MASS HEALTH CONTAINMENT LAW

posted Aug 10, 2012, 12:04 PM by Frank Baskin   [ updated Aug 10, 2012, 12:08 PM ]
This recently passed law contains many provisions. The following will impact the delivery of mental and behavioral health services. Some of its components include.....FOR MORE CLICK TITLE.....
  • Accountable Care Organizations (ACOs) must integrate or contract out for behavioral health services. Since doctors will be rewarded for keeping patients well, behavioral health services will be a necessity, creating many new opportunities for behavioral health providers like social workers.
  • Insurance companies and managed care organizations will now have to provide their “medical necessity criteria sets” for review by the Department of Public Health Office of Patient Protection. And, for the first time, these criteria sets must be made available to providers, including social workers, and consumers either through posting on their website or, for criteria sets defined as “proprietary,” upon request.
  • ACOs must comply with federal and state Mental Health Parity. The Division of Insurance will have the power to regulate this requirement and reporting to the Attorney General will be required. In addition, if a behavioral health provider is removed from an ACO, that provider will have the ability to appeal.
  • There will be access to $30 million in federal grants for behavioral health providers to move to electronic medical records.
  • There will be a new 19 member Healthcare Workforce Council, which will oversee the newly created loan repayment program for behavioral health providers (including social workers). Behavioral Health will be represented on the Council.
  • The bill also creates a 19 member Behavioral Health Special Task Force, of which NASW MA Chapter is a member. NASW will strongly advocate for and support the needs of social workers and consumers as the task force addresses a variety of as yet unanswered issues with respect to the new payment system. The Task Force will report out by July 1, 2013. 
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