Therapy in L.A.


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April 2001
By Alan Solomon, Ph.D.

California law, and the laws of many other states, now requires that insurance coverage for certain psychological conditions must be consistent with coverage for other medical conditions. This applies to diagnosis and medically necessary treatment of "severe mental illness of a person of any age", as well as to "serious emotional disturbance of a child". Coverage must be available for insurance programs that start, are amended, or renewed on or after July 1, 2000.

More specifically, "severe mental illness" or "serious emotional disturbances of a child" include:

  • Schizophrenia
  • Schizoaffective disorder
  • Bipolar disorder (manic-depressive illness)
  • Major depressive disorders
  • Panic disorder
  • Obsessive-compulsive disorder
  • Pervasive developmental disorder or autism
  • Anorexia nervosa
  • Bulimia nervosa
This mandate affects coverage for outpatient therapy, inpatient hospitalization, and day treatment programs. If a plan includes reimbursement for prescription drugs for medical conditions, it must also provide medication benefits for the above psychological diagnoses. Copayments, lifetime maximums, and deductibles for psychological care must also mirror those for other medical conditions. This bill, known as the California Mental Health Parity Act, passed as Assembly Bill (AB) 88.

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