Chapter 141 of the Acts of 2000 , Section 20, is hereby amended by adding the following:
Health plans that determine medically necessity for behavioral health services that require a review, must provide a pre-service review, and must take reasonable steps to ensure that consumers and providers of behavioral health services are informed of the option of pre-service review including but not limited to providing such information in any written, electronic or telephonic communication describing health plan benefit information. A post-service review that might deny payment will not be considered valid if a pre-service review has not been offered.
Further, Behavioral Health plans must give no fewer than 180 days notice to behavioral health providers of any decision to not renew a contract without cause for termination.
Further, should a Behavioral Health Plan not renew a behavioral health provider contract, said plan must continue to cover payment for an existing treatment past the termination date of the contract, until such treatment is no longer medically necessary consistent with terms of contract in place at the time of non-renewal and usual and customary utilization management processes.
Further, Behavioral Health Providers shall not be prohibited from collecting any portion of a deductible for services rendered at the time of service.
Further, Health Plans must show cause for not renewing provider contracts, and must demonstrate that any lawful communication
concerning regulations and statutes that effect service delivery is not a factor in said non-renewal
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