Massachusetts 2025-2026 Regular Session

Massachusetts Senate Bill S742 Compare Versions

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

Old	New	Differences
1	1	1 of 1
2	2	SENATE DOCKET, NO. 1890 FILED ON: 1/16/2025
3	3	SENATE . . . . . . . . . . . . . . No. 742
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Paul R. Feeney
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 cognitive rehabilitation for individuals with an acquired brain injury.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :Paul R. FeeneyBristol and NorfolkJames B. EldridgeMiddlesex and Worcester2/4/2025Dylan A. FernandesPlymouth and Barnstable2/10/2025Jacob R. OliveiraHampden, Hampshire and Worcester2/10/2025Joanne M. ComerfordHampshire, Franklin and Worcester2/15/2025Sal N. DiDomenicoMiddlesex and Suffolk2/20/2025Nick CollinsFirst Suffolk3/4/2025Michael O. MooreSecond Worcester3/7/2025 1 of 17
16	16	SENATE DOCKET, NO. 1890 FILED ON: 1/16/2025
17	17	SENATE . . . . . . . . . . . . . . No. 742
18	18	By Mr. Feeney, a petition (accompanied by bill, Senate, No. 742) of Paul R. Feeney, James B.
19	19	Eldridge, Dylan A. Fernandes, Jacob R. Oliveira and other members of the Senate for legislation
20	20	relative to cognitive rehabilitation. Financial Services.
21	21	[SIMILAR MATTER FILED IN PREVIOUS SESSION
22	22	SEE SENATE, NO. 635 OF 2023-2024.]
23	23	The Commonwealth of Massachusetts
24	24	_______________
25	25	In the One Hundred and Ninety-Fourth General Court
26	26	(2025-2026)
27	27	_______________
28	28	An Act relative to cognitive rehabilitation for individuals with an acquired brain injury.
29	29	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
30	30	of the same, as follows:
31	31	1 SECTION 1. Chapter 32A of the General Laws, as appearing in the 2022 Official Edition
32	32	2Official Edition, is hereby amended by inserting after section 17R the following section:-
33	33	3 Section 17S. (a) For purposes of this section, the following terms shall have the following
34	34	4meanings:-
35	35	5 “Acquired brain injury (ABI)” is any injury to the brain which occurs after birth and can
36	36	6be caused by infectious diseases, metabolic disorders, endocrine disorders or diminished oxygen,
37	37	7brain tumors, toxins, disease that affects the blood supply to the brain, stroke or a traumatic brain
38	38	8injury. 2 of 17
39	39	9 “Cognitive communication therapy” treats problems with communication which have an
40	40	10underlying cause in a cognitive deficit rather than a primary language or speech deficit.
41	41	11 “Cognitive rehabilitation therapy (CRT)” is a process of re-learning cognitive skills
42	42	12essential for daily living through the coordinated specialized, integrated therapeutic treatments
43	43	13which are provided in dynamic settings designed for efficient and effective re-learning following
44	44	14damage to brain cells or brain chemistry due to brain injury.
45	45	15 “Community reintegration services” provide incremental guided real-world therapeutic
46	46	16training to develop skills essential for an individual to participate in life: to re-enter employment;
47	47	17to go to school and engage in other productive activity; to safely live independently; and to
48	48	18participate in their community while avoiding re-hospitalization and long-term support needs.
49	49	19 “Functional rehabilitation therapy and remediation” is a structured approach to
50	50	20rehabilitation for brain disorders which emphasizes learning by doing, and focuses re-learning a
51	51	21specific task in a prescribed format, with maximum opportunity for repeated correct practice.
52	52	22Compensatory strategies are developed for those skills which are persistently impaired and
53	53	23individuals are trained on daily implementation. To ensure acquisition and use, focus is set on re-
54	54	24learning those skills essential for safe daily living in the environment in which they will be used:
55	55	25home and community settings.
56	56	26 “Medical necessity” or “medically necessary,” health care services that are consistent
57	57	27with generally accepted principles of professional medical practice.
58	58	28 “Neurobehavioral therapy” is a set of medical and therapeutic assessment and treatments
59	59	29focused on behavioral impairments associated with brain disease or injury and the amelioration
60	60	30of these impairments through the development of pro-social behavior. 3 of 17
61	61	31 “Neurocognitive therapy” is treatment of disorders in which the primary clinical deficit is
62	62	32in cognitive function which has not been present since birth and is a decline from a previously
63	63	33attained level of function.
64	64	34 “Neurofeedback therapy” is a direct training of brain function to enhance self-regulatory
65	65	35capacity or an individual’s ability to exert control over behavior, thoughts and feelings. It is a
66	66	36form of biofeedback whereby a patient can learn to control brain activity that is measured and
67	67	37recorded by an electroencephalogram.
68	68	38 “Neuropsychological testing” is a set of medical and therapeutic assessment and
69	69	39treatments focused on amelioration of cognitive, emotional, psychosocial and behavioral deficits
70	70	40caused by brain injury.
71	71	41 “Psychophysiological testing and treatment” is a set of medical and therapeutic
72	72	42assessment and treatments focused on psychophysiological disorders or physical disorders with
73	73	43psychological overlay.
74	74	44 “Post-acute residential treatment” includes integrated medical and therapeutic services,
75	75	45treatment, education, and skills training within a 24/7 real-world environment of care- a home
76	76	46and community setting. Maximum opportunity to for correct practice of skill in the context of
77	77	47use develops new neural pathways which ensure ongoing skill use and avoidance of re-
78	78	48hospitalization and long-term care.
79	79	49 (b) Any coverage offered by the commission to an active or retired employee of the
80	80	50commonwealth insured under the group insurance commission shall provide coverage for
81	81	51medically necessary treatment related to or as a result of an acquired brain injury. Medically
82	82	52necessary treatment shall include, but is not limited to, cognitive rehabilitation therapy; cognitive 4 of 17
83	83	53communication therapy; neurocognitive therapy and rehabilitation; neurobehavioral,
84	84	54neurophysiological, neuropsychological and psychophysiological testing and treatment;
85	85	55neurofeedback therapy; functional rehabilitation therapy and remediation; community
86	86	56reintegration services; post-acute residential treatment services; inpatient services; outpatient and
87	87	57day treatment services; home and community based treatment. The benefits in this section shall
88	88	58not include any lifetime limitation or unreasonable annual limitation of the number of days or
89	89	59sessions of treatment services. Any limitations shall be separately stated by the commission. The
90	90	60benefits in this section shall not be subject to any greater deductible, coinsurance, copayments, or
91	91	61out-of-pocket limits than any other benefit provided by the commission.
92	92	62 (c) The commissioner of insurance shall require a health benefit plan issuer to provide
93	93	63adequate training to personnel responsible for preauthorization of coverage or utilization review
94	94	64for services under this section, in consultation with the Brain Injury Association of
95	95	65Massachusetts.
96	96	66 (d) Individual practitioners and treatment facilities shall be qualified to provide acute care
97	97	67and post-acute care rehabilitation services through possession of the appropriate licenses,
98	98	68accreditation, training and experience deemed customary and routine in the trade practice.
99	99	69 SECTION 2. Chapter 175 of the General Laws, as appearing in the 2022 Official Edition,
100	100	70is hereby amended by inserting after section 47QQ, the following section:-
101	101	71 Section 47RR. (a) For purposes of this section, the following terms shall have the
102	102	72following meanings:-
103	103	73 “Acquired brain injury (ABI)” is any injury to the brain which occurs after birth and can
104	104	74be caused by infectious diseases, metabolic disorders, endocrine disorders or diminished oxygen, 5 of 17
105	105	75brain tumors, toxins, disease that affects the blood supply to the brain, stroke or a traumatic brain
106	106	76injury.
107	107	77 “Cognitive communication therapy” treats problems with communication which have an
108	108	78underlying cause in a cognitive deficit rather than a primary language or speech deficit.
109	109	79 “Cognitive rehabilitation therapy (CRT)” is a process of relearning cognitive skills
110	110	80essential for daily living through the coordinated specialized, integrated therapeutic treatments
111	111	81which are provided in dynamic settings designed for efficient and effective re-learning following
112	112	82damage to brain cells or brain chemistry due to brain injury.
113	113	83 “Community reintegration services” provide incremental guided real-world therapeutic
114	114	84training to develop skills essential for an individual to participate in life: to re-enter employment;
115	115	85to go to school and engage in other productive activity; to safely live independently; and to
116	116	86participate in their community while avoiding re-hospitalization and long-term support needs.
117	117	87 “Functional rehabilitation therapy and remediation” is a structured approach to
118	118	88rehabilitation for brain disorders which emphasizes learning by doing, and focuses relearning a
119	119	89specific task in a prescribed format, with maximum opportunity for repeated correct practice.
120	120	90Compensatory strategies are developed for those skills which are persistently impaired and
121	121	91individuals are trained on daily implementation. To ensure acquisition and use, focus is set on re-
122	122	92learning those skills essential for safe daily living in the environment in which they will be used:
123	123	93home and community settings.
124	124	94 “Medical necessity” or “medically necessary,” health care services that are consistent
125	125	95with generally accepted principles of professional medical practice. 6 of 17
126	126	96 “Neurobehavioral therapy” is a set of medical and therapeutic assessment and treatments
127	127	97focused on behavioral impairments associated with brain disease or injury and the amelioration
128	128	98of these impairments through the development of pro-social behavior.
129	129	99 “Neurocognitive therapy” is treatment of disorders in which the primary clinical deficit is
130	130	100in cognitive function which has not been present since birth and is a decline from a previously
131	131	101attained level of function.
132	132	102 “Neurofeedback therapy” is a direct training of brain function to enhance self-regulatory
133	133	103capacity or an individual’s ability to exert control over behavior, thoughts and feelings. It is a
134	134	104form of biofeedback whereby a patient can learn to control brain activity that is measured and
135	135	105recorded by an electroencephalogram.
136	136	106 “Neuropsychological testing” is a set of medical and therapeutic assessment and
137	137	107treatments focused on amelioration of cognitive, emotional, psychosocial and behavioral deficits
138	138	108caused by brain injury.
139	139	109 “Psychophysiological testing and treatment” is a set of medical and therapeutic
140	140	110assessment and treatments focused on psychophysiological disorders or physical disorders with
141	141	111psychological overlay.
142	142	112 “Post-acute residential treatment” includes integrated medical and therapeutic services,
143	143	113treatment, education, and skills training within a 24/7 real-world environment of care - a home
144	144	114and community setting. Maximum opportunity for correct practice of skill in the context of use
145	145	115develops new neural pathways which ensure ongoing skill use and avoidance of re-
146	146	116hospitalization and long-term care. 7 of 17
147	147	117 (b) The following shall provide coverage for medically necessary treatment related to or
148	148	118as a result of an acquired brain injury: (ii)any policy of accident and sickness insurance, as
149	149	119described in section 108, which provides hospital expense and surgical expense insurance and
150	150	120which is delivered, issued or subsequently renewed by agreement between the insurer and
151	151	121policyholder in the commonwealth; (ii) any blanket or general policy of insurance described in
152	152	122subdivision (A), (C) or (D) of section 110 which provides hospital expense and surgical expense
153	153	123insurance and which is delivered, issued or subsequently renewed by agreement between the
154	154	124insurer and the policyholder in or outside of the commonwealth; or (iii) any employees’ health
155	155	125and welfare fund which provides hospital expense and surgical expense benefits and which is
156	156	126delivered, issued or renewed to any person or group of persons in the commonwealth. Medically
157	157	127necessary treatment shall include, but is not limited to, cognitive rehabilitation therapy; cognitive
158	158	128communication therapy; neurocognitive therapy and rehabilitation; neurobehavioral,
159	159	129neurophysiological, neuropsychological and psychophysiological testing and treatment;
160	160	130neurofeedback therapy; functional rehabilitation therapy and remediation; community
161	161	131reintegration services; post-acute residential treatment services; inpatient services; outpatient and
162	162	132day treatment services; home and community based treatment. The benefits in this section shall
163	163	133not include any lifetime limitation or unreasonable annual limitation of the number of days or
164	164	134sessions of treatment services. Any limitations shall be separately stated by the insurer. The
165	165	135benefits in this section shall not be subject to any greater deductible, coinsurance, copayments, or
166	166	136out-of-pocket limits than any other benefit provided by the insurer.
167	167	137 (c) The commissioner of insurance shall require a health benefit plan issuer to provide
168	168	138adequate training to personnel responsible for preauthorization of coverage or utilization review 8 of 17
169	169	139for services under this section, in consultation with the Brain Injury Association of
170	170	140Massachusetts.
171	171	141 (d) Individual practitioners and treatment facilities shall be qualified to provide acute care
172	172	142and post-acute care rehabilitation services through possession of the appropriate licenses,
173	173	143accreditation, training and experience deemed customary and routine in the trade practice.
174	174	144 SECTION 3. Chapter 176A of the General Law, as appearing in the 2022 Official
175	175	145Edition, is hereby amended by inserting after section 8QQ the following section:-
176	176	146 Section 8RR. (a) For purposes of this section, the following terms shall have the
177	177	147following meanings:-
178	178	148 “Acquired brain injury (ABI)” is any injury to the brain which occurs after birth and can
179	179	149be caused by infectious diseases, metabolic disorders, endocrine disorders or diminished oxygen,
180	180	150brain tumors, toxins, disease that affects the blood supply to the brain, stroke or a traumatic brain
181	181	151injury.
182	182	152 “Cognitive communication therapy” treats problems with communication which have an
183	183	153underlying cause in a cognitive deficit rather than a primary language or speech deficit.
184	184	154 “Cognitive rehabilitation therapy (CRT)” is a process of re-learning cognitive skills
185	185	155essential for daily living through the coordinated specialized, integrated therapeutic treatments
186	186	156which are provided in dynamic settings designed for efficient and effective re-learning following
187	187	157damage to brain cells or brain chemistry due to brain injury.
188	188	158 “Community reintegration services” provide incremental guided real-world therapeutic
189	189	159training to develop skills essential for an individual to participate in life: to re-enter employment; 9 of 17
190	190	160to go to school and engage in other productive activity; to safely live independently; and to
191	191	161participate in their community while avoiding re-hospitalization and long-term support needs.
192	192	162 “Functional rehabilitation therapy and remediation” is a structured approach to
193	193	163rehabilitation for brain disorders which emphasizes learning by doing, and focuses re-learning a
194	194	164specific task in a prescribed format with maximum opportunity for repeated correct practice.
195	195	165Compensatory strategies are developed for those skills which are persistently impaired and
196	196	166individuals are trained on daily implementation. To ensure acquisition and use, focus is set on re-
197	197	167learning those skills essential for safe daily living in the environment in which they will be used:
198	198	168home and community settings.
199	199	169 “Medical necessity” or “medically necessary,” health care services that are consistent
200	200	170with generally accepted principles of professional medical practice.
201	201	171 “Neurobehavioral therapy” is a set of medical and therapeutic assessment and treatments
202	202	172focused on behavioral impairments associated with brain disease or injury and the amelioration
203	203	173of these impairments through the development of pro-social behavior.
204	204	174 “Neurocognitive therapy” is treatment of disorders in which the primary clinical deficit is
205	205	175in cognitive function which has not been present since birth and is a decline from a previously
206	206	176attained level of function.
207	207	177 “Neurofeedback therapy” is a direct training of brain function to enhance self-regulatory
208	208	178capacity or an individual’s ability to exert control over behavior, thoughts and feelings. It is a
209	209	179form of biofeedback whereby a patient can learn to control brain activity that is measured and
210	210	180recorded by an electroencephalogram. 10 of 17
211	211	181 “Neuropsychological testing” is a set of medical and therapeutic assessment and
212	212	182treatments focused on amelioration of cognitive, emotional, psychosocial and behavioral deficits
213	213	183caused by brain injury.
214	214	184 “Psychophysiological testing and treatment” is a set of medical and therapeutic
215	215	185assessment and treatments focused on psychophysiological disorders or physical disorders with
216	216	186psychological overlay.
217	217	187 “Post-acute residential treatment” includes integrated medical and therapeutic services,
218	218	188treatment, education, and skills training within a 24/7 real-world environment of care- a home
219	219	189and community setting. Maximum opportunity for correct practice of skill in the context of use
220	220	190develops new neural pathways which ensure ongoing skill use and avoidance of re-
221	221	191hospitalization and long-term care.
222	222	192 (b) Any contract between a subscriber and the corporation under an individual or group
223	223	193hospital service plan which is delivered, issued or renewed within the commonwealth shall
224	224	194provide coverage for medically necessary treatment related to or as a result of an acquired brain
225	225	195injury. Medically necessary treatment shall include, but is not limited to, cognitive rehabilitation
226	226	196therapy; cognitive communication therapy; neurocognitive therapy and rehabilitation;
227	227	197neurobehavioral, neurophysiological, neuropsychological and psychophysiological testing and
228	228	198treatment; neurofeedback therapy; functional rehabilitation therapy and remediation; community
229	229	199reintegration services; post-acute residential treatment services; inpatient services; outpatient and
230	230	200day treatment services; home and community based treatment. The benefits in this section shall
231	231	201not include any lifetime limitation or unreasonable annual limitation of the number of days or
232	232	202sessions of treatment services. Any limitations shall be separately stated by the insurer. The 11 of 17
233	233	203benefits in this section shall not be subject to any greater deductible, coinsurance, copayments, or
234	234	204out-of-pocket limits than any other benefit provided by the insurer.
235	235	205 (c) The commissioner of insurance shall require a health benefit plan issuer to provide
236	236	206adequate training to personnel responsible for preauthorization of coverage or utilization review
237	237	207for services under this section, in consultation with the Brain Injury Association of
238	238	208Massachusetts.
239	239	209 (d) Individual practitioners and treatment facilities shall be qualified to provide acute care
240	240	210and post-acute care rehabilitation services through possession of the appropriate licenses,
241	241	211accreditation, training and experience deemed customary and routine in the trade practice.
242	242	212 SECTION 4. Chapter 176B of the General Laws, as appearing in the 2022 Official
243	243	213Edition, is hereby amended by inserting after section 4QQ the following section:-
244	244	214 Section 4RR. (a) For purposes of this section, the following terms shall have the
245	245	215following meanings:-
246	246	216 “Acquired brain injury (ABI)” is any injury to the brain which occurs after birth and can
247	247	217be caused by infectious diseases, metabolic disorders, endocrine disorders or diminished oxygen,
248	248	218brain tumors, toxins, disease that affects the blood supply to the brain, stroke or a traumatic brain
249	249	219injury.
250	250	220 “Cognitive communication therapy” treats problems with communication which have an
251	251	221underlying cause in a cognitive deficit rather than a primary language or speech deficit.
252	252	222 “Cognitive rehabilitation therapy (CRT)” is a process of relearning cognitive skills
253	253	223essential for daily living through the coordinated specialized, integrated therapeutic treatments 12 of 17
254	254	224which are provided in dynamic settings designed for efficient and effective re-learning following
255	255	225damage to brain cells or brain chemistry due to brain injury.
256	256	226 “Community reintegration services” provide incremental guided real-world therapeutic
257	257	227training to develop skills essential for an individual to participate in life: to re-enter employment;
258	258	228to go to school and engage in other productive activity; to safely live independently; and to
259	259	229participate in their community while avoiding re-hospitalization and long-term support needs.
260	260	230 “Functional rehabilitation therapy and remediation” is a structured approach to
261	261	231rehabilitation for brain disorders which emphasizes learning by doing, and focuses re-learning a
262	262	232specific task in a prescribed format, with maximum opportunity for repeated correct practice.
263	263	233Compensatory strategies are developed for those skills which are persistently impaired and
264	264	234individuals are trained on daily implementation. To ensure acquisition and use, focus is set on re-
265	265	235learning those skills essential for safe on daily living in the environment in which they will be
266	266	236used: home and community settings.
267	267	237 “Medical necessity” or “medically necessary,” health care services that are consistent
268	268	238with generally accepted principles of professional medical practice.
269	269	239 “Neurobehavioral therapy” is a set of medical and therapeutic assessment and treatments
270	270	240focused on behavioral impairments associated with brain disease or injury and the amelioration
271	271	241of these impairments through the development of pro-social behavior.
272	272	242 “Neurocognitive therapy” is treatment of disorders in which the primary clinical deficit is
273	273	243in cognitive function which has not been present since birth and is a decline from a previously
274	274	244attained level of function. 13 of 17
275	275	245 “Neurofeedback therapy” is a direct training of brain function to enhance self-regulatory
276	276	246capacity or an individual’s ability to exert control over behavior, thoughts and feelings. It is a
277	277	247form of biofeedback whereby a patient can learn to control brain activity that is measured and
278	278	248recorded by an electroencephalogram.
279	279	249 “Neuropsychological testing” is a set of medical and therapeutic assessment and
280	280	250treatments focused on amelioration of cognitive, emotional, psychosocial and behavioral deficits
281	281	251caused by brain injury;
282	282	252 “Psychophysiological testing and treatment” is a set of medical and therapeutic
283	283	253assessment and treatments focused on psychophysiological disorders or physical disorders with
284	284	254psychological overlay.
285	285	255 “Post-acute residential treatment” includes integrated medical and therapeutic services,
286	286	256treatment, education, and skills training within a 24/7 real-world environment of care, – a home
287	287	257and community setting. Maximum opportunity for correct practice of skill in the context of use
288	288	258develops new neural pathways which ensure ongoing skill use and avoidance of re-
289	289	259hospitalization and long-term care.
290	290	260 (b) Any subscription certificate under an individual or group medical service agreement
291	291	261delivered, issued or renewed within the commonwealth shall provide coverage for medically
292	292	262necessary treatment related to or as a result of an acquired brain injury. Medically necessary
293	293	263treatment shall include, but is not limited to, cognitive rehabilitation therapy; cognitive
294	294	264communication therapy; neurocognitive therapy and rehabilitation; neurobehavioral,
295	295	265neurophysiological, neuropsychological and psychophysiological testing and treatment;
296	296	266neurofeedback therapy; functional rehabilitation therapy and remediation; community 14 of 17
297	297	267reintegration services; post-acute residential treatment services; inpatient services; outpatient and
298	298	268day treatment services; home and community based treatment. The benefits in this section shall
299	299	269not include any lifetime limitation or unreasonable annual limitation of the number of days or
300	300	270sessions of treatment services. Any limitations shall be separately stated by the insurer. The
301	301	271benefits in this section shall not be subject to any greater deductible, coinsurance, copayments, or
302	302	272out-of-pocket limits than any other benefit provided by the insurer.
303	303	273 (c) The commissioner of insurance shall require a health benefit plan issuer to provide
304	304	274adequate training to personnel responsible for preauthorization of coverage or utilization review
305	305	275for services under this section, in consultation with the Brain Injury Association of
306	306	276Massachusetts.
307	307	277 (d) Individual practitioners and treatment facilities shall be qualified to provide acute care
308	308	278and post-acute care rehabilitation services through possession of the appropriate licenses,
309	309	279accreditation, training and experience deemed customary and routine in the trade practice.
310	310	280 SECTION 5. Chapter 176G of the General Laws, as appearing in the 2022 Official
311	311	281Edition, is hereby amended by inserting after section 4GG the following section:-
312	312	282 Section 4II. (a) For purposes of this section, the following terms shall have the following
313	313	283meanings:-
314	314	284 “Acquired brain injury (ABI)” is any injury to the brain which occurs after birth and can
315	315	285be caused by infectious diseases, metabolic disorders, endocrine disorders or diminished oxygen,
316	316	286brain tumors, toxins, disease that affects the blood supply to the brain, stroke or a traumatic brain
317	317	287injury. 15 of 17
318	318	288 “Cognitive communication therapy” treats problems with communication which have an
319	319	289underlying cause in a cognitive deficit rather than a primary language or speech deficit.
320	320	290 “Cognitive rehabilitation therapy (CRT)” is a process of relearning cognitive skills
321	321	291essential for daily living through the coordinated specialized, integrated therapeutic treatments
322	322	292which are provided in dynamic settings designed for efficient and effective re-learning following
323	323	293damage to brain cells or brain chemistry due to brain injury.
324	324	294 “Community reintegration services” provide incremental guided real-world therapeutic
325	325	295training to develop skills essential for an individual to participate in life: to re-enter employment;
326	326	296to go to school or engage in other productive activity; to safely live independently; and to
327	327	297participate in their community while avoiding re-hospitalization and long-term support needs.
328	328	298 “Functional rehabilitation therapy and remediation” is a structured approach to
329	329	299rehabilitation for brain disorders which emphasizes learning by doing, and focuses re-learning a
330	330	300specific task in a prescribed format, with maximum opportunity for repeated correct practice.
331	331	301Compensatory strategies are developed for those skills which are persistently impaired and
332	332	302individuals are trained on daily implementation. To ensure acquisition and use, focus is set on re-
333	333	303learning those skills essential for safe daily living in the environment in which they will be used:
334	334	304home and community settings.
335	335	305 “Medical necessity” or “medically necessary,” health care services that are consistent
336	336	306with generally accepted principles of professional medical practice.
337	337	307 “Neurobehavioral therapy” is a set of medical and therapeutic assessment and treatments
338	338	308focused on behavioral impairments associated with brain disease or injury and the amelioration
339	339	309of these impairments through the development of pro-social behavior. 16 of 17
340	340	310 “Neurocognitive therapy” is treatment of disorders in which the primary clinical deficit is
341	341	311in cognitive function which has not been present since birth and is a decline from a previously
342	342	312attained level of function.
343	343	313 “Neurofeedback therapy” is a direct training of brain function to enhance self-regulatory
344	344	314capacity or an individual’s ability to exert control over behavior, thoughts and feelings. It is a
345	345	315form of biofeedback whereby a patient can learn to control brain activity that is measured and
346	346	316recorded by an electroencephalogram.
347	347	317 “Neuropsychological testing” is a set of medical and therapeutic assessment and
348	348	318treatments focused on amelioration of cognitive, emotional, psychosocial and behavioral deficits
349	349	319caused by brain injury.
350	350	320 “Psychophysiological testing and treatment” is a set of medical and therapeutic
351	351	321assessment and treatments focused on psychophysiological disorders or physical disorders with
352	352	322psychological overlay.
353	353	323 “Post-acute residential treatment” includes integrated medical and therapeutic services,
354	354	324treatment, education, and skills training within a 24/7 real-world environment of care – a home
355	355	325and community setting. Maximum opportunity for correct practice of skill in the context of use
356	356	326develops new neural pathways which ensure ongoing skill use and avoidance of re-
357	357	327hospitalization and long-term care.
358	358	328 (b) Any individual or group health maintenance contract shall provide coverage for
359	359	329medically necessary treatment related to or as a result of an acquired brain injury. Medically
360	360	330necessary treatment shall include, but is not limited to, cognitive rehabilitation therapy; cognitive
361	361	331communication therapy; neurocognitive therapy and rehabilitation; neurobehavioral, 17 of 17
362	362	332neurophysiological, neuropsychological and psychophysiological testing and treatment;
363	363	333neurofeedback therapy; functional rehabilitation therapy and remediation; community
364	364	334reintegration services; post-acute residential treatment services; inpatient services; outpatient and
365	365	335day treatment services; home and community based treatment. The benefits in this section shall
366	366	336not include any lifetime limitation or unreasonable annual limitation of the number of days or
367	367	337sessions of treatment services. Any limitations shall be separately stated by the insurer. The
368	368	338benefits in this section shall not be subject to any greater deductible, coinsurance, copayments, or
369	369	339out-of-pocket limits than any other benefit provided by the insurer.
370	370	340 (c) The commissioner of insurance shall require a health benefit plan issuer to provide
371	371	341adequate training to personnel responsible for preauthorization of coverage or utilization review
372	372	342for services under this section, in consultation with the Brain Injury Association of
373	373	343Massachusetts.
374	374	344 (d) Individual practitioners and treatment facilities shall be qualified to provide acute care
375	375	345and post-acute care rehabilitation services through possession of the appropriate licenses,
376	376	346accreditation, training and experience deemed customary and routine in the trade practice.