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Advocates push to require commercial insurance to cover community behavioral health center services
Summary
Witnesses told the Joint Committee on Financial Services that Community Behavioral Health Centers (CBHCs) provide 24/7 crisis and coordinated services but commercial insurers often do not reimburse the bundled outpatient services that MassHealth covers; bills (S703/H1276) would require parity.
Advocates, providers and hospital groups urged the Joint Committee on Financial Services to require commercial insurers to cover the full package of services offered by Community Behavioral Health Centers (CBHCs), arguing that current practice creates a two-tier system where only MassHealth enrollees reliably receive integrated crisis and long-term outpatient supports.
Liz Ganz, vice president for government affairs at the Association for Behavioral Healthcare, told the committee CBHCs — created under the roadmap for behavioral-health reform and launched in January 2023 — are intended as a single point of entry for behavioral-health services, offering 24/7 crisis response, mobile crisis, short-term crisis-stabilization beds and a bundled core outpatient package that supports long-term recovery. MassHealth reimburses the core bundle via a bundled payment, Ganz said, but commercial carriers do not consistently cover the same bundle or reimburse at comparable rates.
Kimberly Fisher of Riverside Community Care described patient-level examples: a young man who stabilized while at a CBHC but lost access to CBHC services after taking a job that changed his insurance plan, triggering a relapse and subsequent emergency department visit and detox admission. Fisher said CBHC teams provide clinical care plus care coordination, peer services and nursing/medical coordination that collectively reduce ED boarding and hospital use.
Hospital representatives and provider associations supported parity. Lee Simons of the Massachusetts Health and Hospital Association said the CBHC model and the MassHealth bundled-payment approach help reduce ED boarding and shift crisis care into community settings, but commercial coverage gaps threaten that progress.
Why it matters: Testimony emphasized that CBHCs expand capacity for community-based crisis care and reduce pressure on emergency departments; uneven commercial reimbursement limits access to those with employer or commercial coverage.
Next steps: Supporters asked the committee to advance S 703 / H 1276 to require commercial carriers to cover the CBHC core outpatient bundle at rates no less than MassHealth.
