Behavioral Health Provider Comparable Worth Study.

Plain English Breakdown

The bill summary and digest text do not specify penalties for non-compliance, only that there may be civil penalties prescribed.

Behavioral Health Provider Comparable Worth Study

The bill requires a study comparing compensation and reimbursement rates between behavioral health providers and medical-surgical providers, with reports due by January 1, 2028.

What This Bill Does

• Requires the Department of Industrial Relations to conduct a study on how much behavioral health providers are compensated compared to medical-surgical providers in terms of both direct payments and through intermediaries like health systems.
• Includes analysis of compensation and reimbursement across specified payment flows, including payments made by health care service plans and insurers directly to providers and payments made to intermediaries for services.
• Requires health care service plans, insurers, intermediaries, and health systems to report data about payments they make or receive.
• Protects sensitive information shared during the study process from being disclosed publicly.
• Requires a final report with findings to be submitted to the Legislature by January 1, 2028.

Who It Names or Affects

• Behavioral health providers
• Medical-surgical providers
• Health care service plans and insurers
• Intermediaries and health systems

Terms To Know

Comparable Worth Study

A study that compares the compensation of different types of workers to see if it is fair.

Proprietary Information

Confidential business information that companies do not want shared publicly.

Limits and Unknowns

• The bill does not specify what actions will be taken based on the study's findings.
• It is unclear how much data intermediaries and health systems are required to share.
• There may be penalties for entities that do not comply with reporting requirements.

Official Summary Text

AB 2511, as introduced, Ahrens.
Behavioral Health Provider Comparable Worth Study.
Existing law establishes the Department of Industrial Relations in the Labor and Workforce Development Agency and provides that one of the functions of the department is to foster, promote, and develop the welfare of the wage earners of California, to improve their working conditions, and to advance their opportunities for profitable employment.
This bill would require the department, in consultation with the Department of Managed Health Care, the Department of Insurance, the Department of Health Care Access and Information, and the Office of Health Care Affordability, to conduct a comparable worth study to examine and compare compensation and reimbursement for behavioral health providers with compensation and reimbursement for similarly situated medical-surgical providers. The bill would require the study to analyze compensation and reimbursement
across specified payment flows, including payments made by health care service plans and health insurers directly to behavioral health providers and medical-surgical providers, and payments made to intermediaries and health systems for behavioral health services and medical-surgical services. The bill would require the department to take certain actions in conducting the study, including developing a methodology for determining which behavioral health provider roles are comparable to which medical-surgical provider roles.
The bill would require a health care service plan or health insurer to report certain data to the department with respect to payments made directly to providers and payments made to intermediaries and health systems. The bill would also require specified intermediaries and health systems to report certain data to the department relating to payments received and payments made. The bill would make an entity that fails to comply with the reporting
requirements subject to civil penalty, as prescribed.
The bill would require the department and the other state entities listed above to protect the confidentiality of any propriety or commercially sensitive information submitted pursuant to the bill, as provided. The bill would require the department, on or before January 1, 2028, to submit a report to the Legislature containing the findings of the study.
Existing constitutional provisions require that a statute that limits the right of access to the meetings of public bodies or the writings of public officials and agencies be adopted with findings demonstrating the interest protected by the limitation and the need for protecting that interest.
This bill would make legislative findings to that effect.

Current Bill Text

Download Bill PDF