Bill > H1151

This bill requires health insurance providers in Massachusetts to provide comprehensive coverage for individuals with acquired brain injuries (ABIs), which are brain injuries that occur after birth due to various causes like stroke, disease, or trauma. The bill mandates that insurance plans cover a wide range of medically necessary treatments, including cognitive rehabilitation therapy, neurocognitive therapy, neurobehavioral therapy, neurofeedback therapy, community reintegration services, and post-acute residential treatment. Importantly, these coverage requirements apply to state employee group insurance, individual and group health insurance policies, medical service agreements, and health maintenance contracts. The bill prohibits lifetime or unreasonable annual limitations on treatment services and ensures that these services cannot be denied solely based on the treatment location. Additionally, the bill requires insurance companies to provide training to personnel handling preauthorization and utilization review for these services, in consultation with the Brain Injury Association of Massachusetts. Practitioners and treatment facilities must be qualified through appropriate licenses, accreditation, and experience, including programs regulated by the Executive Office of Health and Human Services and accredited by the Commission on Rehabilitation Facilities (CARF) with a Brain Injury Specialty Program.

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https://malegislature.gov/Bills/194/H1151