Four laws related to improving access to behavioral health care in Oklahoma are now in effect after Healthy Minds Policy Initiative’s work with lawmakers during this legislative session.
Zack Stoycoff, the initiative’s executive director, said Healthy Minds worked diligently with legislators to pass its four priority bills, which is the most policy Healthy Minds has seen succeed since it started in 2019.
"Many of these bills can seem pretty wonky to the average Oklahoman,” Stoycoff said. “They really get to some of the most systemic reasons why we can’t get behavioral health care. … These bills are designed to really help Oklahoma families and help Oklahomans who struggle with these issues in real and meaningful ways, immediately.”
Senate Bill 442 was authored by Rep. Chris Sneed (R-Fort Gibson) and Sen. John Michael Montgomery (R-Lawton), who resigned in July. It’s based on research conducted by Healthy Minds in February, which found that, out of the state’s five largest private insurance providers, 65% of their behavioral health providers were unreachable, and half of those had disconnected or out-of-service phone lines.
Now, Oklahoma insurance companies will have to update their directories every 60 days to ensure they're accurate. The law also requires insurers to remove providers from plan directories if they haven’t submitted a claim in a year.
“The net effect is that, the insurance company, this is their product to you and I, and if you're not keeping it accurate and updated, it would be like a car dealership selling us a car and saying ‘We don't know if it runs right. Good luck,’” Stoycoff said. “And so, we're simply saying, make sure the car runs right when we buy it.”
SB 254, authored by Sen. Jessica Garvin (R-Duncan) and Rep. Jeff Boatman (R-Tulsa), requires commercial insurance companies to arrange behavioral health care for their members if they can’t find timely access.
Healthy Minds interviewed providers in nine urban, suburban and rural zip codes across the state and found that, out of the 40 providers interviewed, 60% could offer information about wait times, 33% could offer an appointment in a month, and 18% could offer one in a week.
Stoycoff also said Healthy Minds found that insurance plans leave out the vast majority of available providers, with the best example being an insurance company covering only 30% of available behavioral health providers.
To get timely access to care, patients must call their insurance company to work with them to find a provider. From there, insurance companies have 30 days to locate care for a routine outpatient visit, seven days for an inpatient visit and 24 hours for a more urgent situation, like crisis care center visits.
If care cannot be located, the insurance company must arrange care out of network. The cost for plan members will be capped based on individual plans to match copays and deductibles for in-network providers.
Both of these laws will be regulated by the Oklahoma Insurance Department, and Stoycoff said Oklahomans can call the department if they are having issues with access.
"If you have an issue with an insurance company, and you feel like they are not upholding these laws, get the Oklahoma Insurance Department phone number and call them and issue a complaint. They will tell you if it is not one of their regulated plans," Stoycoff said. "And if not, the federal government has a complaint number as well that you can call."
Other laws now in effect include House Bill 2175 and SB 444. HB 2175, authored by Rep. Cynthia Roe (R-Lindsay) and Sen. Paul Rosino (R-Oklahoma City), creates the Behavioral Health Workforce Development Fund.
Stoycoff said the fund would allow the Oklahoma Department of Mental Health and Substance Abuse Services to operate a loan repayment program for anyone wanting to get a degree that allows them to be a therapist or another mental health professional. It will also allow funding to go toward increasing the number of psychiatric residencies in Oklahoma.
The program would have to receive funding in the next state budget, and Stoycoff said a good start for the fund would be $17 million.
SB 444, also authored by Montgomery and Rep. Nicole Miller (R-Edmond), would allow medical health providers to be reimbursed for consulting on cases with primary care doctors.
Stoycoff said this would create easier points of entry for access to mental health care, especially in rural areas.
“Nearly half of people who die by suicide had seen a primary care physician in the last month of their life,” Stoycoff said. “We are missing opportunities in health care, in the most basic setting where you should receive health care, to screen, diagnose and intervene in life-saving issues of behavioral health.”
This idea is based on an integrated care model, which is an approach to health care characterized by collaboration and communication among different health professionals.
Healthy Minds will present during an interim study from 8:30 to 11:30 a.m. Tuesday on Oklahoma’s behavioral health workforce.