Bill > S709

This bill requires various types of health insurance in Massachusetts to provide coverage for two specific mental health treatment approaches: Coordinated Specialty Care (CSC) for first-episode psychosis and Assertive Community Treatment (ACT), which are team-based, evidence-based treatment practices designed to support individuals with serious mental illness or serious emotional disturbance. The bill defines these services in detail, emphasizing person-centered, recovery-oriented treatment models that are adaptable for both adult and pediatric patients. Key provisions include mandating that insurance plans cover these services without limiting the number of visits, requiring payment through bundled treatment models rather than fee-for-service, and removing disability or functional impairment as preconditions for treatment. The bill applies to various types of insurance providers, including student health plans, state employee plans, individual and group policies, and health maintenance organizations. Additionally, the legislation requires the Division of Insurance to convene a working group to develop appropriate billing codes for these services, mandates that carriers demonstrate adequate provider networks, and requires an independent analysis after five years to assess the impact of these coverage requirements on healthcare costs and patient outcomes.

Business and Industry, Health and Social Services

https://malegislature.gov/Bills/194/S709