Mass. Gen. Laws ch. 118E, sec. 10E — MA Code / Part I / Title XVII / Chapter 118E / Section 10E
Healthy start program; medical assistance for pregnant women and infants; eligibility; types of assistance; protection from billing and collection practices
Status: in_force

Section 10E. The division shall establish a program of medical care and assistance for pregnant women and infants who are not otherwise eligible for medical assistance under chapter 118E and who lack private health insurance coverage or have health insurance coverage which does not cover all medically necessary care covered by the program established by this section. The division shall furnish such medical assistance to each such pregnant woman and infant residing in the commonwealth in accordance with standards of eligibility established by the division; provided, however, that the income eligibility standards shall not be more than 200 per cent of the non-farm income poverty guidelines defined by the United States Office of Management and Budget. Assistance furnished pursuant to this section shall include, but shall not be limited to, the following care and services; provided, however, that unless otherwise specified to the contrary no payment shall be allowed for inpatient hospitalization: (i) all medically necessary care to maintain health during the course of the pregnancy and delivery, including newborn hospital care; (ii) all medically necessary postpartum obstetric and gynecological care; (iii) newborn care, including one postpartum pediatric ambulatory visit; and (iv) outreach services designed to identify and encourage the participation of pregnant women and infants in this program. The division shall ensure that all women who appear to be eligible for medical assistance under said chapter 118E are assisted in enrolling for such coverage. The division shall promulgate and, from time to time, amend regulations detailing eligibility criteria, services to be covered in conformity with appropriate standards of care, and reimbursement policies. Notwithstanding section 3 of chapter 6B or any other law to the contrary, no acute hospital shall deny access to care and services to recipients of the healthy start program established by this section; provided, however, that such recipients shall be exempt from any collection action, pre-admission deposit or any other form of billing or collection procedures arising from treatment by an acute care hospital provided under the healthy start program; and provided further, that a healthy start card shall constitute sole verification of application and eligibility for free care for inpatient hospital services. The program established herein shall be known as the healthy start program.

Section 10E. The division shall establish a program of medical care and assistance for pregnant women and infants who are not otherwise eligible for medical assistance under chapter 118E and who lack private health insurance coverage or have health insurance coverage which does not cover all medically necessary care covered by the program established by this section. The division shall furnish such medical assistance to each such pregnant woman and infant residing in the commonwealth in accordance with standards of eligibility established by the division; provided, however, that the income eligibility standards shall not be more than 200 per cent of the non-farm income poverty guidelines defined by the United States Office of Management and Budget.

Assistance furnished pursuant to this section shall include, but shall not be limited to, the following care and services; provided, however, that unless otherwise specified to the contrary no payment shall be allowed for inpatient hospitalization:

(i) all medically necessary care to maintain health during the course of the pregnancy and delivery, including newborn hospital care;

(ii) all medically necessary postpartum obstetric and gynecological care;

(iii) newborn care, including one postpartum pediatric ambulatory visit; and

(iv) outreach services designed to identify and encourage the participation of pregnant women and infants in this program.

The division shall ensure that all women who appear to be eligible for medical assistance under said chapter 118E are assisted in enrolling for such coverage.

The division shall promulgate and, from time to time, amend regulations detailing eligibility criteria, services to be covered in conformity with appropriate standards of care, and reimbursement policies.

Notwithstanding section 3 of chapter 6B or any other law to the contrary, no acute hospital shall deny access to care and services to recipients of the healthy start program established by this section; provided, however, that such recipients shall be exempt from any collection action, pre-admission deposit or any other form of billing or collection procedures arising from treatment by an acute care hospital provided under the healthy start program; and provided further, that a healthy start card shall constitute sole verification of application and eligibility for free care for inpatient hospital services. The program established herein shall be known as the healthy start program.