Bill > H905

This bill aims to expand coverage and access to behavioral health services by requiring health insurers and Medicaid managed care organizations to cover medically necessary inpatient psychiatric services for up to 14 days without requiring preauthorization, with notification of admission required within 48 hours and utilization review allowed to begin on day 7, and clarifying that emergency service program teams do not constitute preauthorization. It also mandates the development of a streamlined process for admitting patients to inpatient behavioral health services from community settings without requiring an emergency department medical screening, and requires insurers and Medicaid contractors to assist providers in finding inpatient or community-based mental health and substance abuse placements 24/7. Furthermore, the bill addresses payment rates for services, including reimbursement for patients "boarded" in emergency departments beyond 24 hours after an admission decision, and requires the adoption of updated coding and payment standards for mental health and substance abuse services, with supplemental payments for providers to cover the difference between reimbursement and the cost of care for MassHealth members. It also proposes the creation of a specialized unit for children and adolescents with intellectual disabilities and behavioral health needs, and establishes a task force to identify and recommend solutions for streamlining judicial reviews for psychiatric commitments and guardianships. Finally, it mandates that carriers cover community-based wraparound services for children and adolescents, similar to those provided under a specific existing law.