Amendment ID: S2871-7

Amendment 7

Behavioral Health Urgent Care

Mr. Cyr moves that the proposed new text be amended by adding the following section:-

"SECTION X. (a) For the purposes of this section, the following terms shall have the following meanings unless the context clearly requires otherwise:

'Behavioral Health Urgent Care Provider', a Mental Health Center designated as a Behavioral Health Urgent Care Provider, as set forth in 130 CMR 429.000.

'Behavioral Health Urgent Care Provider Services', shall include, but not be limited to: (i) diagnostic psychiatric evaluations; (ii) individual, group, couple, and family therapy; (iii) psychotherapy for crisis; (iv) case consultation; (v) family consultation; and (vi) evaluation and management medication visits as set forth in 101 CMR 306.000 and 103 CMR 429.000.

(b) Notwithstanding any general or special law to the contrary, a carrier licensed by the division of insurance, directly or through any entity that manages or administers mental health or substance use disorder benefits for the carrier, shall ensure that payment for any services provided by a Behavioral Health Urgent Care Provider include a rate add-on of at least 15 per cent over a negotiated fee schedule consistent with the MassHealth Behavioral Health Urgent Care Provider methodology, provided that a carrier shall not lower a negotiated fee schedule to comply with this section. For purposes of this section, a carrier shall pay a rate add-on of at least15 per cent for all Behavioral Health Urgent Care Provider Services delivered by a Behavioral Health Urgent Care Provider regardless of whether the presenting reason for care is determined to be an urgent behavioral health need."