130 CMR, § 427.405

Current through Register 1536, December 6, 2024
Section 427.405 - Services Provided by Out-of-State Providers

The Division pays for services provided in another state to the same extent that it pays for services within its boundaries if the services are provided to a recipient who is a resident of Massachusetts and any of the following conditions are met:

(A) services are needed because of a medical emergency;
(B) services are needed and the recipient's health would be endangered if the recipient were required to travel to the Commonwealth;
(C) the Division determines, on the basis of medical advice, that the needed services, or necessary supplementary resources, are more readily available in another state; or
(D) the recipient lives in an area of Massachusetts that borders another state, and it is a general practice of recipients in that area to use medical resources in the adjacent state.

130 CMR, § 427.405

Amended by Mass Register Issue 1494, eff. 4/28/2023.