Bill > H1997

This bill aims to further define medical necessity determinations for mental health treatment. The key provisions are: 1) For MassHealth (Medicaid) services, the definition of "Medically Necessary Services" is amended to include the requirement that medical necessity for mental health treatment be determined by the treating clinician in consultation with the patient, and noted in the patient's medical record. 2) For private insurance plans regulated under Massachusetts law, the bill amends the requirements for medical necessity reviews to specify that medical necessity for mental health services shall be determined by the treating clinician in consultation with the patient, and noted in the patient's medical record. The overall intent of the bill is to give treating clinicians and patients more authority and input in determining what mental health services are medically necessary, rather than having those determinations made solely by the insurance provider.

Health and Social Services

https://malegislature.gov/Bills/193/H1997