The bill amends various chapters of the General Laws to enhance coverage for medically necessary treatments related to acquired brain injuries (ABI) for active and retired employees insured under the group insurance commission. It introduces a new section that defines key terms associated with ABI, such as cognitive rehabilitation therapy, neurofeedback therapy, and community reintegration services. The legislation mandates that health benefit plans cover a wide range of treatments without imposing lifetime or unreasonable annual limitations on the number of treatment days or sessions. It also prohibits the denial of benefits based solely on the treatment being provided at non-hospital facilities and requires that any limitations imposed by insurers be clearly stated.
Additionally, the bill mandates that the Commissioner of Insurance ensure that health benefit plan issuers provide adequate training for personnel responsible for preauthorization and utilization review of ABI-related services. It establishes qualifications for individual practitioners and treatment facilities, ensuring they possess the necessary licenses and accreditations to deliver acute and post-acute care rehabilitation services. This comprehensive approach aims to improve access to essential rehabilitation services and support for individuals recovering from brain injuries, facilitating their reintegration into daily life and community activities.