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PART I
TITLE XVII
CHAPTER 118E
Massachusetts Laws
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PART I
ADMINISTRATION OF THE GOVERNMENT
(Chapters 1 through 182)
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TITLE XVII
PUBLIC WELFARE
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CHAPTER 118E
DIVISION OF MEDICAL ASSISTANCE
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Section 1
Duties of office
Section 2
Established authority
Section 2A
Director of dental services
Section 3 to 5
Repealed, 2003, 26, Sec. 308
Section 6
Medical care advisory committee; member; staff; report from office of Medicaid
Section 7
Powers
Section 8
Definitions
Section 9
Eligibility
Section 9A
MassHealth; beneficiaries; eligibility; payment; information applications
Section 9B
Participation of commonwealth; budget neutrality certification; projected expenditure and revenue reports; beneficiary distinctions
Section 9C
Medical insurance reimbursement programs; definitions; eligibility; expenditures; submission of plans
Section 9D
Senior care options initiative; senior care organizations; enrollment choices; advisory committee; report
Section 9E
Application for authority; implementation of measures; waiver of measures due to hardship
Section 10
Medical care assistance program for pregnant women and infants
Section 10A
Required coverage for prenatal care, childbirth and postpartum care
Section 10B
Required coverage for newborn hearing screening tests
Section 10C
Required coverage for items medically necessary for the diagnosis or treatment of diabetes
Section 10D
Required coverage for treatment of breast and cervical cancer
Section 10E
Healthy start program; medical assistance for pregnant women and infants; eligibility; types of assistance; protection from billing and collection practices
Section 10F
Health care services for dependent and adopted youths; funding; types of services; eligibility; program reports; no entitlement
Section 11
Cooperation with federal authorities
Section 12
Policies; procedures; rules and regulations; contracts
Section 13
Rate changes; review
Section 13A
Non-acute hospitals; rates and terms of payment
Section 13B
Hospital rate increases; quality standards and benchmarks
Section 14
Nursing home negotiated rate contracts
Section 14A
Reimbursement to nursing homes for admissions to acute care and chronic disease or rehabilitation hospitals
Section 15
Medicaid benefits; rules and regulations; managed care; personal expenses
Section 16
Primary and supplemental medical care and assistance program for disabled residents; assistance program for chronically ill or disabled persons forced to leave employment or substantially reduce work hours
Section 16A
Medical care and assistance program for disabled children
Section 16A1/2
Costs incurred for medical programs projected to exceed available appropriations; notice
Section 16B
Repealed, 1996, 203, Sec. 16
Section 16C
Child health insurance program; medical benefits; costs; eligibility
Section 16D
Aliens or persons residing in United States under color of law; benefits
Section 17
Reimbursements for non-generic drugs
Section 17A
Emergency services provided to beneficiaries for emergency medical conditions
Section 18
Medical insurance purchases for persons eligible for assistance
Section 19
Prior approval of medical services; methods; rules and regulations; posttreatment examinations
Section 20
Application; forms; application by institution
Section 21
Inquiry by department; notification of applicant; agreement
Section 21A
Medical assistance eligibility of an institutionalized spouse
Section 22
Third party payments; repayment; assignment; subrogation
Section 23
Subrogation rights; health insurance benefits; garnishment of wages
Section 23A
Financial institutions; request for deposit and withdrawal records; penalty
Section 24
Repealed, 1996, 450, Sec. 157
Section 25
Exempt income and resources
Section 26
Identification card
Section 27
Redetermination of eligibility
Section 28
Disposal of resources at less than fair market value; period of ineligibility
Section 29
Transfer of interest in real property; notice
Section 30
Time of payment
Section 31
Adjustment or recovery of payments
Section 32
Provision of death certificate and probate petition to division; liability of estate beneficiaries; claims against estate; sale or transfer of property subject to lien or claim
Section 32A
Repealed, 2005, 6, Sec. 14
Section 33
Long term care insurance purchasers; liability for medical assistance paid
Section 34
Liens and encumbrances
Section 35
Reimbursement for covered claims; submission of information
Section 36
Eligible providers; responsibility for overpayments
Section 37
Distribution of rules, regulations to providers; administrative sanctions
Section 38
Submission of bills by providers; appeals for erroneous denials; overpayments; civil collection actions
Section 39
False representations, failure to disclose; penalty
Section 40
False statements or representations by providers; penalty
Section 41
Bribery or rebates; penalty
Section 41A
Repealed, 2001, 177, Sec. 27
Section 42
Excess charges; penalty
Section 43
Health care facilities; additional charges as precondition for admission or continuance; penalty
Section 44
Civil remedies; limitations
Section 45
Venue; actions relating to false claims
Section 46
Availability of other remedies
Section 46A
Providers; submission of claims for payment not in compliance with policies and procedures of medical assistance program; proof of clerical or administrative error
Section 47
Persons aggrieved; right to hearing; investigation; decision; rehearing; notice
Section 47A
Benefits available only to otherwise eligible individuals showing lawful presence in the United States or meeting applicable federal requirements necessary to qualify for benefits for which the commonwealth receives federal reimbursement
Section 48
Board of hearings
Section 49
Use and disclosure of information
Section 50
Contract for administrative functions; underwriting of program
Section 51
Utilization review of care and services; data processing and collection procedures; liability in civil actions
Section 52
Maintenance of standards for providers; development of new programs
Section 53
Covered services
Section 54
Wellness program for MassHealth enrollees
Section 55
Repealed, 2008, 451, Sec. 75
Section 56 to 60
[There is no 118E:56 to 60.]
Section 61
Availability of benefits to persons recognized as a spouse under laws of the commonwealth
Section 62
Acceptance and recognition of information submitted pursuant to coding standards and guidelines required; use of standardized claim formats
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