H1276 — An Act improving access to community behavioral health centers

Summary

An Act improving access to community behavioral health centers

Bill Text

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The bill mandates that various types of health insurance and service contracts provide nondiscriminatory coverage for behavioral health bundled services at community behavioral health centers.

• Chapter 32A, Section 30

  Section 31. (a) For the purposes of this section, the following words shall have the following meanings: “Behavioral health bundled services”, services delivered by a community behavioral health center as specified in 101 CMR 305.00 for the evaluation, diagnosis, treatment, care coordination, management, or peer support of patients with mental health, developmental or substance use disorder, provided that services are reimbursed through a flat rate per encounter. “Community Behavioral Health Centers”, a clinic licensed by the department of public health and regulated pursuant to 130 CMR 448.00. (b) Any health plan offered by the commission shall provide to an active or retired employee of the commonwealth who is insured under the group insurance commission benefits on a nondiscriminatory basis for medically necessary behavioral health bundled services delivered through community behavioral health centers.

  Adds a new section requiring health plans for state employees to cover behavioral health bundled services.

• Chapter 175, Section 47PP

  Section 47QQ. (a) For the purposes of this section, the following words shall have the following meanings: “Behavioral health bundled services”, services delivered by a community behavioral health center as specified in 101 CMR 305.00 for the evaluation, diagnosis, treatment, care coordination, management, or peer support of patients with mental health, developmental or substance use disorder, provided that services are reimbursed through a flat rate per encounter. “Community Behavioral Health Centers”, a clinic licensed by the department of public health and regulated pursuant to 130 CMR 448.00. (b) Any individual policy of accident and sickness insurance issued pursuant to section 108, which provides hospital expense and surgical expense insurance, and a group blanket or general policy of accident and sickness insurance issued pursuant to section 110, which provides hospital expense and surgical expense insurance, which is issued or renewed within or without the commonwealth, shall provide benefits on a nondiscriminatory basis for medically necessary behavioral health bundled services delivered through community behavioral health centers.

  Introduces a new section that mandates coverage for behavioral health bundled services in individual and group insurance policies.

• Chapter 176A, Section 38

  Section 39. (a) For the purposes of this section, the following words shall have the following meanings: “Behavioral health bundled services”, services delivered by a community behavioral health center as specified in title 101 CMR 305.00 for the evaluation, diagnosis, treatment, care coordination, management, or peer support of patients with mental health, developmental or substance use disorder, provided that services are reimbursed through a flat rate per encounter. “Community Behavioral Health Centers”, a clinic licensed by the department of public health and regulated pursuant to 130 CMR 448.00. (b) Any contract between a subscriber and the corporation under an individual or group hospital service plan which is issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis for medically necessary behavioral health bundled services delivered through community behavioral health centers.

  Establishes requirements for coverage of behavioral health bundled services in hospital service plans.

• Chapter 176B, Section 25

  Section 26. (a) For the purposes of this section, the following words shall have the following meanings: “Behavioral health bundled services”, services delivered by a community behavioral health center as specified in title 101 CMR 305.00 for the evaluation, diagnosis, treatment, care coordination, management, or peer support of patients with mental health, developmental or substance use disorder, provided that services are reimbursed through a flat rate per encounter. “Community Behavioral Health Centers”, a clinic licensed by the department of public health and regulated pursuant to 130 CMR 448.00. (b) Any subscription certificate under an individual or group medical service agreement which is issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis for medically necessary behavioral health bundled services delivered through community behavioral health centers.

  Requires medical service agreements to cover behavioral health bundled services nondiscriminately.

• Chapter 176G, Section 33

  Section 34. (a) For the purposes of this section, the following words shall have the following meanings: “Behavioral health bundled services”, services delivered by a community behavioral health center as specified in 101 CMR 305.00 for the evaluation, diagnosis, treatment, care coordination, management, or peer support of patients with mental health, developmental or substance use disorder, provided that services are reimbursed through a flat rate per encounter. “Community Behavioral Health Centers”, a clinic licensed by the department of public health and regulated pursuant to title 130 CMR 448.00. (b) Any health maintenance contract issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis for medically necessary behavioral health bundled services delivered through community behavioral health centers.

  Mandates that health maintenance contracts include coverage for behavioral health bundled services.

Sponsors

• James J. O'Day · Primary

Subjects