California Sets ‘Generally Accepted Standards Of Care’ For Behavioral Health Medical Necessity & Utilization Review

A new California law to strengthen mental health and addiction parity in the state requires health plans to base their medical necessity and utilization review criteria for behavioral health services on “generally accepted standards of care.” Parity is defined as coverage for medically necessary treatment of mental health and addiction under the same terms and conditions applied to other medical conditions. The law defines generally accepted standards of care as guidelines developed by non-profit health care professional associations, peer-reviewed, scientific literature, and expert consensus. The provisions went into effect on January 1, 2021. The California Department of Managed . . .