This is Christine Doherty.

"He wanted to be a firefighter since he was little, but when he graduated high school, he went to community college."

Her son, Ryan Matlock, had already overdosed at least once on fentanyl at 23 years old.

Desperate to save himself, Ryan begged his health insurance plan to place him in a residential treatment facility that knew how to handle fentanyl addiction.

After a couple of days in the facility, Ryan's insurance denied him further coverage.

On Saturday, March 20th, 2021, Ryan's older sister, Haley, picked him up and drove him home.

Three days later, Ryan died of an overdose.

In California that year, fentanyl claimed 5,961 lives.

Last year, the total climbed to 6,850.

California requires insurers to cover medically necessary mental health treatment.

To patients, the separation between what that law requires and what health plans provide often feels like a gaping chasm.

Staying in a hospital or treatment facility after an insurance denial could burden patients with thousands of dollars of medical debt.

Leaving could kill them.

Patients who are denied treatment authorization generally first appeal to their health plans.

Both the Department of Managed Health Care and the Department of Insurance allow people to request independent medical reviews, in which outside experts review cases for the state and determine whether a health plan rightfully denied treatment.

The relatively few people who do file for independent medical reviews with the state can find themselves waiting a long time.

Advocates and some legislators have long expressed frustration that the state has not taken a more proactive role in holding health plans to account for refusing to pay for behavioral health care.

They say waiting for people in crisis to figure out how to navigate a complicated system is simply too passive.

With CalMatters, I'm Jocelyn Wiener.