State Updates

Massachusetts DOI Provides Guidance on Mandated Mental Health Wellness Examinations

 

On January 16, 2024, the Division of Insurance issued Bulletin 2024-02 regarding the coverage and content of mandated behavioral health wellness examination coverage. 

Applicable state statutes define a "mental health wellness examination" as a "screening or assessment that seeks to identify any behavioral or mental health needs and appropriate resources for treatment.” Such screenings and assessments can include but are not limited to consultation on healthy lifestyle changes, referrals for ongoing treatment, mental health services and other necessary supports, and discussion of potential options for medication, and personal history and mental or cognitive state.  

After consultation with a working group convened by the Department of Mental Health that included medical providers from trade groups and carriers to develop criteria for such examinations, the Division provided details of what these examinations should include in Appendix A of the bulletin. Special considerations are given to taking a comprehensive mental health history, providing for a shared decision-making process, and having an outcome with appropriate recommendations.

Employers that sponsor group health plans should be aware of this bulletin and contact their carrier for further information.

Bulletin 2024-02 »

PPI Benefit Solutions does not provide legal or tax advice. Compliance, regulatory and related content is for general informational purposes and is not guaranteed to be accurate or complete. You should consult an attorney or tax professional regarding the application or potential implications of laws, regulations or policies to your specific circumstances.

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