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Budget Summary FY2016

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Outside Section 105
Data Current as of:  8/19/2015

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MassHealth Coverage of Substance Abuse

SECTION 105.   Said chapter 118E is hereby further amended by inserting after section 10H the following section:-

Section 10I. The division and its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms and third-party administrators under contract to a Medicaid managed care organization or primary care clinician plan shall provide coverage for the administration of all federal Food and Drug Administration approved drugs for the treatment of opioid or alcohol dependence and shall establish billing codes and rates of payment for providers of licensed clinical stabilization services to administer the approved drugs to individuals in need of treatment.

For the purposes of this section, "clinical stabilization services" shall mean a 24-hour clinically managed post detoxification treatment for adults or adolescents, as defined by the department of public health, usually following acute treatment services for substance abuse, which may include intensive education and counseling regarding the nature of addiction and its consequences, relapse prevention, outreach to families and significant others and aftercare planning, for individuals beginning to engage in recovery from addiction.