▸SECTION 12
of chapter 118E of the General Laws, as appearing in the 2022 Official Edition, is hereby amended by inserting after the ninth paragraph the following paragraphs:-
The division shall certify and ensure that all contracted accountable care organizations, contracted health insurers, health plans, health maintenance organizations, and behavioral health management firms and third party administrators under contract to a Medicaid managed care organization or primary care clinician plan provide equal access to behavioral health services, benefits and medications of comparable quality in providing medical assistance to recipients.
The division shall obtain the approval of the secretary of the executive office of health and human services for all behavioral health services, benefits, and medications, including, but not limited to, policies, protocols, standards, contract specifications, utilization review and utilization management criteria and outcome measurements, used by all contracted accountable care organizations, contracted insurers, health plans, health maintenance organizations, behavioral health management firms and third party administrators under contract to a Medicaid managed care organization or primary care clinician plan.
Notwithstanding the provision of any general or special law to the contrary, all contracted accountable care organizations, contracted health insurers, health plans, health maintenance organizations and behavioral health management firms and third-party administrators under contract to a Medicaid managed care clinician plan shall submit its method of determining reimbursement levels to all network inpatient mental health and substance use providers and how such methodology is sufficient to meet the costs of providing inpatient care. Such method shall include, but not be limited to, the range of payment amounts including the median payment levels and how such payments are regularly updated. A report including this information shall be submitted on an annual basis from the date of the original submission to the division, the house and senate committees on ways and means, the committee on health care financing, and the committee on mental health, substance use and recovery no later than 90 days after the effective date of this act.
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Section 12 of chapter 118E of the General Laws, as appearing in the 2022 Official Edition, is hereby amended by inserting after the ninth paragraph the following paragraphs:-
The division shall certify and ensure that all contracted accountable care organizations, contracted health insurers, health plans, health maintenance organizations, and behavioral health management firms and third party administrators under contract to a Medicaid managed care organization or primary care clinician plan provide equal access to behavioral health services, benefits and medications of comparable quality in providing medical assistance to recipients.
The division shall obtain the approval of the secretary of the executive office of health and human services for all behavioral health services, benefits, and medications, including, but not limited to, policies, protocols, standards, contract specifications, utilization review and utilization management criteria and outcome measurements, used by all contracted accountable care organizations, contracted insurers, health plans, health maintenance organizations, behavioral health management firms and third party administrators under contract to a Medicaid managed care organization or primary care clinician plan.
Notwithstanding the provision of any general or special law to the contrary, all contracted accountable care organizations, contracted health insurers, health plans, health maintenance organizations and behavioral health management firms and third-party administrators under contract to a Medicaid managed care clinician plan shall submit its method of determining reimbursement levels to all network inpatient mental health and substance use providers and how such methodology is sufficient to meet the costs of providing inpatient care. Such method shall include, but not be limited to, the range of payment amounts including the median payment levels and how such payments are regularly updated. A report including this information shall be submitted on an annual basis from the date of the original submission to the division, the house and senate committees on ways and means, the committee on health care financing, and the committee on mental health, substance use and recovery no later than 90 days after the effective date of this act.