Bill > H1277

This bill amends multiple chapters of Massachusetts law to standardize and expand healthcare coverage for substance use and mental health treatment, specifically focusing on three key types of services: acute treatment services (24-hour medically supervised addiction treatment), clinical stabilization services (24-hour post-detoxification treatment), and co-occurring treatment services (inpatient detoxification treatment in psychiatric facilities). The bill requires various health insurance providers, including the state group insurance commission, Medicaid, and private insurers, to cover these medically necessary treatments for up to 14 days without requiring prior authorization. Additionally, the bill mandates that facilities notify insurance carriers within 48 hours of admission, allows utilization review procedures to begin on the seventh day of treatment, and ensures that substance use disorder evaluations can be conducted without preauthorization. Importantly, the bill stipulates that medical necessity will be determined by the treating clinician in consultation with the patient and documented in the patient's medical record, which aims to provide more flexibility and patient-centered care for individuals seeking treatment for substance use and mental health conditions.

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https://malegislature.gov/Bills/194/H1277