The Massachusetts Senate unanimously passed a sweeping mental health reform bill last Thursday that takes a large step forward in ensuring that insurance coverage for mental health benefits are equal to and no more restrictive than coverage for physical health benefits, and, perhaps most importantly, helps eliminate the stigma of seeking treatment for behavioral health services.
A major component of the legislation for which the hospital community has long advocated is the removal of insurance company prior authorization for adults and children who are experiencing a mental health crisis. Timely treatment decisions for those patients are now in the hands of clinicians and the patients rather than the insurer. The legislation – The Mental Health ABC Act – also addresses the long-standing issue of mental health and primary care providers being reimbursed at different rates. The bill sets a rate floor mechanism to ensure that insurers reimburse mental healthcare at the same rate as primary care.
It also establishes a pilot program at the Department of Public Health to increase student access to tele-behavioral health services. The program would be modeled off of the successful initiative currently in use by Heywood Healthcare and public schools in its service area.
The Mental Health ABC Act also contains a number of mechanisms to increase the pipeline of mental health workers by creating a Psychiatric Mental Health Nurse Practitioner Fellowship Pilot Program for community health centers; another pilot program through the Department of Higher Education to support individuals from diverse backgrounds seeking careers in mental health; and a sweeping workforce commission to study a variety of issues ranging from identifying shortages in inpatient and community-based settings, how commercial insurance and MassHealth reimbursement rates and administrative processes affect the workforce, and barriers to providers’ acceptance of commercial insurance and MassHealth.
MHA and its membership were able to secure through an amendment filed by Sen. Jim Welch (D-West Springfield) an enhancement to the bill’s provision requiring hospital emergency departments (EDs) to have the ability to evaluate, stabilize, and refer behavioral health patients; the amendment allows the use of telemedicine and e-consultation to meet the new requirement.
Hospitals applauded a component of the legislation that prohibits insurers from denying coverage for mental health services and primary care services solely because they were delivered on the same day in the same facility. Providers had consistently argued that the insurer practice disrupted the integration of mental health and primary care.
MHA’s President & CEO Steve Walsh praised the chief authors of the bill: Senators Julian Cyr (D-Truro), co-chair of the Joint Committee on Mental Health, Substance Use and Recovery; Senate President Karen Spilka (D-Ashland); Cindy Friedman (D-Arlington), co-chair of the Joint Committee on Health Care Financing; and Michael Rodrigues (D-Westport), chair of the Senate Committee on Ways and Means. Walsh said, “Massachusetts hospitals have long sought parity in coverage between behavioral health and medical/surgical care. I applaud the Senate for their leadership on an issue so critical and personal to our patients and their families. This legislation is an important step forward in ensuring that every Massachusetts resident has access to the mental health services they need and deserve.”