Public Meeting Notice  Department of Mental Health Medical Necessity Commission - 1/19/2024

Previous Meeting Minutes

• Medical Necessity Commission Minutes 1/20/2023
• Medical Necessity Commission Minutes 12/16/2022
• Medical Necessity Commission Minutes 11/18/2023

• Feasibility of Uniform Medical Necessity Criteria (Consideration of motions introduced at 10/20/23 meeting, further amended at 11/19/23)
  • Commission member Rohn Friedman introduced a motion, seconded by commission member Joseph Shrand, to include in the Commission’s report a recommendation that the Legislature require minimum uniform behavioral health medical necessity criteria across payers, to the maximum degree possible. 
  • Commission member Joseph Shrand further proposed the commission’s report include the following recommendation: The commission submits that a common medical necessity criterion can be established with the contribution of clinicians, patient advocates, those with lived experience, and insurance companies. Such medical necessity criteria shall be drawn from curated current medically necessity criteria from insurance companies, addressing health care services or supplies needed to diagnose or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine, and integrated with any novel contributions from the members of the medical necessity committee.
• Additional Recommendations (where does the Commission have agreement and what should be considered in recommendations)
• Report Development (who will write, review, edit, minority reports)
• New Business not Anticipated at Time of Posting

Meetings are held the 3^rd Friday of each month via hybrid format

In person

DMH, Commissioner’s Office, 25 Staniford Street, Boston, MA, Room 2114