H 5091 requires the state bureau providing medical services to children and youth in the care of the Department of Children and Families to follow MassHealth and Department of Public Health pediatric care standards. This includes ensuring access to mental health, physical health, preventative care, and health promotion services. The bill also mandates the bureau to monitor medical contracts to improve both access to care and the quality of services for these children. It directly affects children in state custody by establishing concrete health care standards and oversight mechanisms.
This bill requires healthcare providers and facilities in Massachusetts to screen children for PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) and PANS (Pediatric Acute Onset Neuropsychiatric Syndrome) during routine care. It mandates that all physicians, child psychiatrists, psychologists, social workers, and mental health counselors screen patients using evidence-based protocols developed by the Department of Public Health. Healthcare facilities serving children must ensure these screenings occur at specified intervals. The bill also requires the Department to establish clinical criteria for diagnosis and develop implementing regulations within 180 days. The screening requirement applies to all medical and clinical settings treating children.
This bill requires insurance plans and Medicaid to approve non-emergency medical transportation (like ambulances and wheelchair vans) for specific services - dialysis, behavioral health, and post-acute care - valid for at least 3 business days, reducing delays for patients. It also mandates that insurers pay providers at least 2.5 times standard rates for these services to ensure adequate compensation. The law applies to Medicaid managed care organizations, commercial insurers, and health plans covering these transportation needs. A study on reimbursement adequacy and workforce impacts is also required.
This bill (H 4899) requires health insurance plans in Massachusetts to cover post-pregnancy mental health care - including postpartum and post-miscarriage care - without any out-of-pocket costs like deductibles or copays. It applies to both private insurance and Medicaid plans, ensuring coverage is equally available to enrollees and their spouses or dependents. The law explicitly adds this care to existing pregnancy-related coverage requirements in multiple sections of state health laws and prohibits unreasonable delays or restrictions in accessing these services.
H 4893 requires health insurance plans in Massachusetts to cover at least six sessions of preventive behavioral health services for individuals under 21 who have a positive screening for depression, anxiety, or other emotional concerns (or for infants whose caregivers screen positive for postpartum depression), without cost-sharing or prior authorization. This applies to group insurance plans for state employees, private insurance policies, and health plans governed by state law, covering individual, family, or group sessions delivered in pediatric primary care, community, or school settings. Insurers must accept alternative diagnosis codes (like Social Determinants of Health Z-codes) for billing these services. The bill directly affects children, adolescents, and infants with early behavioral health screenings by mandating accessible, no-cost preventive care to help prevent more severe conditions.
H 4895 removes preauthorization requirements for insured patients seeking specific mental health services, including inpatient psychiatric care, crisis stabilization, substance use disorder treatment, and community-based acute care. It directly affects Commonwealth employees with group insurance and Medicaid recipients by ensuring coverage for these services without prior insurer approval. Key provisions require facilities to notify insurers within 3 business days of admission (limited to basic patient and treatment details) while guaranteeing coverage for services provided before notification. The bill also expands the definition of "licensed mental health professional" to include more provider types, such as licensed clinical social workers and master's-level clinicians under supervision. These changes aim to streamline access to critical mental health care by reducing administrative barriers.
This bill (H 4898) requires Massachusetts health insurers and Medicaid to cover specific addiction and mental health treatment services without preauthorization. It defines three key services: "acute treatment" (24-hour medically supervised addiction care), "clinical stabilization" (post-detox recovery support), and "co-occurring treatment" (inpatient psychiatric care for dual diagnosis). The law mandates coverage for up to 14 days for clinical stabilization and co-occurring services, with facilities required to notify insurers within 48 hours of admission. It directly affects Commonwealth employees (via Group Insurance Commission), Medicaid beneficiaries, and private insurers offering hospital/surgical coverage in Massachusetts. Medical necessity is determined by clinicians, not insurers, streamlining access to critical early recovery care.
H 4952 amends Massachusetts health insurance laws to expand who can diagnose and treat autism spectrum disorder (ASD) for insurance coverage. The bill updates definitions in multiple statutes to include licensed nurse practitioners and psychiatric nurse mental health clinical specialists alongside physicians for ASD diagnosis, treatment, and related pharmacy care. These changes require health insurance policies to cover services by these providers starting January 1, 2027, directly affecting individuals seeking ASD care and insurers managing coverage.
This bill (H 4942) expands the definition of "licensed mental health professional" in five Massachusetts statutes to include licensed rehabilitation counselors. It directly affects rehabilitation counselors by recognizing them as qualified providers under existing laws governing insurance, healthcare services, and professional scope. The key mechanism adds "licensed rehabilitation counselor" to the list of covered professionals in sections related to mental health services, insurance coverage, and healthcare financing. This change aims to increase consumer access to rehabilitation counseling services by ensuring they are included in the same legal framework as other mental health professionals.
By Mr. Fernandes, a petition (accompanied by bill) (subject to Joint Rule 12) of Dylan A. Fernandes for legislation to support men's mental health. Mental Health, Substance Use and Recovery.
