reglab/housing_qa huggingface dataset:
MA Gen L ch 118e § 13l (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 13l - Restriction of Hospital Access to Discounted Purchase of Prescription Drugs

Section 13L. The secretary of health and human services, hereinafter ''the secretary'', shall not restrict or limit an eligible hospital's access to the discounted purchase of prescription drugs to the full extent permitted under section 340B of the Public Health Service Act, as codified under 42 U.S.C. 256b unless the secretary provides the following not less than 180 days before the proposed effective date of the limitation or restriction: (i) notice to eligible hospitals of the proposed restriction or limitation; and (ii) a report with the joint committee on health care financing and the senate and house committees on ways and means detailing: (A) the proposed restriction or limitation; (B) the anticipated aggregate savings to the commonwealth; (C) the estimated fiscal impact of the restriction or limitation on each affected hospital; and (D) the manner in which the secretary plans to mitigate the fiscal impact, which may include measures to maintain savings already achieved by providers under said 42 U.S.C. 256b.
MA Gen L ch 118e § 14a (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 14a - Reimbursement to Nursing Homes for Admissions to Acute Care and Chronic Disease or Rehabilitation Hospitals

Section 14A. The division shall treat admissions to acute care hospitals and chronic disease or rehabilitation hospitals as equivalent for purposes of reimbursing nursing homes to reserve beds for medical assistance recipients during brief absences from nursing homes by such recipients to obtain hospital care.  In the event that a nursing facility resident who is age 22 years or under and is a MassHealth recipient leaves the nursing facility for non-medical reasons, the facility shall preserve his bed for a period of up to 10 calendar days per year and the division shall pay to preserve his bed in the facility for a period of up to 10 calendar days per year.
MA Gen L ch 118e § 15 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 15 - Medicaid Benefits; Rules and Regulations; Managed Care; Personal Expenses

Section 15. The division shall provide Medicaid benefits for such medical care or services as Title XIX and regulations adopted thereunder by the secretary require. The division may provide Medicaid benefits for such additional medical care or services as Title XIX and said regulations permit.  The amount, duration and scope of the aforesaid care and services shall be determined by the rules and regulations of the division, provided such rules and regulations are consistent with the provisions of this chapter and Title XIX. Such rules and regulations may include appropriate limitations on care and services based on such criteria as medical necessity or utilization control procedures.  The division shall develop regulations and procedures requiring a recipient of medical assistance under this chapter to participate in a program of managed care, upon determination by the department, pursuant to the provisions of 42 USC 1396n(a), subject to appeal by the recipient, that said recipient has demonstrated a pattern of excessive or inappropriate utilization of a covered benefit.  Any person who is eligible for assistance under the provisions of this chapter who is not maintaining his or her own home and who is receiving care in a licensed nursing home, a licensed chronic hospital, a licensed rest home, an approved public medical institution, or a public psychiatric institution shall retain the first sixty dollars of monthly income for clothing, personal needs allowance, and leisure time activities. If there is no such income, or if such income is less than sixty dollars, the recipient shall be paid, in advance, the difference between such income and sixty dollars.  A person who acts as a fiduciary for another person eligible for assistance and who fails to provide the first $60 of monthly income or to pay for the amount of income that a resident is required to contribute for their care as established by Medicaid shall be liable for the financial loss.  The division shall provide by regulation that personal laundry costs shall not be charged to the amount retained by or paid to the recipient pursuant to this section. Personal laundry costs shall be reimbursed through rates paid to such institutions.
MA Gen L ch 118e § 16 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|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 16. The division shall establish a program of primary and supplemental medical care and assistance for certain disabled residents of the commonwealth including persons who are blind who are not eligible for medical assistance pursuant to Title XIX of the federal Social Security Act. The benefits of such program shall be available to all such persons (1) who are not covered for medical costs relative to their disability by an employer's group health insurance plan, (2) who are not eligible for medical assistance under any work incentive programs with federal participation, and (3) who, if not engaged in substantial gainful activity, would meet all eligibility requirements for supplemental security income under the provisions of Title XVI of said Social Security Act at the time of application for said program of medical care and assistance. Subsequent to their enrollment in said program, such disabled residents may continue in enrollment in said program notwithstanding the fact that they no longer meet the financial requirements of said Title XVI in accordance with income requirements established by the division. The cost of such program shall be funded, in part, by premium contributions, co-payments, and deductibles contributed by enrollees according to a sliding scale schedule designed by the division.  The division shall further establish a program of assistance for persons forced to leave employment due to the onset or worsening of a severe and chronic disability or illness or whose access to employer sponsored health insurance is jeopardized by a substantial reduction in work hours as a result of such disability or illness. The benefits of such program shall provide for assistance in paying health insurance premiums offered through a group plan of health insurance sponsored by the employer for those persons whose continuing disability or illness would likely result in their becoming eligible for benefits under this chapter; provided that the cost of such benefits shall be paid, in part, by payments from such persons according to a sliding fee schedule established by the division.
MA Gen L ch 118e § 16a (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 16a - Medical Care and Assistance Program for Disabled Children

Section 16A. The division shall establish a program of medical care and assistance for certain disabled children of the commonwealth, including children who are blind. The benefits of such program shall be available to children who are not eligible for medical assistance programs with federal financial participation and who would meet the disability requirements for supplemental security income under the provisions of Title XVI of the Social Security Act. The cost of such program shall be funded, in part, by premium contributions, co-payments and deductibles according to a sliding scale schedule designed by the division.
MA Gen L ch 118e § 16a1/2 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 16a1/2 - Costs Incurred for Medical Programs Projected to Exceed Available Appropriations; Notice

Section 16A1/2. The commissioner shall notify the house and senate committees on ways and means and the secretary of administration and finance whenever costs incurred for any program of medical care authorized by sections 9A, 16 and 16A are projected to exceed available appropriations for the current fiscal year or for costs authorized for expenditure for prior fiscal years. Such notice shall be filed within five business days of the commissioner's determination of such projection. Any such notice shall be accompanied by the following information: (a) an explanation of the reasons for any such deficiency or insufficient authorization for prior year expenditures; (b) revised total expenditure projections for any such items of appropriation that shall update the budget neutrality plan required pursuant to section 9B; (c) revised member month caseload assumptions for any such program of medical care that is projected to incur such a deficiency; (d) revised per member per month cost assumptions for any such program of medical care that is projected to incur such a deficiency; and (e) a description of all cost control measures, including quantification of the savings therefrom, that the division would propose to implement to prevent or ameliorate any such deficiency.
MA Gen L ch 118e § 17 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 17 - Reimbursements for Non-Generic Drugs

Section 17. Multiple source drugs listed in the Massachusetts list of interchangeable drug products established pursuant to the provisions of section thirteen of chapter seventeen of the General Laws and regulations adopted thereunder shall not be reimbursable except for the ''Massachusetts maximum allowable cost'', as defined by regulations of the department, unless the division grants prior authorization based upon the provision of written documentation by the practitioner to the division that satisfactorily demonstrates that a recipient's medical condition requires the use of a nongeneric drug and unless the practitioner writes on the face of the prescription in his or her own handwriting the words ''brand name medically necessary'' under the words ''no substitution'' in a manner consistent with applicable state law; provided that a pharmacist dispensing in accordance with this section shall be exempt from the provisions of the fourth paragraph of section twelve D of chapter one hundred and twelve.
MA Gen L ch 118e § 18 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 18 - Medical Insurance Purchases for Persons Eligible for Assistance

Section 18. The division may purchase on behalf of any person eligible for medical assistance under this chapter medical insurance furnished in accordance with the provisions of chapter one hundred and seventy-five, one hundred and seventy-six A, one hundred and seventy-six B or one hundred and seventy-six G, provided that such medical insurance, in conjunction with any supplemental coverage that may be available to such person by the division under this chapter, would enable such person to obtain medical care and services comparable to those afforded any other similar eligible person under this chapter, at no greater cost to such person or the division. The third party liability unit of the division is hereby authorized to establish services and procedures which seek to maximize and coordinate the utilization of health care benefits provided under any such purchase of medical insurance for such person.
MA Gen L ch 118e § 19 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 19 - Prior Approval of Medical Services; Methods; Rules and Regulations; Posttreatment Examinations

Section 19. The division shall establish methods of approving services to be performed as a prerequisite to extending medical assistance. Said methods of prior approval may include, but need not be limited to: (1) in the case of restorative dentistry, or dentures, examination of proposed recipients or of diagnostic information regarding proposed recipients by dental consultants of the department; (2) in the case of orthodontic services, procedures which assure that medical assistance will be provided only for severe handicapping malocclusions; and (3) in the case of transportation to obtain medical care, a statement from the attending physician certifying that such transportation is necessary due to a physical disability.  Assistance under this chapter for nursing services for persons twenty years of age or under may be available only after a medical review team under the supervision or with the approval of the department of public health, in cooperation with the division and the departments of mental health and developmental services, approves such services for such persons. The department of public health, in cooperation with the division and such other departments, shall promulgate rules and regulations for such services, and any person or facility offering such services shall receive prior certification from the department of public health.  The division shall establish methods of random posttreatment examination of recipients of medical care or services under this chapter in order to assure that the care or services for which the division is billed were actually performed as described.
MA Gen L ch 118e § 20 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 20 - Application; Forms; Application by Institution

Section 20. An application or reapplication by an individual for medical assistance shall be made to the division on forms prepared by the division. Such forms shall include but not be limited to the following:—the name, address and social security number of the applicant and the name, address and social security number of any member of the family sixteen years of age and older, the total income from wages, salaries, pensions, fees, tips, bonuses and all other sources of income of all such persons, the ownership and description of any motor vehicle or boat, or trailer, or similar assets readily convertible into cash owned by any member of the family. Such form shall require that the applicant provide information to determine his or her eligibility for medical assistance under penalty of perjury.  An institution furnishing services under this chapter shall have the right to make such application on behalf of an individual only if, and to the extent, provided by regulations of the division.
MA Gen L ch 118e § 21 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 21 - Inquiry by Department; Notification of Applicant; Agreement

Section 21. Upon receipt of such application, the division shall make full inquiry concerning the eligibility of the applicant, his or her need for medical assistance and his or her resources and income, if any, and, shall make its decision: (1) within ninety days after receipt of such application for applicants who apply for medical assistance on the basis of a disability; and (2) within forty-five days after receipt of such application for all other persons. At the time of such initial decision, and in the event of any subsequent decision, the applicant or recipient shall be notified in writing of such decision and shall be informed of the reason therefor and of his right to appeal and of the method by which he may appeal under this chapter.  The division may enter into an agreement with the secretary, or with any government or private agency, whereby the secretary or agency shall determine on behalf of the division the eligibility for medical assistance under this chapter of all or certain applicants for such assistance.
MA Gen L ch 118e § 23a (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 23a - Financial Institutions; Request for Deposit and Withdrawal Records; Penalty

Section 23A. Upon written request signed by an authorized employee or agent of the division, the treasurer of a financial institution shall provide, without charge, the deposit and withdrawal records of the preceding 5 years for an applicant for or recipient of medical assistance under this chapter to any authorized employee or agent of the division or to the applicant or recipient. A treasurer who unreasonably refuses to provide these records within the time limit provided in the request or who willfully provides false information in the reply shall forfeit $50 to the commonwealth.  For the purposes of this section, ''financial institution'' shall mean a national bank, federal savings bank, federal savings and loan association or federal credit union, if such bank, association or credit union is authorized to transact business and has its main office or a branch office in the commonwealth; or a trust company, credit union, co-operative bank or savings bank, if such company, credit union or bank is organized and exists under the laws of the commonwealth or any other state of the United States or is otherwise authorized to do business in the commonwealth and has its main office or a branch office in the commonwealth; or a benefit association, insurance company or safe deposit company authorized to do business in the commonwealth.
MA Gen L ch 118e § 25a (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 25a - Determination of Eligibility for Qualified Medicare Beneficiary, Specified Low-Income Medicare Beneficiary and Qualified Individual Programs; Consideration of Certain Income or Assets

Section 25A. (a) For individuals 65 years of age or older, the division shall not consider income in an amount equivalent to 30 per cent of the federal poverty level or assets in an amount equivalent to the federal resource limit for the Medicare Saving programs, each as adjusted annually, in determining eligibility for the Qualified Medicare Beneficiary, Specified Low-Income Medicare Beneficiary and Qualified Individual programs, described in 42 U.S.C. section 1396a(a)(10)(E) and also known as the Medicare Saving or Medicare Buy-In programs. Enrollment in the Qualified Individual program shall be capped if the federal allotment for the program is exhausted.  (b) Prior to implementing subsection (a), the division shall obtain all required federal approvals, including amending its state plan, and shall promulgate regulations to implement this section.
MA Gen L ch 118e § 26 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 26 - Identification Card

Section 26. The division shall issue a numbered identification card to persons receiving medical assistance under this chapter. Such card shall bear the date of issue and shall be presented to providers as verification of eligibility for medical assistance. The division shall establish by rules and regulations such procedures as may be necessary for the purpose of recalling identification on termination of eligibility.
MA Gen L ch 118e § 27 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 27 - Redetermination of Eligibility

Section 27. If an individual has become eligible under this chapter, eligibility shall be reconsidered or redetermined:  (a) When required on the basis of information the division has obtained previously about anticipated changes in the individual's situation.  (b) Promptly within thirty days, after a report is obtained from any source which indicates that changes in the individual's circumstances may affect the amount of assistance to which he or she is entitled or may make him or her ineligible.  (c) Periodically in accordance with federal law.  (d) If any recipient shall by gift, inheritance, or other manner acquire additional assets during any twelve month interval following determination of his or her eligibility, the recipient shall, to the extent required by federal law, immediately report such acquisition to the division which shall immediately make a reevaluation of such recipient's eligibility.
MA Gen L ch 118e § 28 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 28 - Disposal of Resources at Less Than Fair Market Value; Period of Ineligibility

Section 28. In determining the eligibility of an institutionalized individual, as defined by Title XIX, the division shall impose a period of ineligibility, consistent with said Title XIX, against any such individual if said individual or his spouse disposes of resources for less than fair market value. In determining the eligibility of a non-institutionalized individual, as defined in said Title XIX, the division may impose a period of ineligibility as permitted by said Title XIX.
MA Gen L ch 118e § 29 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 29 - Transfer of Interest in Real Property; Notice

Section 29. Whenever an individual who is receiving medical assistance under this chapter transfers an interest in real or personal property, such individual shall notify the division. Such notice shall include, at a minimum, the individual's name, social security number or, if different, medical assistance identification number, the date of transfer and the dollar value, if any, paid or received by the individual receiving benefits under this chapter.
MA Gen L ch 118e § 30 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 30 - Time of Payment

Section 30. When the division determines that an applicant is eligible for Medicaid, it shall pay for eligible care and services furnished on or after the date of application. Payment shall be made to the provider, institution or insurance entity supplying medical services. The date of application for Medicaid of an individual who has applied for financial assistance under the provisions of chapter one hundred and eighteen A or section one hundred and thirty-one of chapter six, shall be deemed to be the date of application for such financial assistance, whether or not such financial assistance is granted. If consistent with Title XIX of the federal Social Security Act and the regulations established thereunder, the division shall pay for eligible care and services furnished to an eligible applicant during the three months immediately prior to the month in which the applicant filed his or her application; provided, however, that, at the time such care or services are furnished to such individual, that individual upon application would have been eligible for Medicaid pursuant to this chapter.