Massachusetts 2023-2024 Regular Session

Massachusetts House Bill H1156 Compare Versions

Only one version of the bill is available at this time.

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1	1	1 of 1
2	2	HOUSE DOCKET, NO. 1951 FILED ON: 1/19/2023
3	3	HOUSE . . . . . . . . . . . . . . . No. 1156
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Andres X. Vargas and Kate Donaghue
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act relative to opioid use disorder treatment and rehabilitation coverage.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :DATE ADDED:Andres X. Vargas3rd Essex1/18/2023Kate Donaghue19th Worcester1/19/2023Mindy Domb3rd Hampshire1/25/2023Jack Patrick Lewis7th Middlesex1/26/2023David Paul Linsky5th Middlesex1/26/2023Christine P. Barber34th Middlesex1/27/2023Carmine Lawrence Gentile13th Middlesex2/9/2023Priscila S. Sousa6th Middlesex2/15/2023Smitty Pignatelli3rd Berkshire2/24/2023 1 of 6
16	16	HOUSE DOCKET, NO. 1951 FILED ON: 1/19/2023
17	17	HOUSE . . . . . . . . . . . . . . . No. 1156
18	18	By Representatives Vargas of Haverhill and Donaghue of Westborough, a petition (accompanied
19	19	by bill, House, No. 1156) of Andres X. Vargas, Kate Donaghue and others relative to opioid use
20	20	disorder treatment and rehabilitation. Financial Services.
21	21	The Commonwealth of Massachusetts
22	22	_______________
23	23	In the One Hundred and Ninety-Third General Court
24	24	(2023-2024)
25	25	_______________
26	26	An Act relative to opioid use disorder treatment and rehabilitation coverage.
27	27	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
28	28	of the same, as follows:
29	29	1 SECTION 1. Subsection (a) of section 2RRRR of chapter 29 of the General Laws, as
30	30	2appearing in the 2018 Official Edition, is hereby amended by inserting after the word “services”,
31	31	3in line 6, the following words:- , including certain non-profit substance use disorder treatment
32	32	4facilities pursuant to section 19E of chapter 94C,.
33	33	5 SECTION 2. Chapter 32A of the General Laws is hereby amended by inserting after
34	34	6section 17R, as inserted by section 2 of chapter 260 of the acts of 2020, the following section:-
35	35	7 Section 17S. Any coverage offered by the commission to an active or retired employee of
36	36	8the commonwealth insured under the group insurance commission shall provide coverage for
37	37	9prescribed or dispensed opioid antagonists as defined in section 19B of chapter 94C, and opioid
38	38	10agonist treatment, including partial agonist treatment. The prescribed or dispensed drug in this
39	39	11section shall be deemed medically necessary and shall not require prior authorization. Said drug
40	40	12shall not be subject to deductible, coinsurance, copayments or out-of-pocket limits. The 2 of 6
41	41	13commission shall reimburse providers, including but not limited to acute care hospitals,
42	42	14freestanding psychiatric facilities, and substance use disorder facilities, that dispense opioid
43	43	15antagonist, opioid agonist treatment and partial agonist treatment directly to the patient.
44	44	16 SECTION 2. Chapter 94C of the General Laws is hereby amended by inserting after
45	45	17section 19D the following section:-
46	46	18 Section 19E. (a) For the purposes of this section, the following words shall, unless the
47	47	19context clearly requires otherwise, have the following meanings:
48	48	20 “Opioid antagonist”, as defined in section 19B.
49	49	21 “Substance use disorder treatment facility”, nonprofit or for-profit facilities that offer: (i)
50	50	22acute treatment services and detoxification services; (ii) clinical stabilization services; (iii)
51	51	23transitional support services; (iv) residential support services; or (v) outpatient counseling
52	52	24services.
53	53	25 (b) Upon discharge of a patient from a substance use disorder treatment facility, the
54	54	26facility shall prescribe and dispense no less than 2 doses of an opioid antagonist to the patient or
55	55	27a legal guardian.
56	56	28 (c) The department of public health may subject to appropriation provide, at no cost to
57	57	29the substance use disorder treatment facility, opioid antagonists to nonprofit substance use
58	58	30disorder treatment facilities to be dispensed to patients pursuant to this section.
59	59	31 SECTION 3. Section 25J½ of chapter 111 of the General Laws, as appearing in the 2020
60	60	32Official Edition, is hereby amended by inserting after the first paragraph the following
61	61	33paragraph:- 3 of 6
62	62	34 Upon discharge of a patient who has a history of or is actively using opioids, diagnosed
63	63	35with opioid use disorder or who experienced an opioid-related overdose, the acute care hospital
64	64	36or satellite emergency facility shall prescribe or dispense no less than 2 doses of an opioid
65	65	37antagonist to the patient and notify the patient’s primary care physician or preferred care
66	66	38provider in consultation with the patient, if known. For the purposes of this section, “opioid
67	67	39antagonist” shall be as defined in section 19B of chapter 94C.
68	68	40 SECTION 4. Said chapter 111 is hereby amended by adding the following section:-
69	69	41 Section 243. The department shall, subject to appropriation, purchase doses of opioid
70	70	42antagonists, as defined in section 19B of chapter 94C, for distribution to acute care hospitals,
71	71	43community behavioral health centers and nonprofit substance use disorder treatment facilities
72	72	44pursuant to section 19E of chapter 94C.
73	73	45 The department shall notify said nonprofit substance use disorder treatment facilities that
74	74	46they may participate in the Municipal Naloxone Bulk Purchase Trust Fund pursuant to section
75	75	472RRRR of chapter 29.
76	76	48 SECTION 5. Chapter 118E of the General Laws is hereby amended by inserting after
77	77	49section 10N, as inserted by section 39 of said chapter 260, the following section:-
78	78	50 Section 10O. The division and its contracted health insurers, health plans, health
79	79	51maintenance organizations, behavioral health management firms and third-party administrators
80	80	52under contract to a Medicaid managed care organization, accountable care organization, or
81	81	53primary care clinician plan shall provide coverage for prescribed or dispensed opioid antagonists,
82	82	54as defined in section 19B of chapter 94C, and opioid agonist treatment, including partial agonist
83	83	55treatment. The prescribed or dispensed drug in this section shall be deemed medically necessary 4 of 6
84	84	56and shall not require prior authorization. Said drug shall not be subject to any deductible,
85	85	57coinsurance, copayments or out-of-pocket limits. The division and its contracted health insurers,
86	86	58health plans, health maintenance organizations, behavioral health management firms and third-
87	87	59party administrators shall reimburse providers, including but not limited to acute care hospitals,
88	88	60freestanding psychiatric facilities, and substance use disorder facilities, that dispense opioid
89	89	61antagonist, opioid agonist treatment and partial agonist treatment directly to the patient.
90	90	62 SECTION 6. Chapter 175 of the General Laws is hereby amended by inserting after
91	91	63section 47NN, as inserted by section 47 of said chapter 260, the following section:-
92	92	64 Section 47OO. Any policy, contract, agreement, plan or certificate of insurance issued,
93	93	65delivered or renewed within the commonwealth, which is considered creditable coverage under
94	94	66section 1 of chapter 118M, shall provide coverage for prescribed or dispensed opioid antagonists,
95	95	67as defined in section 19B of chapter 94C, and opioid agonist treatment, including partial agonist
96	96	68treatment. The prescribed or dispensed drug in this section shall be deemed medically necessary
97	97	69and shall not require prior authorization. Said drug shall not be subject to any deductible,
98	98	70coinsurance, copayments or out-of-pocket limits. The policy, contract, agreement, plan or
99	99	71certificate of insurance shall reimburse providers, including but not limited to acute care
100	100	72hospitals, freestanding psychiatric facilities, and substance use disorder facilities, that dispense
101	101	73opioid antagonist, opioid agonist treatment and partial agonist treatment directly to the patient.
102	102	74 SECTION 7. Chapter 176A of the General Laws is hereby amended by inserting after
103	103	75section 8OO, as inserted by section 48 of said chapter 260, the following section:-
104	104	76 Section 8PP. Any contract between a subscriber and the corporation under an individual
105	105	77or group hospital service plan that is delivered, issued, or renewed within the commonwealth 5 of 6
106	106	78shall provide, coverage for prescribed or dispensed opioid antagonists, as defined in section 19B
107	107	79of chapter 94C, and opioid agonist treatment, including partial agonist treatment. The prescribed
108	108	80or dispensed drug in this section shall be deemed medically necessary and shall not require prior
109	109	81authorization. Said drug shall not be subject to any deductible, coinsurance, copayments or out-
110	110	82of-pocket limits. The contract shall reimburse providers, including but not limited to acute care
111	111	83hospitals, freestanding psychiatric facilities, and substance use disorder facilities, that dispense
112	112	84opioid antagonist, opioid agonist treatment and partial agonist treatment directly to the patient.
113	113	85 SECTION 8. Chapter 176B of the General Laws is hereby amended by inserting after
114	114	86section 4OO, as inserted by section 50 of said chapter 260, the following section:-
115	115	87 Section 4PP. Any subscription certificate under an individual or group medical service
116	116	88agreement delivered or issued or renewed in the commonwealth, shall provide coverage for
117	117	89prescribed or dispensed opioid antagonists, as defined in section 19B of chapter 94C, and opioid
118	118	90agonist treatment, including partial agonist treatment. The prescribed or dispensed drug in this
119	119	91section shall be deemed medically necessary and shall not require prior authorization. Said drug
120	120	92shall not be subject to any deductible, coinsurance, copayments or out-of-pocket limits. The
121	121	93subscription certificate shall reimburse providers, including but not limited to acute care
122	122	94hospitals, freestanding psychiatric facilities, and substance use disorder facilities, that dispense
123	123	95opioid antagonist, opioid agonist treatment and partial agonist treatment directly to the patient.
124	124	96 SECTION 9. Chapter 176G of the General Laws is hereby amended by inserting after
125	125	97section 4GG, as inserted by section 52 of said chapter 260, the following section:-
126	126	98 Section 4HH. An individual or group health maintenance contract that is issued or
127	127	99renewed within or without the commonwealth shall provide coverage for prescribed or dispensed 6 of 6
128	128	100opioid antagonists, as defined in section 19B of chapter 94C, and opioid agonist treatment,
129	129	101including partial agonist treatment. The prescribed or dispensed drug in this section shall be
130	130	102deemed medically necessary and shall not require prior authorization. Said drug shall not be
131	131	103subject to any deductible, coinsurance, copayments or out-of-pocket limits. The individual or
132	132	104group health maintenance contract shall reimburse providers, including but not limited to acute
133	133	105care hospitals, freestanding psychiatric facilities, and substance use disorder facilities, that
134	134	106dispense opioid antagonist treatment, opioid agonist treatment and partial agonist treatment
135	135	107directly to the patient.
136	136	108 SECTION 11. Notwithstanding any general or special law to the contrary, the division of
137	137	109insurance, in consultation with the division of medical assistance, shall promulgate regulations or
138	138	110issue sub-regulatory guidance to require carriers reimburse providers, including but not limited
139	139	111to acute care hospitals, freestanding psychiatric facilities, and substance use disorder facilities,
140	140	112for opioid antagonist and opioid agonist treatment, including partial agonist treatment, dispensed
141	141	113directly to the patient.