(SACRAMENTO, CA) – As California debates the prospect of universal healthcare, the California State Assembly today showed bipartisan support of legislation by Assemblymember Marc Levine (D-Marin County) to expand access to medically necessary services to anyone enrolled in the state’s Medi-Cal program. AB 1355 (Levine) was approved on a vote of 68 to 0.
Levine’s AB 1355 will allow all 13.5 million Californians enrolled in Medi-Cal to seek an independent medical review (IMR) if they are denied coverage for a medically necessary procedure, prescription, mental health, dental or other relevant service. An IMR is a secondary review of the denial of a medical service by an independent panel of physicians. Currently, all Californians with commercial insurance have access to IMRs, yet over 4 million Medi-Cal members do not. AB 1355 will bring parity for all Californians seeking access to medically necessary care, regardless of their plan or service.
Existing IMRs have shown to be favorable to members obtaining medically necessary care; about 60 percent of these reviews have resulted in people receiving their requested service. In stark contrast, less than 28 percent of hearings involving Medi-Cal managed care plan members were granted.
“All Californians deserve equitable access to quality healthcare,” said Assemblymember Levine. “We have seen historic enrollment in Medi-Cal programs that resulted in improved the health outcomes of millions of Californians. But our work is not done. We must continue to improve health outcomes by allowing anyone enrolled in a Medi-Cal plan appeal rights to obtain medically necessary care. Improving healthcare access and quality doesn’t have to be divisive. The State Assembly’s approval of AB 1355 today is proof that there are bipartisan solutions to expand healthcare for all.”
AB 1355 now heads to the State Senate for further consideration.