Mass. General Laws c.118E § 10O

Coverage of mental health, community-based, and intensive community-based acute treatment without preauthorization requirement; facility notification

This is an unofficial version of a Massachusetts General Law. For more information on this topic, please see: Law about Medicaid (MassHealth)

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Updates

Added by St.2022, c.177, § 42, effective November 8, 2022

Section 10O

For the purposes of this section, the following terms shall have the following meanings unless the context clearly requires otherwise:-

“Community-based acute treatment”, 24-hour clinically managed mental health diversionary or step-down services for children and adolescents that is usually provided as an alternative to mental health acute treatment.

“Intensive community-based acute treatment”, intensive 24-hour clinically managed mental health diversionary or step-down services for children and adolescents that is usually provided as an alternative to mental health acute treatment.

“Mental health acute treatment”, 24-hour medically supervised mental health services provided in an inpatient facility, licensed by the department of mental health, that provides psychiatric evaluation, management, treatment and discharge planning in a structured treatment milieu.

The division and its contracted health 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 shall cover the cost of medically necessary mental health acute treatment, community-based acute treatment and intensive community-based acute treatment and shall not require a preauthorization before obtaining treatment; provided, however, that the facility shall notify the carrier of the admission and the initial treatment plan within 72 hours of admission.

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Last updated: August 10, 2022
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