Mandated Services for Child-Adolescent Mental Health Disorders

On Dec. 14, 2018, the Div. of Insurance and Dept. of Mental Health jointly issued Bulletin 2018-07 to clarify certain mandated benefits for child-adolescent services. Specifically, the bulletin describes the benefits required to treat and diagnose mental health disorders of children and adolescents and highlights the importance of providing such benefits on a non-discriminatory basis.

To clarify the coverage requirements, the bulletin highlights services for intermediate care and outpatient services, such as in-home behavioral therapy, family support and training, mobile crisis intervention and intensive care coordination. It also provides carriers two separate timelines for ensuring that any necessary changes to the evidence of coverage and other documents are timely implemented and accurately represent the benefits for child-adolescent services in a manner consistent with the bulletin. One timeline was provided for family support and training and therapeutic mentoring and another timeline encompasses all other applicable services.

The changes mandated by this bulletin must be incorporated into insured health plan certificates of coverage, utilization criteria or other rating/claims systems for plans issued or renewed on and after July 1, 2019. To assist carriers in the timely implementation of the rules, carriers are expected to file materials with the Div. of Insurance that confirm they are following the bulletin’s timelines.

Employers in MA should make note of the carrier requirements detailed in this bulletin. Though the bulletin is directed at carriers, it might also impact the employer regarding the insurance mandate, coverage requirements, etc.

Bulletin 2018-07 »