Amendment 543

Budget Amendment ID: FY2024-S3-543

EHS 543

Behavioral Health Hospital Support and Workforce Solutions

Messrs. Keenan, Lewis and Collins and Ms. Lovely moved that the proposed new text be amended by adding the following 8 new sections:-

“SECTION ___. Chapter 111 of the General Laws, as appearing in the 2020 Official Edition, is hereby amended in section 51½ by striking the definition of “licensed mental health professional” and inserting in place thereof the following:-

“Licensed mental health professional”, a: (i) licensed physician who specializes in the practice of psychiatry or addiction medicine; (ii) licensed psychologist; (iii) licensed independent clinical social worker; (iv) licensed certified social worker; (v) licensed mental health counselor; (vi) licensed mental health counselor; (vii) licensed physician assistant who practices in the field of psychiatry or addiction medicine; (viii) licensed psychiatric clinical nurse specialist; (ix) licensed psychiatric mental health nurse practitioner; (x) certified addictions registered nurse; (xi) licensed alcohol and drug counselor I as defined in section 1 of chapter 111J; (xii) healthcare provider, as defined in section 1, qualified within the scope of the individual's license to perform substance use disorder evaluations, including an intern, resident or fellow pursuant to the policies and practices of the hospital and medical staff; (xiii) other licensed master’s level mental health clinician, including, but not limited to, licensed alcohol and drug counselor and licensed marriage and family therapist; or (xiv) individual with a master’s degree in a clinical behavioral health practice pursuing licensure post master’s under the supervision of an appropriately licensed and credentialed clinician.

SECTION ___. Section 51¾ of chapter 111 of the General Laws, as inserted by Chapter 177 of the Acts of 2022, is hereby amended by striking out the second sentence and replacing it with the following sentence:-

The regulations shall define “licensed mental health professional”, which shall include, but not be limited to, a: (i) licensed physician who specializes in the practice of psychiatry or addiction medicine; (ii) licensed psychologist; (iii) licensed independent clinical social worker; (iv) licensed certified social worker; (v) licensed mental health counselor; (vi) licensed supervised mental health counselor; (vii) licensed physician assistant who practices in the field of psychiatry; (viii) licensed psychiatric clinical nurse specialist; (ix) licensed psychiatric mental health nurse practitioner; (x) healthcare provider, as defined in section 1, qualified within the scope of the individual's license to conduct an evaluation of a mental health condition, including an intern, resident or fellow pursuant to the policies and practices of the hospital and medical staff; (xi) other licensed master’s level mental health clinician, including, but not limited to, licensed alcohol and drug counselor and licensed marriage and family therapist; or (xii) individual with a master’s degree in a clinical behavioral health practice pursuing licensure post master’s under the supervision of an appropriately licensed and credentialed clinician.

SECTION ___. Section 1 of chapter 175 of the general laws, as amended by chapter 177 of the acts of 2022, is hereby amended by inserting after the definition of “Domestic company” the following definition:-

“Emergency services programs”, all programs subject to contract between the Massachusetts Behavioral Health Partnership and provider organizations for the provision of acute care hospital and community-based emergency behavioral health services, including, but not limited to, behavioral health crisis assessment, intervention and stabilization services 24 hours per day, 7 days per week, through: (i) mobile crisis intervention services for youth; (ii) mobile crisis intervention services for adults; (iii) emergency service provider community-based locations; (iv) emergency departments of acute care hospitals or satellite emergency facilities; (v) adult community crisis stabilization services; and (vi) youth community crisis stabilization services.

SECTION ___. Section 47B of chapter 175 of the General Laws, as so appearing, is hereby amended by striking out the second paragraph of subsection (i) and replacing it with the following paragraph:-

For the purposes of this section, ''licensed mental health professional'' shall mean a licensed physician who specializes in the practice of psychiatry or addiction medicine; a licensed psychologist; a licensed independent clinical social worker; a licensed mental health counselor; a licensed nurse mental health clinical specialist; a licensed physician assistant who practices in the field of psychiatry or addiction medicine; a licensed psychiatric mental health nurse practitioner, other licensed master’s level mental health clinician including, but not limited to, a licensed alcohol and drug counselor I, as defined in section 1 of chapter 111J, or a licensed marriage and family therapist within the lawful scope of practice for such therapist; or a clinician practicing under the supervision of a licensed professional, and working towards licensure, in a clinic or hospital licensed under chapter 111.

SECTION ___. Section 8A of chapter 176A of the general laws, as amended by chapter 177 of the acts of 2022, is hereby amended by striking out the second paragraph of subsection (i) and replacing it with the following paragraph:-

SECTION ___. Section 4A of chapter 176B of the general laws, as amended by chapter 177 of the acts of 2022, is hereby amended by striking out the second paragraph of subsection (i) and replacing it with the following paragraph:-

SECTION ___. Section 4M of chapter 176G of the general laws, as amended by chapter 177 of the acts of 2022, is hereby amended by striking out the second paragraph of subsection (i) and replacing it with the following paragraph:-

SECTION ___. Notwithstanding any general or special law to the contrary, the division of insurance, in consultation with the division of medical assistance, shall promulgate regulations or issue sub-regulatory guidance, within 30 days of the effective date of this act, to require carriers reimburse acute care hospitals with emergency departments or satellite emergency facilities for the provision of emergency behavioral health services, including, but not limited to, behavioral health crisis assessment, intervention, and stabilization services. The regulations or sub-regulatory guidance shall include reimbursement for the provision of emergency behavioral services via telemedicine, electronic or telephonic consultation, in accordance with section 51¾ of chapter 111 of the general laws. The contractual rate for these services may be no less than the prevailing MassHealth rate for behavioral health emergency department crisis evaluations. This does not preclude a hospital from billing for other medically necessary services traditionally reimbursed through an emergency department visit and is also in addition to required reimbursement by carriers for each day a member waits in an emergency department, observation unit or inpatient floor for placement in an appropriate inpatient psychiatric placement, as required by section 78 of chapter 177 of the acts of 2022. The insurer shall reimburse other medically necessary services and for patients awaiting an inpatient psychiatric placement in addition to payment for emergency behavioral health services. Behavioral health services provided in this setting under this section shall be deemed medically necessary and shall not require prior authorization by an insurer.”