The bill mandates the Executive Office of Health and Human Services to conduct a comparative analysis of the per diem payment rates for inpatient psychiatric and substance use hospitals under the MassHealth program. This analysis will compare the rates provided by MassHealth Managed Care Entities (MCEs) to the MassHealth Fee for Service (FFS) rates. The bill includes specific tables that outline the per diem rates for various age groups and specialty services, such as psychiatric services for children and adolescents with neurodevelopmental disorders and eating disorders, as well as substance abuse treatment rates.
Additionally, the bill stipulates that MassHealth contracted MCEs, excluding Senior Care Options (SCO) and One Care, must adopt the MassHealth FFS rates as a minimum rate floor for both psychiatric and substance abuse treatment services. The analysis is to be reported as of January 2026, and the bill emphasizes the importance of ensuring that the rates reflect adequate compensation for these critical health services.