An Act related to comprehensive clinical and extended support services
This bill (HD 375) requires health insurance plans in Massachusetts to cover specific addiction treatment services without preauthorization. It defines "transitional support services" (short-term residential care after stabilization) and mandates coverage for up to 30 days of acute treatment, clinical stabilization, and transitional support services for:
1) Active or retired Commonwealth employees with group insurance, and
2) All insured individuals under Medicaid and general health plans.
Facilities must notify insurers within 48 hours of admission and provide discharge plans, with utilization reviews allowed only after 14 days (and not restricting future care unless 30+ consecutive days are provided). Medical necessity is determined by the treating clinician, not insurers.
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0 primary · 3 co-sponsors
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