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HOUSE DOCKET, NO. 3661 FILED ON: 1/20/2023
HOUSE . . . . . . . . . . . . . . . No. 1242
The Commonwealth of Massachusetts
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PRESENTED BY:
Jon Santiago
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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act providing equitable access to behavioral health services for MassHealth consumers.
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PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Jon Santiago9th Suffolk1/19/2023 1 of 2
HOUSE DOCKET, NO. 3661 FILED ON: 1/20/2023
HOUSE . . . . . . . . . . . . . . . No. 1242
By Representative Santiago of Boston, a petition (accompanied by bill, House, No. 1242) of Jon
Santiago relative to providing equitable access to behavioral health services for MassHealth
consumers. Health Care Financing.
The Commonwealth of Massachusetts
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In the One Hundred and Ninety-Third General Court
(2023-2024)
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An Act providing equitable access to behavioral health services for MassHealth consumers.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Section 12 of chapter 118E of the General Laws, as appearing in the 2020
2Official Edition, is hereby amended by inserting after the ninth paragraph the following
3paragraphs:-
4 The division shall certify and ensure that all contracted accountable care organizations,
5contracted health insurers, health plans, health maintenance organizations, and behavioral health
6management firms and third party administrators under contract to a Medicaid managed care
7organization or primary care clinician plan provide equal access to behavioral health services,
8benefits and medications of comparable quality in providing medical assistance to recipients.
9 The division shall obtain the approval of the secretary of the executive office of health
10and human services for all behavioral health services, benefits, and medications, including, but
11not limited to, policies, protocols, standards, contract specifications, utilization review and
12utilization management criteria and outcome measurements, used by all contracted accountable 2 of 2
13care organizations, contracted insurers, health plans, health maintenance organizations,
14behavioral health management firms and third party administrators under contract to a Medicaid
15managed care organization or primary care clinician plan.
16 Notwithstanding the provision of any general or special law to the contrary, all contracted
17accountable care organizations, contracted health insurers, health plans, health maintenance
18organizations and behavioral health management firms and third-party administrators under
19contract to a Medicaid managed care clinician plan shall submit its method of determining
20reimbursement levels to all network inpatient mental health and substance use providers and how
21such methodology is sufficient to meet the costs of providing inpatient care. Such method shall
22include, but not be limited to, the range of payment amounts including the median payment
23levels and how such payments are regularly updated. A report including this information shall be
24submitted to the division and the house and senate committees on ways and means; the
25committee on health care financing, and the committee on mental health, substance use and
26recovery no later than 90 days after the effective date of this act.