New Legislation establishes Recovery Coach Licensure, updates Substance-Exposed Newborn Policy

On December 23, 2024, Governor Maura Healey signed An Act relative to treatments and coverage for substance use disorder and recovery coach licensure, which makes treatment and recovery support more affordable and accessible for residents living with substance use disorder. 

“This important legislation reflects an approach to substance use disorder that emphasizes recovery, compassion, and evidence-based care,” said Public Health Commissioner Robbie Goldstein, MD, PhD. 

While the bill includes many important new mandates and protections, those advocating for Overdose Prevention Centers were disappointed that the bill did not include provisions for "facilities where people who use drugs can safely consume pre-obtained drugs under supervision of trained health care workers."(from Massachusetts for Overdose Prevention Centers).

The bill signed by the Governor:

• Mandates that insurance providers cover opioid reversal drugs and expands access. This bill mandates that all health plans cover emergency opioid antagonists (EOAs) — opioid reversal drugs such as naloxone and Narcan — without cost-sharing or prior authorization. It also requires hospitals and treatment facilities to educate patients on EOAs and prescribe or dispense at least two doses of EOAs to patients with a history of overdose, opioid use, or opioid use disorder (OUD) upon discharge. 
• Prohibits life insurance limits or refusal based on EOA history. This legislation prohibits life insurance companies from limiting or refusing coverage to a person solely because they obtained an EOA for themselves or others.
• Updates insurance requirements for non-opioid pain treatment. The bill updates requirements for insurance providers to ensure adequate coverage and access to pain management services without prior authorization, including non-opioid alternatives to pain treatment.
• Mandates insurance coverage for recovery coaches. The bill mandates all health plans cover recovery coach services without cost-sharing or prior authorization at no less than MassHealth rates, regardless of the setting in which the services are provided.
• Establishes recovery coaching licensure. This legislation establishes recovery coach licensing and oversight within DPH and codifies the practice of recovery coaching to ensure qualifications, proper use of titles, and compliance with DPH regulations. It also directs BSAS to study and report on barriers to certification, credentialing, and other employment and practice requirements for recovery coaches, while also ensuring timely and standardized licensure and renewal processes and establishing a peer support program for recovery coaches and their employers that includes mentorship, technical assistance, and other resources.
• Creates protections for harm reduction measures, which establishes a criminal and civil liability protections for people who, in good faith, provide or utilize fentanyl test strips or other drug testing equipment.
• Updates policy for infants affected by prenatal substance exposure.  The bill mandates a collaborative approach to conducting comprehensive assessments of how substance use may affect parental capacity and infant safety, prioritizing family unity and access to appropriate support systems. A parent who is stable in recovery will no longer automatically require a report for abuse or neglect.