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Massachusetts Embraces Telemental Health for Medicaid Members

Massachusetts has expanded its MassHealth program to allow those on Medicaid to access mental health and addiction treatment services though a telemedicine platform.

Source: ThinkStock

By Eric Wicklund

- Roughly 1.9 million Massachusetts residents on Medicaid will soon be able to access mental health services through telemedicine.

MassHealth, the commonwealth’s Medicaid and Children’s Health Insurance Provider (CHIP) program, recently announced that members can use an audio-visual virtual care platform to access a therapist, psychiatrist or substance abuse counselor.

“We continue to make changes in the MassHealth program – in both funding and policy – to improve access to behavioral health treatment for members,” Health and Human Services Secretary Marylou Sudders said in a press release. “By introducing telehealth, we are increasing access to treatment for mental illness, addictions and co-occurring illness for members across the state.”

“Tele-behavioral health can help improve the efficiency and effectiveness of our provider workforce and remove unnecessary obstacles to provide treatment for MassHealth members who have difficulty leaving their home environment, who live in rural areas, and or have other unique needs,” added Dan Tsai, MassHealth’s Assistant Secretary. “In addition, behavioral health providers are also incentivized to promote and utilize telehealth services and are reimbursed at the same rates as in-person visits.”

MassHealth officials say they expect to spend between $300,000 and $400,000 on the program in 2020. The service is open to residents seeking access to “psychologists, psychiatrists, psychoanalysts, clinical social workers, behavioral health nurses, nurse practitioners, and professional counselors.” 

Included in the announcement are specific guidelines for prescribing Schedule II controlled substances. A provider can only prescribe such medications via telehealth after first conducting an in-person exam, and in-person exams are required every three months for the duration of the prescription.

The announcement is a positive step in a state struggling to embrace connected health platforms to improve access to care – yet which is chock-full of hospitals and health systems using telemedicine and mHealth.

Just last month, the Blue Cross Blue Shield Foundation reported that more than half of those responding to a December 2018 survey had problems accessing behavioral health services. Many reported long waits for an in-person appointment, while others cited a shortage of qualified mental health providers.

And last year, Massachusetts lawmakers failed to pass telehealth payment parity legislation – one of only a handful of states that still does not require payers to reimburse providers for telehealth services at the same rate as in-person care. The commonwealth received a ‘F’ from the American Telemedicine Association for payment parity in the ATA 2017 state report cards, and in 2018 was among a handful of states rates as restrictive in telemedicine policies by Manatt Health, a healthcare legal and consulting arm of Manatt, Phelps & Phillips.

In a 2017 meeting, mental health providers lamented the lack of support from state officials in pushing telehealth and telemedicine –particularly in the western half of the state, which lacks the resources available in Boston and Worcester.

“On the one hand, we have the technology, but we don't have the payment and regulatory support to do that,” Karin Jeffers, who heads the six-clinic Clinical & Support Options in western Massachusetts and serves on the board of the Association for Behavioral Health, told the gathering

The MassHealth announcement may be part of Gov. Charles Baker’s ongoing effort to revamp the program into an accountable care system.  It drew praise from the Association for Behavioral Healthcare, a statewide advocacy organization for behavioral health and addiction treatment providers.

“Telehealth will greatly expand the availability of behavioral health care treatment options providers can offer MassHealth members,” Vic DiGravio, the organization’s President and CEO, said in the MassHealth press release. “The Baker administration has invested heavily in behavioral health care, and we are proud to work with MassHealth on improving access to and creating a system of care for individuals seeking treatment in the Commonwealth.”

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