Mental health, substance use & recovery

Senator Friedman has sponsored the following bills relative to mental health, substance use and recovery in the 2019-2020 legislative session:

S588 An Act relative to mental health parity implementation

  • Summary: This bill would help to ensure parity in insurance coverage for mental health and substance use disorder care by: (1) improving enforcement through enhanced carrier self-reporting; (2) addressing barriers created by insurers such as onerous and time-consuming approval processes; (3) applying parity across payers, including the Group Insurance Commission and MassHealth; and (4) ensuring consistent and fair application of medical necessity criteria.

S589 An Act relative to limits on insurers’ retroactive clawbacks for mental health and substance use disorder services

  • Summary: This bill would place limits on insurers’ retroactive “clawbacks” of claims payments to behavioral health, mental health, and substance use disorder care providers.

S590 An Act to require health care coverage for the emergency psychiatric services

  • Summary: This bill would redefine emergency psychiatric services (ESPs) as “all programs subject to contract between the mass behavioral health partnership and nonprofit organizations for the provision of said emergency services.” This new definition would require commercial insurance companies, which provide hospital expense and surgical expense insurance, to also provide benefits for medically necessary behavioral health emergency services provided by ESPs around the state on a nondiscriminatory basis.

S593 An Act to promote the accessibility, quality and continuity of care for consumers of behavioral health, substance use disorder and mental health services

  • Summary: This bill would give health care professionals who provide behavioral health, substance use disorder, and mental health services the authority to collectively bargain with insurance carriers and behavioral health managers, without the worry of violating current antitrust laws.

S685 An Act relative to accountable care

  • Summary: This bill would require all accountable care organizations (ACOs) that contract with MassHealth or its managed care entities, to file an annual public report of their pre-ACO baseline expenditures as well as their current spending on behavioral health services, primary care, acute care costs, emergency services, pharmacy, and other specialties as MassHealth deems appropriate. This legislation would also require that eligibility and enrollment data for Community Partner coordination services be provided.

S941 An Act relative to improving access to emergency treatment plans

  • Summary: This bill would improve access to emergency treatment plans, commonly referred to as Rogers Orders, which are used to order anti-psychotic treatment for incapacitated persons when the court finds (using the substituted judgment standard) that the person, if he or she were not incapacitated, would consent to such treatment. The legislation would improve access to these plans by requiring a quicker timeline for hearings and decisions, creating a detailed treatment plan, assigning a treatment monitor to oversee the treatment plan, and establishing a process to return to court in the event of treatment non-compliance.

S942 An Act provide critical community services

  • Summary: This bill would create a new process to involuntarily commit an adult individual with a mental illness to community-based mental health services and supports (called “critical community health services”). Criteria for eligibility would include a history of lack of compliance with treatment for mental illness and a finding that the individual is at substantial risk of inflicting serious harm to himself or others and has shown an inability to provide for basic physical needs, including medical and psychiatric treatment and shelter.

S1144 An Act relative to mental health peer specialists certification

  • Summary: This bill would create a commission to study the scope of mental health peer support programs to determine the appropriate training and certification requirements necessary for such programs.

S1145 An Act ensuring access to addiction services

  • Summary: This bill would require that all Section 35 involuntary civil commitment beds for substance use disorder (SUD), for men and women, be in facilities approved by the Department of Public Health (DPH) or the Department of Mental Health (DMH), and not in correctional facilities. It would also require that people with SUD who are civilly committed under Section 35 be treated as patients, not as criminals.

S1146 An Act to provide more timely treatment of inpatient mental health care

  • Summary: This bill would help protect and improve access to inpatient psychiatric care in Massachusetts by addressing a number of areas: (1) requiring the Department of Mental Health (DMH) regulations to take into consideration physician supply issues for inpatient mental health facilities; (2) requiring that second opinions be sought and conducted more quickly; (3) preventing delays in scheduling commitment hearings; and (4) creating an expedited process for children under the Department of Children and Families’ (DCF)  care who are hospitalized in inpatient psychiatric hospitals and in need of anti-psychotic medication.

S1147 An Act relative to a behavioral health workforce commission

  • Summary: This bill would create a Behavioral Health Workforce Commission composed of state officials, and well as provider and consumer groups to both study workforce needs and identify reasons for the current shortages in inpatient and community-based settings.

S1148 An Act relative to medical necessity for mental health acute treatment

  • Summary: This bill would mandate coverage for mental health acute treatment and stabilization services, similar to what was mandated for addiction treatment in Chapter 258 of the Acts of 2014. It would also ensure that medical necessity for services provided to patients in the midst of a mental health crisis will be determined by the treating clinician in consultation with the patient, not by an insurance company.

S1263 An Act relative to a special commission on support group model integration in health care

  • Summary: This bill would establish a special legislative commission to study and make recommendations on the integration of peer support groups into the healthcare system.

Senator Friedman has co-sponsored the following bills relative to mental health, substance use and recovery in the 2019-2020 legislative session:

S706 An Act to ensure prescription drug cost transparency and affordability

  • Summary: Prescription drug prices are the leading factor in driving up health care costs across the system, impacting the budgets of individuals, families, employers and the state. This bill would improve  transparency around the underlying costs to produce prescription drugs; restrain abuses by pharmacy benefit managers (PBMs); authorize the Health Policy Commission to set upper payment limits for unreasonably high-priced drugs; require pharmacists to inform consumers if purchasing a drug at the retail price would be cheaper than purchasing through insurance; provide tools to strengthen MassHealth’s ability to negotiate lower drug prices; and support a permanent authorization and funding source for “academic detailing” to ensure doctors receive accurate information to counter biased drug manufacturer marketing.

H910 An Act relative to mental health parity implementation

  • Summary: This bill would ensure that all federal mental health parity laws are fully implemented in Massachusetts.

S1149 An Act strengthening prescription drug safety and drug stewardship

  • Summary: This bill would remove an automatic sunset provision that weakens the Commonwealth’s  ability to implement an important opioid safety program that makes manufacturers responsible for operating or financing a safe drug disposal program. Without this bill, the law is set to sunset in 2021.

S1162 An Act to increase substance use prevention and awareness and reduce overdose abandonment

  • Summary: This bill would require each public school to include in their substance use prevention curriculum plans to educate and inform students about Good Samaritan laws in order to discourage overdose abandonment. The bill would also allow schools to collaborate with other schools in order to find the most successful education and awareness methods.

S1153 An Act to remove administrative barriers to behavioral health services

  • Summary: This bill removes prior authorization requirements for inpatient mental health services within the MassHealth program, so long as the provider notifies MassHealth within 48 hours of the inpatient admission.  While this standard has been adopted by the majority of the commercial health insurers in the state, the MassHealth program still requires prior authorization, which has led to increased ED boarding and delayed access to medical necessary care for these patients. 

S1154 An Act to protect children’s mental health services

  • Summary: This bill would establish an ombudsman position within the Office of the Child Advocate in order to identify barriers to effective child mental health treatment, to propose solutions, to monitor compliance with relevant statutes, and to resolve complaints filed on behalf of a child.

S1606 An Act protecting youth from nicotine addiction

  • Summary: This bill would place an excise tax on e-cigarettes and other vaping products, and increases taxes on cigarettes and cigars.

H1700 An Act ensuring access to addiction services

  • Summary: This bill would ensure that those individuals who are deemed at risk to self or others because of a substance use disorder, and are committed under Section 35, be treated in a healthcare facility and not a correctional facility. This would prohibit sending men to Massachusetts Alcohol and Substance Abuse Center (MASAC) as long as the Department of Corrections (DOC) oversees that facility.

H1747 An Act helping overdosing persons in emergencies

  • Summary: This bill would provide hope to those suffering from addiction by ensuring that firefighters and state and local police officers are all are equipped with Narcan while on duty. Further, this bill would work the existing Department of Public Health (DPH)-approved Narcan training into the current first aid training all first responders are required to undergo. Additionally, the legislation restates the “good Samaritan” language included in last year’s comprehensive opioid treatment and prevention legislation to further protect first responders administering Narcan in good faith while on duty, while also leaving room for advancements to be made by specifying that only a DPH-approved opioid antagonist can be carried, in case there is a drug developed that is more effective than Narcan in the future.