plans would be a crime, this bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.

Bill Text

Action History

  1. Chaptered by Secretary of State. Chapter 151, Statutes of 2020.

  2. Approved by the Governor.

  3. Enrolled and presented to the Governor at 3 p.m.

  4. Assembly amendments concurred in. (Ayes 31. Noes 7.) Ordered to engrossing and enrolling.

  5. Reconsideration granted. (Ayes 39. Noes 0.)

  6. Motion to reconsider made by Senator Wiener.

  7. Assembly amendments concurred in. (Ayes 30. Noes 8.) Ordered to engrossing and enrolling.

  8. In Senate. Concurrence in Assembly amendments pending.

  9. Read third time. Passed. (Ayes 63. Noes 1. Page 5221.) Ordered to the Senate.

  10. Read second time. Ordered to third reading.

  11. Read second time and amended. Ordered to second reading.

  12. From committee: Do pass as amended. (Ayes 14. Noes 1.) (August 20).

  13. August 18 set for first hearing. Placed on suspense file.

  14. Coauthors revised.

  15. Read second time and amended. Re-referred to Com. on APPR.

  16. From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 13. Noes 0.) (August 4).

  17. From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.

  18. Referred to Com. on HEALTH.

  19. In Assembly. Read first time. Held at Desk.

  20. Read third time. Passed. (Ayes 30. Noes 5. Page 3862.) Ordered to the Assembly.

  21. Read second time. Ordered to third reading.

  22. Read second time and amended. Ordered to second reading.

  23. From committee: Do pass as amended. (Ayes 5. Noes 2. Page 3766.) (June 18).

  24. Set for hearing June 18.

  25. June 9 hearing: Placed on APPR. suspense file.

  26. Set for hearing June 9.

  27. Hearing rescheduled due to Capitol closure.

  28. Set for hearing June 1.

  29. Read second time and amended. Re-referred to Com. on APPR.

  30. From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 7. Noes 2. Page 3533.) (May 13).

  31. Referral to Com. on JUD. rescinded due to the shortened 2020 Legislative Calendar.

  32. Set for hearing May 13.

  33. From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.

  34. Referred to Coms. on HEALTH and JUD.

  35. From printer. May be acted upon on or after February 14.

  36. Introduced. Read first time. To Com. on RLS. for assignment. To print.

Sponsors

Sponsorship breakdown

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1 sponsors · 13 co-sponsors · 108 not signed on · 3 voted No

Sponsors (1)

Co-sponsors (13)

Not signed on (108)

108 members have not signed on to this bill.

Show all 108 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

Unfinished Business SB855 Wiener et al. Concurrence

Passed 30 Yea · 8 Nay · 2 Other
Party YeaNayPresentNot Voting
Unaffiliated 20601
Democratic 10000
Republican 0201
Total 30802
% of votes cast 75%20%0%5%
How each member voted (40)
Member Party Vote
Leyva — Yea
Galgiani — Yea
Bradford — Yea
Hueso — Yea
Hill — Yea
Hertzberg — Yea
Rubio — Yea
Allen — Yea
Pan — Yea
Monning — Yea
Skinner — Yea
Wieckowski — Yea
Wilk — Yea
Mitchell — Yea
Portantino — Yea
Dodd — Yea
Beall — Yea
Roth — Yea
Chang — Yea
Atkins — Yea
Nielsen — Nay
Bates — Nay
Morrell — Nay
Borgeas — Nay
Glazer — Nay
Melendez — Nay
Moorlach — Not Voting
Archuleta, Bob Democratic Yea
Caballero, Anna M. Democratic Yea
Durazo, Maria Elena Democratic Yea
Gonzalez, Lena A. Democratic Yea
Hurtado, Melissa Democratic Yea
Jackson, Corey A. Democratic Yea
McGuire, Mike Democratic Yea
Stern, Henry I. Democratic Yea
Umberg, Thomas J. Democratic Yea
Wiener, Scott D. Democratic Yea
Dahle, Megan Republican Nay
Grove, Shannon Republican Nay
Jones, Brian W. Republican Not Voting

Official roll call →

Unfinished Business SB855 Wiener et al. Concurrence Reconsider

Passed 39 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Democratic 10000
Unaffiliated 27000
Republican 2001
Total 39001
% of votes cast 98%0%0%3%
How each member voted (40)
Member Party Vote
Galgiani — Yea
Leyva — Yea
Bradford — Yea
Morrell — Yea
Hill — Yea
Borgeas — Yea
Hertzberg — Yea
Hueso — Yea
Rubio — Yea
Allen — Yea
Pan — Yea
Monning — Yea
Moorlach — Yea
Nielsen — Yea
Skinner — Yea
Wieckowski — Yea
Wilk — Yea
Mitchell — Yea
Portantino — Yea
Glazer — Yea
Dodd — Yea
Bates — Yea
Beall — Yea
Roth — Yea
Chang — Yea
Atkins — Yea
Melendez — Yea
Archuleta, Bob Democratic Yea
Caballero, Anna M. Democratic Yea
Durazo, Maria Elena Democratic Yea
Gonzalez, Lena A. Democratic Yea
Hurtado, Melissa Democratic Yea
Jackson, Corey A. Democratic Yea
McGuire, Mike Democratic Yea
Stern, Henry I. Democratic Yea
Umberg, Thomas J. Democratic Yea
Wiener, Scott D. Democratic Yea
Dahle, Megan Republican Yea
Grove, Shannon Republican Yea
Jones, Brian W. Republican Not Voting

Official roll call →

SB 855 Wiener Senate Third Reading By Arambula

Passed 63 Yea · 1 Nay · 15 Other
Party YeaNayPresentNot Voting
Unaffiliated 401010
Democratic 21001
Republican 2004
Total 631015
% of votes cast 80%1%0%19%
How each member voted (79)
Member Party Vote
Smith — Yea
Weber — Yea
Cooley — Yea
Friedman — Yea
Jones-Sawyer — Yea
Wood — Yea
Quirk — Yea
Mullin — Yea
Chau — Yea
Chu — Yea
Brough — Nay
Diep — Not Voting
Daly — Not Voting
Obernolte — Not Voting
Fong — Not Voting
Frazier — Not Voting
Bigelow — Not Voting
Voepel — Not Voting
Mathis — Not Voting
Eggman — Not Voting
Burke — Yea
McCarty — Yea
Holden — Yea
Gloria — Yea
Rendon — Yea
Levine — Yea
Bloom — Yea
Kiley — Yea
Medina — Yea
Rodriguez — Yea
Cooper — Yea
Low — Yea
Maienschein — Yea
Mayes — Yea
Waldron — Yea
Gray — Yea
Gonzalez — Yea
Kamlager — Yea
Santiago — Yea
Chiu — Yea
Ting — Yea
Nazarian — Yea
Cunningham — Yea
O'Donnell — Yea
Salas — Yea
Cristina Garcia — Yea
Eduardo Garcia — Yea
Jim Patterson — Not Voting
Luz Rivas — Yea
Mark Stone — Yea
Wendy Carrillo — Yea
Aguiar-Curry, Cecilia M. Democratic Yea
Arambula, Joaquin Democratic Yea
Bauer-Kahan, Rebecca Democratic Yea
Berman, Marc Democratic Yea
Boerner, Tasha Democratic Yea
Bonta, Mia Democratic Yea
Calderon, Lisa Democratic Yea
Cervantes, Sabrina Democratic Yea
Gabriel, Jesse Democratic Yea
Gipson, Mike A. Democratic Yea
Grayson, Timothy S. Democratic Yea
Irwin, Jacqui Democratic Yea
Kalra, Ash Democratic Yea
Limón, Monique Democratic Yea
Muratsuchi, Al Democratic Yea
Petrie-Norris, Cottie Democratic Yea
Quirk-Silva, Sharon Democratic Yea
Ramos, James C. Democratic Yea
Reyes, Eloise Gómez Democratic Yea
Rivas, Robert Democratic Yea
Rubio, Blanca E. Democratic Yea
Wicks, Buffy Democratic Not Voting
Chen, Phillip Republican Yea
Choi, Steven S. Republican Not Voting
Dahle, Megan Republican Not Voting
Flora, Heath Republican Not Voting
Gallagher, James Republican Not Voting
Lackey, Tom Republican Yea

Official roll call →

Do pass as amended.

Passed 14 Yea · 1 Nay · 3 Other
Party YeaNayPresentNot Voting
Democratic 6000
Unaffiliated 8102
Republican 0001
Total 14103
% of votes cast 78%6%0%17%
How each member voted (18)
Member Party Vote
Bigelow — Nay
Voepel — Not Voting
Fong — Not Voting
Quirk — Yea
Gonzalez — Yea
Diep — Yea
Bloom — Yea
Chau — Yea
Eggman — Yea
Eduardo Garcia — Yea
Wendy Carrillo — Yea
Bauer-Kahan, Rebecca Democratic Yea
Bonta, Mia Democratic Yea
Calderon, Lisa Democratic Yea
Gabriel, Jesse Democratic Yea
Petrie-Norris, Cottie Democratic Yea
Rivas, Robert Democratic Yea
Dahle, Megan Republican Not Voting

Official roll call →

Do pass as amended and be re-referred to the Committee on [Appropriations]

Passed 13 Yea · 0 Nay · 2 Other
Party YeaNayPresentNot Voting
Unaffiliated 9001
Democratic 4000
Republican 0001
Total 13002
% of votes cast 87%0%0%13%
How each member voted (15)
Member Party Vote
McCarty — Yea
Nazarian — Yea
Burke — Yea
Mayes — Yea
Santiago — Yea
Waldron — Yea
Rodriguez — Yea
Wood — Yea
Bigelow — Not Voting
Wendy Carrillo — Yea
Aguiar-Curry, Cecilia M. Democratic Yea
Bonta, Mia Democratic Yea
Limón, Monique Democratic Yea
Ramos, James C. Democratic Yea
Flora, Heath Republican Not Voting

Official roll call →

3rd Reading SB855 Wiener et al.

Passed 30 Yea · 5 Nay · 5 Other
Party YeaNayPresentNot Voting
Unaffiliated 20205
Democratic 10000
Republican 0300
Total 30505
% of votes cast 75%13%0%13%
How each member voted (40)
Member Party Vote
Leyva — Yea
Atkins — Yea
Skinner — Yea
Allen — Yea
Dodd — Yea
Hertzberg — Yea
Glazer — Yea
Roth — Yea
Rubio — Yea
Wilk — Yea
Hill — Yea
Mitchell — Yea
Pan — Yea
Beall — Yea
Wieckowski — Yea
Monning — Yea
Galgiani — Yea
Portantino — Yea
Bradford — Yea
Hueso — Yea
Morrell — Nay
Bates — Nay
Chang — Not Voting
Nielsen — Not Voting
Moorlach — Not Voting
Melendez — Not Voting
Borgeas — Not Voting
Archuleta, Bob Democratic Yea
Caballero, Anna M. Democratic Yea
Durazo, Maria Elena Democratic Yea
Gonzalez, Lena A. Democratic Yea
Hurtado, Melissa Democratic Yea
Jackson, Corey A. Democratic Yea
McGuire, Mike Democratic Yea
Stern, Henry I. Democratic Yea
Umberg, Thomas J. Democratic Yea
Wiener, Scott D. Democratic Yea
Dahle, Megan Republican Nay
Grove, Shannon Republican Nay
Jones, Brian W. Republican Nay

Official roll call →

Do pass as amended

Passed 5 Yea · 2 Nay
Party YeaNayPresentNot Voting
Unaffiliated 5100
Republican 0100
Total 5200
% of votes cast 71%29%0%0%
How each member voted (7)
Member Party Vote
Leyva — Yea
Wieckowski — Yea
Hill — Yea
Portantino — Yea
Bradford — Yea
Bates — Nay
Jones, Brian W. Republican Nay

Official roll call →

Placed on suspense file

Passed 7 Yea · 0 Nay
Party YeaNayPresentNot Voting
Republican 1000
Unaffiliated 6000
Total 7000
% of votes cast 100%0%0%0%
How each member voted (7)
Member Party Vote
Leyva — Yea
Wieckowski — Yea
Hill — Yea
Portantino — Yea
Bates — Yea
Bradford — Yea
Jones, Brian W. Republican Yea

Official roll call →

Subjects

healthcare health-insurance
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Frequently asked questions

What does SB 855 do?
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of disability insurers by the Department of Insurance. Existing law, known as the California Mental Health Parity Act, requires every health care service plan contract or disability insurance policy issued, amended, or renewed on or after July 1, 2000, that provides hospital, medical, or surgical coverage to provide coverage for the diagnosis and medically necessary treatment of severe mental illnesses of a person of any age, and of serious emotional disturbances of a child under the same terms and conditions applied to other medical conditions, as specified. Existing law requires those benefits to include, among other things, outpatient services, inpatient hospital services, partial hospital services, and prescription drugs, if the plan contract or policy includes coverage for prescription drugs. This bill would revise and recast those provisions, and would instead require a health care service plan contract or disability insurance policy issued, amended, or renewed on or after January 1, 2021, to provide coverage for medically necessary treatment of mental health and substance use disorders, as defined, under the same terms and conditions applied to other medical conditions. The bill would prohibit a health care service plan or disability insurer from limiting benefits or coverage for mental health and substance use disorders to short-term or acute treatment. The bill would revise the covered benefits to include basic health care services, as defined, intermediate services, and prescription drugs. This bill would require a health care service plan or disability insurer that provides hospital, medical, or surgical coverage to base medical necessity determinations and the utilization review criteria the plan or insurer, and any entity acting on the plan's or insurer's behalf, applies to determine the medical necessity of health care services and benefits for the diagnosis, prevention, and treatment of mental health and substance use disorders, on current generally accepted standards of mental health and substance use disorder care. The bill would require the health care service plan or insurer to apply specified clinical criteria and guidelines in conducting utilization review of the covered health care services and benefits and would prohibit the plan or insurer from applying different, additional, or conflicting criteria than the criteria and guidelines in the specified sources. The bill would authorize the Director of the Department of Managed Health Care or the Insurance Commissioner, as applicable, to assess administrative or civil penalties, as specified, for violation of the requirements relating to utilization review. The bill would make any provision in a health care service plan issued, delivered, amended, or renewed on or after January 1, 2021, that reserves discretionary authority to the plan, or an agent of the plan, to determine eligibility for benefits or coverage, interprets the terms of the contract, or provides standards of interpretation or review that are inconsistent with California law, void and unenforceable, as specified. The bill would declare that its provisions are severable. Because a willful violation of these requirements with respect to health care service plans would be a crime, this bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Who sponsors SB 855?
SB 855 is sponsored by Wiener, Scott D. (Democratic), Beall, Aguiar-Curry, Cecilia M. (Democratic), Chiu, Galgiani, Glazer, Hill, Hurtado, Melissa (Democratic), Arambula, Bauer-Kahan, Rebecca (Democratic), Gabriel, Jesse (Democratic), Maienschein, Waldron, and Wicks, Buffy (Democratic).
What is the current status of SB 855?
This bill has been enacted into law. Introduced January 14, 2020. Enacted.
Where can I track SB 855?
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