14- 191 C.M.R. ch. 40, § III

Current through 2024-51, December 18, 2024
Section 191-40-III - DEMONSTRATION OF APPLICATION FOR ALTERNATE FUNDING
A. Upon First Referral/Request for Services

Persons who seek or are referred for services as defined above must demonstrate eligibility or application for other benefit sources. Persons who are eligible for or entitled to other benefits must utilize those benefits.

Information documenting eligibility, or information necessary to determine eligibility for other benefits sources must be furnished to providers of services by the person referred for or requesting BDS services within a reasonable period of time following the initial referral or request for services.

Providers of services shall assist persons requesting services in demonstrating eligibility or application for other benefit sources.

Persons who must meet a deductible or spend down, or make premium payments to be eligible, must comply with those requirements. Grant funds may be used to the extent necessary to provide services while persons are spending down or paying a deductible.

B. During the Provision of Services

Persons whose eligibility or entitlement for other benefits changes during the course of service provision must take all reasonablesteps to obtain benefits to which they are entitled or eligible. Persons who refuse to make application for other benefits for which they may be eligible or entitled, will be considered ineligible for services financed by General Fund resources unless there is a clinically-based justification for the refusal.

14- 191 C.M.R. ch. 40, § III