MA S771

Requires health insurers to cover up to 14 days of medically necessary acute treatment services, clinical stabilization services, and co-occurring treatment services (detoxification in psychiatric facilities) for adults and adolescents with substance use disorders without preauthorization

Prohibits insurers from requiring preauthorization for substance use disorder evaluations ordered under Chapter 111, Section 51½

Mandates that facilities notify insurance carriers of admission and initial treatment plan within 48 hours, with utilization review permitted beginning on day 7

Medical necessity determinations must be made by the treating clinician in consultation with the patient and documented in the medical record

Applies to Group Insurance Commission plans, MassHealth/Medicaid, and all private insurers including HMOs, hospital service corporations, and medical service corporations