Bill > S835

This bill aims to define and mandate coverage for various mental health treatment services across different types of health insurance in Massachusetts. The bill introduces four key types of mental health services: mental health acute treatment (24-hour medically supervised inpatient services), mental health crisis stabilization services (24-hour diversionary services for adults and adolescents), community-based acute treatment (CBAT, for children and adolescents), and intensive community-based acute treatment (ICBAT, also for children and adolescents). For each of these services, the bill requires health insurers, state employee health plans, Medicaid managed care organizations, and other health plans to cover medically necessary treatments without requiring prior authorization. Medical necessity will be determined by the treating clinician in consultation with the patient. The bill specifies coverage limits for these services: mental health acute treatment has no specified limit, crisis stabilization services are covered for up to 14 days, CBAT services for up to 21 days, and ICBAT services for up to 14 days. Additionally, facilities must provide notification of admission and an initial treatment plan within 48 hours, and utilization review procedures can be initiated after a certain number of days depending on the specific service type. The bill applies to various types of health insurance contracts and plans issued or renewed in Massachusetts, effectively standardizing mental health treatment coverage across the state's healthcare system.

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https://malegislature.gov/Bills/194/S835