A longstanding priority of
the Massachusetts Medical Society (MMS) is the enforcement of state and federal
parity laws and reduction of behavioral health boarding in emergency
departments. For many years, the MMS has worked cooperatively with state health
care leaders, providers, advocates and other professional health care
organizations on Committees, Commissions, Taskforces and Working Groups all
seeking the same goal – equal coverage and access to care for mental health and
substance use disorders as for physical health conditions.
The lack of parity and
inadequate resources especially for dual diagnosis and other difficulties placing
patients leads to “boarding” of patients in emergency departments. Studies have
shown that mental health patients stay in emergency departments awaiting
appropriate placement and treatment approximately twice as long as
medical/surgical patients. This isn’t
good clinical practice, nor is consistent with the humane intentions behind
passage of state and federal mental health parity laws.
The MMS feels strongly that all
patients – regardless of source of health insurance coverage - requiring mental
health evaluations, treatment or emergency evaluations should not suffer
greater impediments to the coverage of their medically necessary services than
victims of an accident, patients with hypertension or patients with any other
legitimate medical need.
With these principles in mind,
the MMS wishes to be recorded in support of the following bills that would help
reduce emergency department boarding and ensure fairness and consistency with
state and national mental health parity initiatives:
- H.2404, An Act to Improve Access to Behavioral Health
Services (Malia)
This
bill would remove pre-authorization requirements for MassHealth patients
seeking inpatient psychiatric care. Because all private and Medicare coverage
options already allow inpatient behavioral health services without a prior
authorization requirement, this provision would implement true mental health
parity. H.2404 would also help reduce ED boarding by requiring EOHHS to create
a streamlined process allowing inpatient admission from the community, rather
than solely from emergency departments; and requiring the creation of a database
of existing behavioral health services across Massachusetts, which will help
identify resources and gaps in care.
- H.2399, An Act Providing Equitable Access to Behavioral Health
Services for Masshealth Consumers (Malia)
This bill would ensure parity for
MassHealth patients. The bill will
ensure comparable access to behavioral health services and medications by all
contracted health insurers, health plans, health maintenance organizations, and
behavioral health management firms providing medical assistance to MassHealth
recipients. It will increase
transparency, access to care and ensure consistancy among all contracted
providers of MassHealth services and would be a significant step towards full
parity.
- H.1070/S.1093, An Act to further define medical necessity
determinations (Khan/Flanagan)
This bill would require that all medically
necessary services for MassHealth and private insurance mental health services
must be determined by the treating clinician in consultation with the patient
and noted in the patient's medical record.
