130 CMR, § 428.410

Current through Register 1536, December 6, 2024
Section 428.410 - Prosthetic Equipment Provided to Institutionalized Members
(A)Nursing Facilities. The MassHealth agency pays prosthetic providers for:
(1) the purchase and repair of prosthetic equipment; and
(2) prosthetic supplies provided for the personal full-time use of a member residing in a nursing facility.
(B)Institutions Licensed as Hospitals, Chronic Disease Hospitals, and Rehabilitation Hospitals. The MassHealth agency does not pay prosthetic providers for the purchase or repair of prosthetic equipment or for supplies provided to a hospitalized member, except for prosthetic equipment that is prescribed for home use after discharge. The hospital record must document the member's discharge plan and that the date of discharge was before the purchase or repair of the prescribed item.
(C)Intermediate Care Facilities for the Mentally Retarded with 16 Beds or More (State Schools).
(1) The MassHealth agency pays prosthetic providers or the purchase and repair of customized prosthetic equipment provided for the personal full-time use of a member residing in an ICF/MR with 16 beds or more (a state school) only if the customization precludes the use of the equipment by subsequent residents in that institution.
(2) The MassHealth agency does not pay prosthetic providers for noncustomized equipment or supplies provided to a member residing in a state school.
(D)Rest Homes. The MassHealth agency pays prosthetic providers for the purchase and repair of prosthetic equipment and for associated supplies provided for the personal full-time use of a member residing in a rest home.

130 CMR, § 428.410

Amended by Mass Register Issue 1354, eff. 12/15/2017.
Amended by Mass Register Issue 1494, eff. 4/28/2023.