Bill > H1145

This bill amends various sections of Massachusetts state law to remove barriers to accessing behavioral health services. The key provisions include: 1. Requiring health insurance plans in Massachusetts to cover medically necessary mental health services within a range of inpatient and outpatient facilities, without requiring prior authorization for treatment. The facilities covered include inpatient psychiatric facilities, community health centers, community mental health centers, outpatient substance use disorder providers, hospital outpatient departments, and community-based acute treatment programs. 2. Allowing facilities to notify the insurance carrier of the patient's admission and initial treatment plan within 3 business days, rather than requiring prior authorization. Services provided prior to notification must still be covered. 3. Specifying that medical necessity is to be determined by the treating clinician in consultation with the patient, and noted in the patient's medical record. 4. Placing restrictions on how long insurance carriers can wait to recoup payments for claims they later deem ineligible, and requiring detailed written notice to providers before attempting to recoup payments. The overall goal of the bill is to improve access to and coverage of necessary behavioral health services for Massachusetts residents.

Business and Industry, Health and Social Services

https://malegislature.gov/Bills/193/H1145