Behavioral Health and Substance Use Disorder Triage Act; enact.

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To: Public Health and
Welfare
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Senator(s) Johnson

SENATE BILL NO. 2887

AN ACT TO ENACT THE BEHAVIORAL HEALTH AND SUBSTANCE USE 1
DISORDER TRIAGE ACT; TO STATE LEGISLATIVE FINDINGS CONCERNING 2
BEHAVIORAL HEALTH TRIAGE; TO PROVIDE THE PURPOSE OF THIS ACT; TO 3
DEFINE TERMS; TO PROVIDE CLINICAL CRITERIA FOR SUBSTANCE USE 4
DISORDERS; TO PROVIDE CLINICAL CRITERIA FOR BEHAVIORAL HEALTH 5
SERVICES; TO LIST ACCEPTABLE FRAMEWORKS; TO PROVIDE FOR 6
CO-OCCURRING DISORDERS; TO PROVIDE APPLICABILITY; TO REQUIRE 7
PAYORS TO ALIGN THEIR UTILIZATION MANAGEMENT PRIOR AUTHORIZATION; 8
TO PROVIDE FOR CONTINUITY OF CARE AND COORDINATION; TO PROVIDE FOR 9
FISCAL IMPACT AND COST IMPACT; TO REQUIRE THE DESIGNATED STATE 10
AGENCY TO ESTABLISH IMPLEMENTATION GUIDANCE, MONITOR PROVIDER AND 11
PAYOR COMPLIANCE, AND ALIGN QUALITY REPORTING STANDARDS; AND FOR 12
RELATED PURPOSES. 13
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 14
SECTION 1. This act shall be known and may be cited as the 15
"Behavioral Health and Substance Use Disorder Triage Act." 16
SECTION 2. (1) The Legislature finds that: 17
(a) Substance use disorder and behavioral health 18
conditions are chronic medical conditions requiring timely, 19
clinically appropriate intervention; 20
(b) Inconsistent and subjective placement decisions 21
result in inappropriate levels of care, fragmented treatment, 22
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increased emergency department utilization, higher overdose risks 23
and an overall increase in the total cost of care; 24
(c) The state lacks a standardized statewide mechanism 25
to ensure that individuals are triaged to the correct level of 26
treatment based on objective clinical data; and 27
(d) Nationally recognized clinical criteria are widely 28
accepted as best practices for determining appropriate levels of 29
care and are necessary for systemic stability. 30
(2) The purpose of this act is to: 31
(a) Mandate the use of objective evidence-based 32
placement criteria across all providers and payors; 33
(b) Ensure individuals receive care at the appropriate 34
level of intensity to maximize recovery; and 35
(c) Improve continuity of care and quality outcomes 36
while containing costs through the reduction of preventable 37
overdoses, emergency department visits and hospitalizations. 38
SECTION 3. For the purposes of this act, the following terms 39
shall have the meanings ascribed herein unless the context clearly 40
requires otherwise: 41
(a) "ASAM Criteria" means the clinical criteria 42
developed by the American Society of Addiction Medicine for 43
assessing and placing in care individuals with substance use 44
disorders. 45
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(b) "Behavioral health services" means mental health 46
assessment and treatment services not primarily related to a 47
substance use disorder. 48
(c) "Substance use disorder services" means the full 49
continuum of care, including prevention assessment, 50
detoxification, residential treatment, partial hospitalization, 51
intensive outpatient and recovery support. 52
(d) "Provider" means any licensed or certified entity 53
or individual delivering behavioral health or substance use 54
disorder services in the state. 55
(e) "Payor" includes Medicaid-managed care 56
organizations, commercial insurers and any state-regulated health 57
benefit plan. 58
SECTION 4. (1) All providers delivering substance use 59
disorder services shall utilize the ASAM Criteria to conduct 60
initial clinical assessments, determine levels of care, support 61
transitions and document medical necessity. 62
(2) Placement decisions shall be based on objective clinical 63
findings and shall not be dictated by provider availability, bed 64
capacity, financial considerations or nonclinical preferences. 65
SECTION 5. (1) For individuals seeking treatment for 66
behavioral health conditions without a diagnosed substance use 67
disorder, providers shall utilize nationally-recognized, 68
evidence-based psychiatric level-of-care criteria. 69
(2) Acceptable frameworks include: 70
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(a) Level of Care Utilization System ("LOCUS") for 71
adults; 72
(b) CALOCUS-CASII for children and adolescents; and 73
(c) Other state-approved nationally recognized 74
psychiatric placement frameworks. 75
(3) Substance use disorder-specific criteria, including 76
ASAM, shall not be applied to individuals whose primary diagnosis 77
is a behavioral health condition without a co-occurring substance 78
use disorder. 79
SECTION 6. For individuals presenting with both behavioral 80
health and substance use disorders, providers shall: 81
(a) Utilize ASAM Criteria to assess substance use 82
disorder severity; 83
(b) Utilize appropriate behavioral health criteria to 84
assess psychiatric acuity; and 85
(c) Ensure placement decisions reflect the highest 86
level of clinical need, identified through the objective 87
assessment of both conditions. 88
SECTION 7. (1) This act shall apply to all services 89
reimbursed under Medicaid-managed care organizations, commercial 90
insurance and state-regulated health benefit plans. 91
(2) Payors are required to align their utilization 92
management, prior authorization and care coordination policies 93
with the criteria-based determinations established in Sections 3 94
and 4 of this act. 95
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ST: Behavioral Health and Substance Use
Disorder Triage Act; enact.
SECTION 8. (1) Providers and payors shall utilize the 96
mandated clinical criteria to support seamless transitions between 97
levels of care. 98
(2) The goal of such coordination is to eliminate treatment 99
gaps that increase the risk of relapse or overdose. 100
SECTION 9. (1) The Legislature recognizes that 101
inappropriate triage results in avoidable expenditures, including 102
emergency department utilization, hospital admissions, crisis 103
stabilization and incarceration-related healthcare costs. 104
(2) Evidence-based clinical triage is a proven method for 105
reducing unnecessary utilization and lowering the total cost of 106
care. 107
(3) This act does not mandate the creation of new benefits 108
but ensures existing services are used efficiently, resulting in 109
cost avoidance rather than new spending. 110
SECTION 10. On or before January 1, 2027, the designated 111
state agency shall establish implementation guidance, monitor 112
provider and payor compliance, and align quality reporting 113
standards with this act. 114
SECTION 11. This act shall take effect and be in force from 115
and after January 1, 2027. 116