Bill > S685

This bill aims to expand coverage for dual diagnosis treatment services in Massachusetts. The key provisions of the bill are: 1. It requires the Group Insurance Commission, MassHealth, and private insurers to cover medically necessary acute treatment services, clinical stabilization services, and co-occurring treatment services for up to 14 days without prior authorization. 2. It also requires coverage, without prior authorization, for substance abuse evaluations ordered under state law. 3. The bill defines these different treatment services and specifies that medical necessity is to be determined by the treating clinician in consultation with the patient. 4. The bill makes these coverage requirements applicable to various health insurance plans and contracts in the state, including those for state employees, Medicaid, and private individual and group plans. Overall, the bill seeks to improve access to comprehensive treatment for individuals with co-occurring substance use and mental health disorders by mandating insurance coverage for a range of necessary services.

Business and Industry, Health and Social Services

https://malegislature.gov/Bills/192/S685