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MA S769
Bill
AI Summary
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Requires insurance carriers to allow patients in ongoing mental health treatment to continue seeing their provider through an out-of-network option when the provider is disenrolled from the network or the patient's carrier changes, except in cases of fraud or quality-related issues
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Defines "continuing course of treatment" as having at least 1 visit in the past 4 months for the same or similar mental health diagnosis or symptoms
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Mandates carriers reimburse out-of-network mental health providers at the usual in-network rate (or median rate if multiple rates exist) as payment in full
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Prohibits carriers from imposing additional charges, costs, or deductibles for using this out-of-network option, though higher co-payments are allowed only if actuarially justified by increased costs and approved by the Division of Health Care Finance and Policy
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Amends Chapter 176O of the Massachusetts General Laws governing health insurance carrier practices
Legislative Description
Providing continuity of care for mental health treatment
Last Action
Committee recommended ought to pass and referred to the committee on Senate Ways and Means
2/9/2026