Bill > S772

This bill aims to expand and standardize addiction treatment coverage across various Massachusetts health insurance programs, including group insurance for state employees, Medicaid, and private health insurance plans. The bill introduces and defines "transitional support services" as short-term, residential support services that provide a safe environment for adults and adolescents recovering from addiction, typically following clinical stabilization services. The legislation mandates that these insurance programs provide coverage for medically necessary acute treatment services, clinical stabilization services, and transitional support services for up to 30 days without requiring preauthorization. Key provisions include requiring treatment facilities to notify carriers within 48 hours of admission, provide a discharge plan, and allowing carriers to initiate utilization review procedures only after 14 days. The bill prohibits carriers from restricting or denying future medically necessary services unless a patient has received at least 30 consecutive days of treatment. Additionally, the bill requires the center for health information and analysis to conduct comprehensive reviews of the expanded coverage's impact on substance use disorder treatment, assessing effects on care continuity, patient access, and associated costs, with initial and final reports to be submitted by October 1, 2026, and October 1, 2028, respectively. The new provisions will take effect on October 1, 2026.

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https://malegislature.gov/Bills/194/S772