Budget Amendment ID: FY2017-S4-405

EHS 405

Definitive Drug Testing

Ms. Flanagan moved that the proposed new text be amended by inserting, after section ___, the following new section:-

“SECTION ___.  The office of Medicaid is directed to amend its coverage policies for clinical urine drug testing, coverage and reimbursement to align with the Centers for Medicare and Medicaid  Services (CMS) guidelines and allow for reimbursement for definitive testing (also includes quantitative and confirmatory testing) sent directly to licensed clinical laboratories without prior presumptive testing being performed.

To ensure appropriate and responsible use, medical necessity documentation and utilization frequency guidelines, as outlined by the Centers for Medicare and Medicaid Services (CMS), shall be implemented by the office of Medicaid.

Notwithstanding any general or special law to the contrary an independent clinical laboratory that is the out-of-state and accredited by the College of American Pathologists shall be deemed eligible and qualified to participate as a MassHealth provider and eligible for payment.”