An Act for supportive care for serious mental illness
By Mr. Cronin, a petition (accompanied by bill, Senate, No. 709) of John J. Cronin for legislation relative to supportive care for serious mental illness. Financial Services.
This bill mandates that health insurance plans provide coverage for coordinated specialty care and assertive community treatment behavioral health care for individuals with first-episode or recurring psychosis. The bill prohibits insurance policies from limiting the number of visits for these services, and directs insurers to use a bundled payment model instead of traditional fee-for-service payment. Under the bill, medical necessity for these treatments shall be deemed approved upon the request of a licensed health professionals, without the need for proving disability or functional impairment. The bill also requires insurers to demonstrate sufficient provider networks and outlines penalties for failing to comply, including facilitating out-of-network access and providing detailed compliance reports.
The bill establishes a working group to create coding solutions for the bundled payment system, and calls for periodic reviews on the financial impact of these treatment models, with a detailed analysis due five years after implementation.
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