Qualified youth drop-in center health care coverage.

Senator Allen's mental health coverage legislation would require California health insurers and Medi-Cal plans to cover mental health and substance use disorder treatment provided at qualified youth drop-in centers for individuals age 25 and younger. The bill expands existing requirements for coverage of these services at school sites.

The legislation defines qualified youth drop-in centers as facilities providing behavioral or primary health services to youth ages 12-25 that received Children and Youth Behavioral Health Initiative funding by 2025 or obtained local educational agency approval. These centers must have capacity to provide services outside school hours.

Under the bill, health plans cannot require prior authorization for covered services at drop-in centers and must reimburse providers at the higher of their contracted rate or the state's fee-for-service schedule. Services would be exempt from copayments, coinsurance, deductibles and other cost-sharing. The Department of Health Care Services would develop and maintain a statewide fee schedule and provider network for these services.

The measure tasks the department with establishing an administration fund supported by fees on participating health plans to cover implementation costs. Implementation requires federal approval to maintain Medi-Cal funding. The provisions would apply to health plan contracts and insurance policies issued, amended or renewed starting January 2024.