Bill > H1244

This bill aims to improve patient-centered access to behavioral health services within Accountable Care Organizations (ACOs) in Massachusetts. The key provisions include: 1. Requiring all ACOs in the Commonwealth to offer patient navigation and care coordination services through "Patient Engagement Advocates" - licensed social workers, nursing aides, community health workers, or peer support specialists. These advocates will help patients access appropriate behavioral health providers, navigate insurance, schedule appointments, provide transportation, and ensure follow-up care to prevent relapse. 2. Mandating that primary care providers within ACOs directly connect patients with diagnosed mental illness or substance use disorders, or with symptoms suggesting such conditions, to the Patient Engagement Advocates within 7 days of discharge or identifying the issue. 3. Allowing ACOs to initiate discharge proceedings for patients who refuse further treatment after evaluation, but requiring they connect such patients to a Patient Engagement Advocate prior to or within 7 days of discharge. 4. Prohibiting ACOs from restricting referrals to only in-network behavioral health specialists. 5. Providing funding for a pilot program with a community-based organization to offer additional patient support services, provider education, and public awareness campaigns. The overall goal is to improve access, coordination, and utilization of behavioral health services within the ACO model to better serve patients.

Health and Social Services

https://malegislature.gov/Bills/192/H1244