March 2024: ROC Monthly Masterminds Call
March 2024: ROC Monthly Masterminds Call
Fighting the Good Fight: Addressing Payor Problems & Legislation to Resolve SB999
Fighting the Good Fight: Addressing Payor Problems & Legislation to Resolve SB999
An Open Discussion with Erin Burke & Joan Borsten
In the ever-evolving landscape of behavioral healthcare, ensuring access to vital treatment for those grappling with mental health and substance use disorders (SUD) remains a pressing concern. Legislative initiatives such as SB999 in California have emerged as pivotal steps toward safeguarding patient rights and fostering effective treatment strategies.
In our recent March Masterminds discussion, we had the privilege of delving into these critical issues with Joan Borsten, Executive Director of Summit Estate Recovery Center, who has been at the forefront of legislative advocacy efforts, including SB999.
Together with Erin Burke, we explored the complexities of payor problems, legislative hurdles, and effective strategies to address them.
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The Significance of SB999
SB999 stands as a beacon of hope for Californians battling mental health and SUD. This bill aims to ensure that individuals receive the necessary level of treatment for safe recovery from addiction by establishing stringent utilization review (UR) criteria for health plans and disability insurers. Joan provided invaluable insights into the core components of SB999, emphasizing its role in safeguarding patient access to timely review decisions, ensuring experienced providers conduct UR, and reinforcing patients' rights to understand treatment denials.
According to Governor Newsom, the bill is ‘premature’ as forthcoming regulations are intended to enforce the sentiment of SB-855. These regulations will require the use of unbiased mental health and substance use disorder clinical standards in coverage reviews and mandate the appropriate training and oversight of staff performing said reviews.
Despite the rejection of SB-999, however, hope remains.
Championing Change Through Advocacy
Advocacy is at the heart of effective change. Joan’s leadership in shaping policies and navigating legislative hurdles serves as an inspiring example of proactive engagement within behavioral healthcare and advancing patient-centric policies.
We’re only getting started.
For further details on SB999, visit Friends of SB999.
