Bill > S1093

This bill aims to further define medical necessity determinations, particularly for mental health treatment. The key provisions are as follows: 1) For the Medicaid program (Chapter 118E), the bill adds a new sentence stating that medical necessity for mental health treatment shall be determined by the treating clinician in consultation with the patient, and noted in the patient's medical record. 2) For private insurance plans (Chapter 176O), the bill adds a similar new sentence stating that medical necessity for mental health services shall be determined by the treating clinician in consultation with the patient, and noted in the patient's medical record. The purpose of these changes is to give more authority to the treating clinician, in consultation with the patient, to determine what mental health services are medically necessary, rather than having those determinations made solely by the insurance provider.

Health and Social Services

https://malegislature.gov/Bills/190/S1093