Section 19 of chapter 118E of the General Laws, as appearing in the 2018 Official Edition, is hereby amended by adding after the first paragraph, the following new paragraph:-
The division and its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms and third party administrators under contract to a Medicaid managed care organization or primary care clinician plan shall not require preauthorization or prior authorization before obtaining medically necessary mental health services within an inpatient psychiatric facility, a community health center, a community mental health center, an outpatient substance use disorder provider, a hospital outpatient department, a community based acute treatment program, or an intensive community based acute treatment program; provided that the facility or provider shall provide the division or its contractors notification of admission within 48 hours of admission; provided further, that utilization review procedures may be initiated after 48 hours of admission; and provided further, that Emergency Service Program teams, so-called, as contracted through MassHealth to conduct behavioral health screenings, shall not be considered a preauthorization or prior authorization requirement pursuant to any admission under this section. Medical necessity shall be determined by the treating healthcare provider and noted in the member’s medical record.
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