Massachusetts S 760: An Act relative to behavioral health clinic rates

Bill Text

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SENATE DOCKET, NO. 2229 FILED ON: 1/20/2023
SENATE . . . . . . . . . . . . . . No. 760

The Commonwealth of Massachusetts
_________________
PRESENTED BY:
John F. Keenan
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act relative to behavioral health clinic rates.
_______________
PETITION OF:

NAME: DISTRICT/ADDRESS:
John F. Keenan Norfolk and Plymouth
Michael O. Moore Second Worcester 2/2/2023
Edward J. Kennedy First Middlesex 3/28/2023
Michael D. Brady Second Plymouth and Norfolk 4/4/2023
John J. Cronin Worcester and Middlesex 4/12/2023
Patrick M. O'Connor First Plymouth and Norfolk 9/15/2023
Joan B. Lovely Second Essex 10/3/2023
Jack Patrick Lewis 7th Middlesex 10/4/2023
James J. O'Day 14th Worcester 10/17/2023
Lydia Edwards Third Suffolk 10/17/2023
Adam J. Scanlon 14th Bristol 10/17/2023
Joanne M. Comerford Hampshire, Franklin and Worcester 10/17/2023
Michelle M. DuBois 10th Plymouth 10/17/2023
Nick Collins First Suffolk 10/18/2023
Jacob R. Oliveira Hampden, Hampshire and Worcester 10/23/2023
Carmine Lawrence Gentile 13th Middlesex 11/1/2023
Sal N. DiDomenico Middlesex and Suffolk 11/3/2023
Patricia D. Jehlen Second Middlesex 11/3/2023

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Brendan P. Crighton Third Essex 11/14/2023

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SENATE DOCKET, NO. 2229 FILED ON: 1/20/2023
SENATE . . . . . . . . . . . . . . No. 760
By Mr. Keenan, a petition (accompanied by bill, Senate, No. 760) of John F. Keenan and
Michael O. Moore for legislation relative to behavioral health clinic rates. Health Care
Financing.

The Commonwealth of Massachusetts

_______________
In the One Hundred and Ninety-Third General Court
(2023-2024)
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An Act relative to behavioral health clinic rates.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:

1 SECTION 1. Chapter 118E of the general laws, as appearing in the 2020 official edition,
2 is hereby amended by inserting after 13D the following section:-
3 Section 13D ½.
4 (a) For the purposes of this section, the following words shall have the following
5 meanings:
6 “Behavioral health clinic”, a clinic licensed by the department of public health pursuant
7 to section 3 and sections 51 through 56 of chapter 111 of the general laws, as appearing in the
8 2020 official edition, and regulated pursuant to title 130 of the code of Massachusetts regulations
9 429.000.

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10 “Behavioral health services”, evaluation, diagnosis, treatment, care coordination,
11 management, or peer support of patients with mental health, developmental or substance use
12 disorder.
13 “Independent practitioner”, an individual who is licensed by the board to practice
14 independent clinical social work and who meets the qualifications set forth in section 131 of
15 chapter 112 of the general laws, as appearing in the 2020 official edition, for an independent
16 clinical social worker and is regulated pursuant to title 130 of the code of Massachusetts
17 regulations 462.000.
18 “Minimum payment rates”, rates of payment for services below which managed care
19 entities may not enter into provider agreements.
20 (b) The division shall increase minimum payment rates for behavioral health services by
21 5% per procedure code for rates of payment effective as of January 1, 2023.
22 (c) Pursuant to sections 13C and 13D, and notwithstanding applicable state and federal
23 laws, the division shall ensure that each rate of payment or component payment in a bundled rate
24 for behavioral health services delivered in behavioral health clinics are no less than 20% above
25 comparable behavioral health services delivered by independent practitioners.
26 (d) The division shall review behavioral health service rates biennially. This review shall
27 include, but not be limited to the following: (i) adoption of an inflationary adjustment factor no
28 less than the total Medicare Economic Index percentage for the past two calendar years; (ii)
29 where possible, comparison of the wage estimate for each classification of staff position to the
30 75th percentile wage estate for that position as determined by the most current United States
31 Bureau of Labor Statistics for the commonwealth; and (iii) consideration of the reasonable cost

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32 to providers of any existing or new governmental mandate that has been enacted, promulgated or
33 imposed by any governmental unit or federal governmental authority.
34 SECTION 2. Said chapter 118E is hereby amended by inserting after section 13K the
35 following new section:-
36 Section 13L.
37 (a) For the purposes of this section, the following words shall have the following
38 meanings:
39 “Behavioral health clinic”, a clinic licensed by the department of public health pursuant
40 to section 3 and sections 51 through 56 of chapt