This bill amends various sections of the General Laws to enhance the availability and coverage of addiction recovery services, specifically focusing on acute treatment services, clinical stabilization services, and newly defined transitional support services. The bill introduces the definition of transitional support services as short-term, residential support services that follow clinical stabilization, aimed at providing a safe environment for individuals transitioning to outpatient care. It mandates that these services, along with acute treatment and clinical stabilization services, be covered for up to 30 days without requiring preauthorization for active or retired employees of the commonwealth insured under the group insurance commission.

Additionally, the bill repeals Section 10H of chapter 118E and makes several amendments to ensure that health insurers and plans provide coverage for these services, including the requirement for facilities to notify carriers of admissions and treatment plans within specified timeframes. It also stipulates that utilization review procedures may only begin after 14 days of service, and no restrictions or denials can occur unless a patient has received at least 30 consecutive days of care. The bill requires a review by the Center for Health Information and Analysis to assess the impact of these changes on the continuum of care and costs, with reports due in 2026 and 2028. The provisions of the bill will take effect on October 1, 2026.

Statutes affected:
Bill Text: 32A-17N, 118E-10H, 175-47GG, 176B-4II, 176G-4AA