Amendment ID: S2133-37-R1
Redraft Amendment 37
Corrective Amendment
Mr. Brewer moves to amend the bill in section 1, by striking out, in line 16, the word “chapter 111B, 111E and section 24” and inserting in place thereof the following words:- “chapters 111B and 111E and sections 24 and 24D”; and
in section1, by striking out, in lines 29 to 31, inclusive, the words “and shall not be affiliated or receive remuneration from a health plan or substance use disorder treatment provider in the commonwealth”; and
in section 9, by inserting after the word “treatment” the second time it appears, in line 139, the following words:- “provided in a medically managed or medically monitored facility”; and
in said section 9, in proposed section 17N of chapter 32A of the General Laws, by adding the following paragraph:- “Medical necessity shall be determined by the substance use disorder treatment facility or the treating clinician in consultation with the patient.”; and
in section 10, by striking out, in line 152, the figure “2102” and inserting in place thereof the following figure:- “2012”; and
in section 23, by inserting after the word “treatment” the second time it appears, in line 292, the following words:- “provided in a medically managed or medically monitored facility”; and
in said section 23, in proposed section 10H of chapter 118E of the General Laws, by inserting after the word “division”, in lines 300 and 302, each time it appears the following words:- “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”; and
in said section 23, by adding the following paragraph:- “Medical necessity shall be determined by the substance use disorder treatment facility or the treating clinician in consultation with the patient.”; and
in section 25, by inserting after the word “treatment” the second time it appears, in line 326, the following words:- “provided in a medically managed or medically monitored facility”; and
in said section 25, in proposed section 47GG of chapter 175 of the General Laws, by adding the following paragraph:- “Medical necessity shall be determined by the substance use disorder treatment facility or the treating clinician in consultation with the patient.”; and
in section 27, by inserting after the word “treatment” the second time it appears, in line 361, the following words:- “provided in a medically managed or medically monitored facility”; and
in said section 27, in proposed section 8II, by adding the following paragraph:- “Medical necessity shall be determined by the substance use disorder treatment facility or the treating clinician in consultation with the patient.”; and
in section 29, by inserting after the word “treatment” the second time it appears, in line 397, the following words:- “provided in a medically managed or medically monitored facility”; and
in said section 29, in proposed section 4II of chapter 176B of the General Laws, by adding the following paragraph:- “Medical necessity shall be determined by the substance use disorder treatment facility or the treating clinician in consultation with the patient.”; and
in section 31, by inserting after the word “treatment” the second time it appears, in line 431, the following words:- “provided in a medically managed or medically monitored facility”; and
in section 31, in proposed section 4AA of chapter 176G of the General Laws, by adding the following paragraph:- “Medical necessity shall be determined by the substance use disorder treatment facility or the treating clinician in consultation with the patient.”; and
in section 39, by striking out, in line 545, the figure “23” and inserting in place thereof the following figure:- “24”; and
by inserting after said section 39 the following section:-
“SECTION 39A. The division of medical assistance shall conduct a review and evaluation of the mandated benefit in section 23 and shall file a report with the clerks of the senate and the house of representatives and the house and senate committees on ways and means, not later than 90 days from the effective date of this act. The report’s analysis and evaluation of the mandated benefit in said section 23 shall include, but not be limited to: the financial impact to the commonwealth of mandating the benefit, including the extent to which the proposed coverage would increase or decrease the cost of the treatment or service over the next 5 years; the extent to which the proposed coverage might increase the appropriate or inappropriate use of the treatment or service over the next 5 years; the extent to which the mandated treatment or service might serve as an alternative for more expensive or less expensive treatment or service; the extent to which the coverage may affect the number and types of providers of the mandated treatment or service over the next 5 years; the effects of mandating the benefit on the cost of health care; the cost to health care consumers of not mandating the benefit in terms of out of pocket costs for treatment or delayed treatment; the effect on the overall cost of the health care delivery system in the commonwealth; and the medical efficacy of mandating the benefit, including the impact of the benefit to the quality of patient care and the health status of the population and the results of any research demonstrating the medical efficacy of the treatment or service compared to alternative treatments or services or not providing the treatment or service. The division of medical assistance shall consult with the center for health information and analysis in creating the report to maximize opportunities for administrative simplification.”; and
by adding the following section:-
“SECTION 47. Sections 13, 21 and 22 shall take effect 6 months from the effective date of this act.”; and;
by inserting the following emergency preamble:-
“Whereas, The deferred operation of this act would tend to defeat its purpose, which is to increase forthwith the opportunities for long-term substance abuse recovery, therefore it is hereby declared to be an emergency law, necessary for the immediate preservation of the public health.”