Bill > H4900

This bill establishes "transitional support services" as short-term, residential support services that follow clinical stabilization services, providing a safe environment for adults and adolescents in addiction recovery as they transition to less intensive care. It mandates that various insurance providers, including those for state employees, Medicaid managed care organizations, and commercial insurance plans, must cover medically necessary acute treatment services, clinical stabilization services, and these new transitional support services for up to 30 days without requiring prior authorization, though facilities must notify insurers of admissions and treatment plans within 48 hours. Insurers can begin utilization reviews on day 14 but cannot deny future services unless a patient has received at least 30 consecutive days of care, and substance use disorder evaluations must also be covered without prior authorization. The bill also repeals an existing section related to these services and requires the Center for Health Information and Analysis to conduct reviews on the impact of these coverage mandates, with initial reports due in October 2026 and final reports in October 2028.

Health and Social Services

Joint Committee on Financial Services (Joint)

https://malegislature.gov/Bills/194/H4900