Budget Amendment ID: FY2027-S4-538

EHS 538

MassHealth Reform for Dually Eligible Individuals

Mr. DiDomenico moved that the proposed new text be amended in section 2, by inserting after section ___ the following section:-

"SECTION ___. Notwithstanding any general or special law to the contrary, including but not limited to 130 CMR 429.000 and 130 CMR 429.404, the MassHealth program shall provide payment to any provider that: (i) is licensed by the department of public health as a mental health center; and (ii) has been designated by MassHealth as a behavioral health urgent care center pursuant to said section 429.404, for covered services delivered to MassHealth members at the behavioral health urgent care case rate established by the executive office of health and human services.

For the purposes of this section, MassHealth shall provide such payment for all MassHealth members receiving covered services at a designated behavioral health urgent care center, including, without limitation, individuals who are dually eligible for benefits under Title XIX and Title XVIII of the federal Social Security Act.

The executive office of health and human services shall promulgate regulations or issue administrative guidance as necessary to implement this section, including the establishment or clarification of the applicable behavioral health urgent care case rate and billing requirements."