Massachusetts 2025-2026 Regular Session

Massachusetts Senate Bill S1390 Compare Versions

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

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1	1	1 of 1
2	2	SENATE DOCKET, NO. 1467 FILED ON: 1/16/2025
3	3	SENATE . . . . . . . . . . . . . . No. 1390
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Julian Cyr
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 access to psychiatric collaborative care.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :Julian CyrCape and Islands 1 of 4
16	16	SENATE DOCKET, NO. 1467 FILED ON: 1/16/2025
17	17	SENATE . . . . . . . . . . . . . . No. 1390
18	18	By Mr. Cyr, a petition (accompanied by bill, Senate, No. 1390) of Julian Cyr for legislation
19	19	relative to access to psychiatric collaborative care. Mental Health, Substance Use and Recovery.
20	20	The Commonwealth of Massachusetts
21	21	_______________
22	22	In the One Hundred and Ninety-Fourth General Court
23	23	(2025-2026)
24	24	_______________
25	25	An Act relative to access to psychiatric collaborative care.
26	26	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
27	27	of the same, as follows:
28	28	1 SECTION 1. Chapter 177 of the acts of 2022 is hereby amended by striking out Section
29	29	284 and inserting in place thereof the following section:-
30	30	3 Section 84. For the purposes of section 22A of chapter 32A of the General Laws, section
31	31	410P of chapter 118E of the General Laws, section 47QQ of chapter 175 of the General Laws,
32	32	5section 8RR of chapter 176A of the General Laws, section 4RR of chapter 176B of the General
33	33	6Laws and section 4JJ of chapter 176G of the General Laws, reimbursement for the psychiatric
34	34	7collaborative care model shall include, but not be limited to, the following current procedural
35	35	8terminology billing codes: (i) 99492; (ii) 99493; (iii) 99494; and (iv) G2214.
36	36	9 SECTION 2. Chapter 118E of the General Laws is hereby amended by inserting after
37	37	10section 13L the following section:-
38	38	11 Section 13M. (a) For the purposes of this section, “psychiatric collaborative care model”
39	39	12shall mean the evidence-based, integrated behavioral health service delivery method in which a 2 of 4
40	40	13primary care team consisting of a primary care provider and a care manager provides structured
41	41	14care management to a patient, and that works in collaboration with a psychiatric consultant that
42	42	15provides regular consultations to the primary care team to review the clinical status and care of
43	43	16patients and to make recommendations.
44	44	17 “Managed care entity”, all contracted health insurers, health plans, health maintenance
45	45	18organizations, behavioral health management firms and third party administrators under contract
46	46	19to a Medicaid managed care organization or primary care clinician plan, and accountable care
47	47	20organizations.
48	48	21 “Minimum payment rates”, rates of payment for services below which managed care
49	49	22entities may not enter into provider agreements.
50	50	23 (b) The division shall increase minimum payment rates for psychiatric collaborative care
51	51	24model billing codes such that they are equal to or greater than the current Medicare Resource-
52	52	25Based Relative Value Scale physician fee schedule for such codes and adjusted annually.
53	53	26 (c) Notwithstanding applicable state and federal laws, the division shall direct its
54	54	27managed care entities to increase minimum payment rates for psychiatric collaborative care
55	55	28model billing codes such that they are equal to or greater than the current Medicare Resource-
56	56	29Based Relative Value Scale physician fee schedule for such codes and adjusted annually.
57	57	30 (d) Pursuant to sections 13C and 13D, and notwithstanding applicable state and federal
58	58	31laws, the division shall ensure that psychiatric collaborative care model billing codes are
59	59	32removed from the defined set of billing codes included in the division’s accountable care
60	60	33organization primary care sub-capitation per-member per-month rate and that said codes shall be
61	61	34paid on a fee-for-service basis. 3 of 4
62	62	35 SECTION 3. Section 22A of Chapter 32A of the General Laws, as appearing in the 2022
63	63	36Official Edition, is hereby amended by inserting after the second paragraph the following
64	64	37paragraphs:-
65	65	38 (c) The commission shall increase minimum payment rates for psychiatric collaborative
66	66	39care model billing codes such that they are equal to or greater than the current Medicare
67	67	40Resource-Based Relative Value Scale physician fee schedule for such codes and adjusted
68	68	41annually.
69	69	42 SECTION 4. Section 47QQ of Chapter 175 of the General Laws, as so appearing, is
70	70	43hereby amended by inserting after the second paragraph the following paragraph:-
71	71	44 (c) An individual policy of accident and sickness insurance issued pursuant to section 108
72	72	45that provides hospital expense and surgical expense insurance or a group blanket or general
73	73	46policy of accident and sickness insurance issued pursuant to section 110 that provides hospital
74	74	47expense and surgical expense insurance that is issued or renewed within or without the
75	75	48commonwealth shall increase minimum payment rates for psychiatric collaborative care model
76	76	49billing codes such that they are equal to or greater than the current Medicare Resource-Based
77	77	50Relative Value Scale physician fee schedule for such codes and adjusted annually.
78	78	51 SECTION 5. Section 8RR of Chapter 176A of the General Laws, as so appearing, is
79	79	52hereby amended by inserting after the second paragraph the following paragraph:-
80	80	53 (c) A contract between a subscriber and the corporation under an individual or group
81	81	54hospital service plan which is delivered, issued or renewed within the commonwealth shall
82	82	55increase minimum payment rates for psychiatric collaborative care model billing codes such that 4 of 4
83	83	56they are equal to or greater than the current Medicare Resource-Based Relative Value Scale
84	84	57physician fee schedule for such codes and adjusted annually.
85	85	58 SECTION 6. Section 4RR of Chapter 176B of the General Laws, as so appearing, is
86	86	59hereby amended by inserting after the second paragraph the following paragraph:-
87	87	60 (c) A subscription certificate under an individual or group medical service agreement that
88	88	61is issued or renewed within the commonwealth shall increase minimum payment rates for
89	89	62psychiatric collaborative care model billing codes such that they are equal to or greater than the
90	90	63current Medicare Resource-Based Relative Value Scale physician fee schedule for such codes
91	91	64and adjusted annually.
92	92	65 SECTION 7. Section 4JJ of Chapter 176G of the General Laws, as so appearing, is
93	93	66hereby amended by inserting after the second paragraph the following paragraph:-
94	94	67 (c) Any individual or group health maintenance contract that is issued or renewed within
95	95	68the commonwealth shall increase minimum payment rates for psychiatric collaborative care
96	96	69model billing codes such that they are equal to or greater than the current Medicare Resource-
97	97	70Based Relative Value Scale physician fee schedule for such codes and adjusted annually.