Bill > S771

This bill addresses dual diagnosis treatment coverage by amending several chapters of Massachusetts law to standardize and expand insurance coverage for substance use disorder and mental health treatments. The bill defines three key types of treatment services: acute treatment services (24-hour medically supervised addiction treatment), clinical stabilization services (post-detoxification treatment), and co-occurring treatment services (inpatient detoxification treatment in psychiatric facilities). The legislation mandates that various state insurance programs, including group insurance for state employees, Medicaid, and private health insurance plans, must cover these medically necessary treatments for up to 14 days without requiring prior authorization. Additionally, the bill requires treatment facilities to notify insurance carriers within 48 hours of admission, allows utilization review procedures to begin on the seventh day of treatment, and ensures that medical necessity is determined by the treating clinician in consultation with the patient. The bill also requires coverage of substance use disorder evaluations without preauthorization, which aims to make mental health and addiction treatment more accessible and streamline the process for individuals seeking help.

Budget and Finance, Business and Industry, Health and Social Services

https://malegislature.gov/Bills/194/S771