An Act to further define medical necessity determinations
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed House
- To Governor
- Became Law
Overview
This bill aims to clarify how health plans determine if mental health crisis stabilization services are medically necessary. It seeks to provide a more specific definition of what constitutes a ‘medically necessary’ service for individuals experiencing a mental health crisis. The legislation focuses on ensuring that these crucial services are covered by health insurance plans when deemed appropriate by a qualified healthcare professional. This bill builds upon previous attempts to refine medical necessity determinations in Massachusetts.
Key provisions
- Defines ‘medically necessary’ mental health crisis stabilization services.
- Addresses coverage for services provided during a mental health crisis.
- Clarifies the role of healthcare professionals in determining medical necessity.
- Aims to improve access to crisis stabilization services.
- Expands upon existing definitions of medical necessity.
- Specifically targets mental health crisis stabilization services.
- Requires health plans to adhere to a clearer standard for coverage.
Who is affected
- Individuals experiencing mental health crises
- Mental health crisis stabilization service providers
- Health insurance plans in Massachusetts
- Individuals seeking mental health care
- Healthcare professionals
Notable changes
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Sponsors
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2 on record
Primary sponsor
Cosponsor
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