reglab/housing_qa huggingface dataset:
MA Gen L ch 118e § 33 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 33 - Long Term Care Insurance Purchasers; Liability for Medical Assistance Paid

Section 33. No claim for costs of a nursing facility or other long-term care services shall be made by the division under section 31 or 32 if the individual receiving medical assistance was permanently institutionalized, had notified the division that the individual had no intention to return home and, on the date of admission to the nursing facility or other medical institution, had long-term care insurance that, when purchased or at any time thereafter, met the requirements of 211 C.M.R. 65.00.
MA Gen L ch 118e § 34 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 34 - Liens and Encumbrances

Section 34. No lien or encumbrance of any kind except as may be permitted by the Secretary, shall be required from or imposed against the property of any individual prior to his death because of Medicaid benefits paid or to be paid on his behalf except pursuant to the judgment of a court on account of benefits incorrectly paid on behalf of a Medicaid recipient.  The division shall not be required to pay a recording fee for filing a notice of lien or encumbrance or a release or discharge of a lien or encumbrance under this section.
MA Gen L ch 118e § 35 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 35 - Reimbursement for Covered Claims; Submission of Information

Section 35. No claim for medical care or services provided for under this chapter shall be reimbursed if any health insurance company, non-profit hospital service corporation, medical service corporation, or other health insurer is liable for such claim under the terms of a group or individual policy providing coverage for such claim to a person eligible for assistance under this chapter. The division shall establish procedures to ensure that no such unauthorized claims are paid, including the soliciting of information regarding alternative health coverage from all applicants and recipients.  Notwithstanding the provisions of any general or special law to the contrary, chronic hospitals and skilled nursing facilities shall seek certification for Title XVIII of the Social Security Act for those services reimbursed under Title XVIII of the Social Security Act.  Notwithstanding any law to the contrary, all health insurers governed by chapters one hundred and seventy-five, one hundred and seventy-six A, one hundred and seventy-six B, one hundred and seventy-six C, one hundred and seventy-six E, one hundred and seventy-six F, and one hundred and seventy-six G, shall provide information to the division which is necessary to carry out the purposes of this section, including the names and addresses of their policyholders or subscribers.
MA Gen L ch 118e § 36 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 36 - Eligible Providers; Responsibility for Overpayments

Section 36. Participation in the medical assistance programs established under this chapter shall be limited to providers of services who have not been convicted of larceny or fraud or any other crime in connection with such services, or the billing therefor and who:  (1) indicate their intention to the division to so participate;  (2) present evidence, satisfactory to the division, of their qualifications to provide such services;  (3) agree to accept, as payment in full, the amounts paid in accordance with the fee schedules provided for under this chapter;  (4) agree to comply with all laws, rules and regulations governing the operation of the programs;  (5) agree to be responsible for all overpayments owed to the division, including, in the case of transfer of ownership, the overpayments of any and all previous owners.  If any individual or entity has an ownership interest in more than one institutional provider, the division may offset any monetary liability of such individual or entity to the division under this section or otherwise from any amounts the division owes to any such institutional provider. Any individual or entity having an ownership interest in an institutional provider shall be liable to the division for all monetary liabilities of such provider to the division to the extent of such individual's or entity's ownership interest. For purposes of this paragraph, an ''ownership interest'' shall include both direct ownership interests and ownership interests in any entity which has an ownership interest in an institutional provider, and an ''institutional provider'' shall mean any entity which participates in any medical assistance program under this chapter as a provider of nursing facility services or acute, chronic, or rehabilitation hospital services.
MA Gen L ch 118e § 37 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 37 - Distribution of Rules, Regulations to Providers; Administrative Sanctions

Section 37. The division shall distribute to all providers a copy of the rules, regulations, standards, and laws governing the medical assistance programs established by this chapter and shall establish administrative sanctions against providers, including, but not limited to, administrative fines, and, suspension or termination from the programs, for any violations of said rules, regulations, standards or laws. The division shall notify the proper professional society and licensing agency of any such violations.
MA Gen L ch 118e § 39 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 39 - False Representations, Failure to Disclose; Penalty

Section 39. Any person or institution which knowingly makes a false representation or, contrary to a legal duty to do so, knowingly fails to disclose any material fact to the division or its agents affecting eligibility or level of benefits for the purpose of causing any person, including the person making such representations, to be supported in whole or in part by the commonwealth, or for the purpose of procuring a payment under any medical assistance program administered by the division, shall be punished by a fine of not less than two hundred nor more than five hundred dollars or by imprisonment for not more than one year.  Nothing in this section shall be construed as preventing the institution of criminal proceedings for the violation of any other law of the commonwealth.
MA Gen L ch 118e § 40 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 40 - False Statements or Representations by Providers; Penalty

Section 40. Any person who furnishes items or services for which payment may be made under this chapter, who: (1) knowingly and willfully makes or causes to be made any false statement or representation of a material fact in any application for any benefit or payment under this chapter; or (2) knowingly and willfully makes or causes to be made any false statement or representation of a material fact for use in determining rights to such benefit or payment; or (3) having knowledge of the occurrence of any event affecting his or her initial or continued right to any such benefit or payment, or the benefit of any other individual in whose behalf he or she has applied for or is receiving such benefit or payment, conceals or fails to disclose such an event with an intent fraudulently to secure such benefit or payment either in a greater amount or quantity than is due or when no such benefit or payment is authorized; or (4) having made application to receive any such benefit or payment for the use and benefit of another and having received it, knowingly and willfully converts such benefits or payment other than for the use and benefit of such person, shall be punished by a fine of not more than ten thousand dollars, or by imprisonment in the state prison for not more than five years or in a jail or house of correction for not more than two and one-half years, or by both such fine and imprisonment.  Any person who does not furnish items of services for which payment may be made under this chapter, who violates any of the provisions of clauses (1) to (4), inclusive, shall be punished by imprisonment in a jail or house of correction for not more than two and one-half years or by a fine of not more than five thousand dollars or by both such fine and imprisonment.
MA Gen L ch 118e § 41 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 41 - Bribery or Rebates; Penalty

Section 41. Whoever solicits or receives any remuneration, including any bribe or rebate, directly or indirectly, overtly or covertly, in cash or in kind in return for purchasing, leasing, ordering or arranging for or recommending purchasing, leasing, or ordering any good, facility, service, or item for which payment may be made in whole or in part under this chapter, or whoever offers or pays any remuneration, including any bribe or rebate, directly or indirectly, overtly or covertly, in cash or in kind to induce such person to purchase, lease, order, or arrange for or recommend purchasing, leasing, or ordering any good, facility, service, or item for which payment may be made in whole or in part under this chapter shall be punished by a fine of not more than ten thousand dollars, or by imprisonment in the state prison for not more than five years or in a jail or house of correction for not more than two and one-half years, or by both such fine and imprisonment.  This section shall not apply to a discount or other reduction in price obtained by a provider of services or other entity under this chapter if the reduction in price is properly disclosed and appropriately reflected in the costs claimed or charges made by the provider or entity under this chapter or to any amount paid by an employer to an employee, who has a bona fide employment relationship with such employer, for employment in the provision of covered items or services.
MA Gen L ch 118e § 42 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 42 - Excess Charges; Penalty

Section 42. Whoever knowingly and willfully charges for any service provided to a patient under this chapter, money or other consideration at a rate in excess of the rates established in accordance with this chapter, shall be punished by a fine of not more than ten thousand dollars, or by imprisonment in the state prison for not more than five years or in a jail or house of correction for not more than two and one-half years, or by both such fine and imprisonment.
MA Gen L ch 118e § 43 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 43 - Health Care Facilities; Additional Charges as Precondition for Admission or Continuance; Penalty

Section 43. Whoever knowingly and willfully charges, solicits, accepts or receives, in addition to any amount otherwise required to be paid under this chapter, any gift, money, donation, or other consideration as a precondition or guarantee of admitting a recipient of services under this chapter whether or not presently certified or otherwise lawfully approved for long term care, to a hospital or nursing facility or to expedite the admission of such recipient or as a requirement for such recipient's continued stay in such a facility shall be punished by a fine of not more than ten thousand dollars or by imprisonment in the state prison for not more than five years or in a jail or house of correction for not more than two and one-half years or by both such fine and imprisonment.
MA Gen L ch 118e § 44 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 44 - Civil Remedies; Limitations

Section 44. If any person violates the provisions of this chapter, the attorney general or a district attorney may bring a civil action, either in lieu of or in addition to a criminal prosecution, and recover three times the amount of damages sustained including the costs of investigation and litigation. No action shall be brought under this section more than six years after it accrues.
MA Gen L ch 118e § 45 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 45 - Venue; Actions Relating to False Claims

Section 45. Any action brought under this chapter may be filed in the district or superior courts of Suffolk county.
MA Gen L ch 118e § 46 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 46 - Availability of Other Remedies

Section 46. The remedies in sections thirty-nine to forty-five, inclusive, are in addition to and do not supersede any other available remedies.
MA Gen L ch 118e § 46a (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 46a - Providers; Submission of Claims for Payment Not in Compliance With Policies and Procedures of Medical Assistance Program; Proof of Clerical or Administrative Error

Section 46A. Any provider making a claim for payment under any medical assistance program administered by the division, which is not submitted in compliance with the billing policies and procedures of said program, shall not be considered in violation of sections 39 to 46, inclusive, for purposes of eligibility pursuant to section 36, upon submission of proof, to the satisfaction of the commissioner, that the submission of the claim was due solely to a clerical or administrative error.
MA Gen L ch 118e § 47 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 47 - Persons Aggrieved; Right to Hearing; Investigation; Decision; Rehearing; Notice

Section 47. Any applicant for or recipient of medical assistance, or the legal representative of such applicant or recipient, aggrieved by the failure of the division to grant medical assistance or by the failure of the division to approve or reject an application within the time limits established by section twenty-one or by the withdrawal of such assistance shall have a right to a hearing, after due notice, upon appeal to the division in the manner and form prescribed by the division; provided, however, such appeal is received by the division within thirty days after official notice of the action taken by the division has been received by the applicant or recipient. Such hearing shall be conducted by the commissioner of medical assistance or a referee designated by the commissioner within the board of hearings established under section forty-eight. The commissioner or the designated referee is hereby empowered to subpoena witnesses, administer oaths, take testimony and secure the production of such books, papers, records and documents as may be relevant to such hearings. The decision of the commissioner, or of the designated referee, small be the decision of the division. Such appeals, hearings, and decisions shall be subject to the provisions of section forty-eight.  The division may make such additional investigation as it may deem necessary and shall make such decision as to the granting of medical assistance and the amount of such assistance to be granted as in its opinion is justified and in conformity with the provisions of this chapter. Applicants or recipients affected by such decisions of the division shall, upon request, be given reasonable notice and opportunity for a hearing as provided under this section. The provisions relating to the conduct of hearings and decisions thereon made, as provided in this section, shall be equally applicable in all cases wherein the division acts upon its own motion.  The commissioner, or the referee designated by the commissioner, shall render and issue his or her decision within ninety days after the date of the filing of the appeal by the aggrieved applicant, or legal representative of an applicant. The commissioner, but not his or her designee, may for good cause shown, direct the director of the board of hearings to conduct a rehearing of the appeal. An order for such rehearing shall not be construed as indicating or implying any position by the commissioner on the merits of the appeal. The director shall send seven days' written notice to all parties, including the date, time and place of such rehearing, which shall be held at a location convenient to the person appealing, and after such rehearing the director may, not later than thirty days after the order for such rehearing, issue a superseding decision.
MA Gen L ch 118e § 47a (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 47a - Benefits Available Only to Otherwise Eligible Individuals Showing Lawful Presence in the United States or Meeting Applicable Federal Requirements Necessary to Qualify for Benefits for Which the Commonwealth Receives Federal Reimbursement

Section 47A. Benefits for individuals age 19 or older for any program established pursuant to this chapter or chapter 118H shall be available only to otherwise eligible individuals who provide satisfactory documentation that they are lawfully present in the United States, including persons permanently residing in the United States under color of law, or to individuals who establish that they meet all applicable federal requirements necessary to qualify for benefits for which the commonwealth receives federal reimbursement under Title XIX and Title XXI of the Social Security Act, including any demonstration program under section 1115 of the Social Security Act.
MA Gen L ch 118e § 49 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 49 - Use and Disclosure of Information

Section 49. The use or disclosure of information concerning applicants and recipients shall be limited to purposes directly connected with the administration of the medical assistance programs established under this chapter and the names of applicants and recipients shall not be published.
MA Gen L ch 118e § 50 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 50 - Contract for Administrative Functions; Underwriting of Program

Section 50. To the extent feasible the division may contract with one or more federal agencies or corporations authorized to do business in the commonwealth, including nonprofit hospital and medical service corporations, to carry out the necessary administrative functions of the medical assistance programs established under this chapter. The division may contract for the underwriting of all or any part of such medical assistance programs with such corporation.
MA Gen L ch 118e § 51 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 51 - Utilization Review of Care and Services; Data Processing and Collection Procedures; Liability in Civil Actions

Section 51. The division, in cooperation with the department of public health and in accordance with the regulations of the secretary, shall establish processes of utilization review for care or services for which medical assistance is available under this chapter.  The division shall establish data processing and collection procedures which will: (1) monitor eligibility of recipients; (2) assure that providers are neither paid twice for the same care or service nor paid in amounts in excess of fee schedules or other applicable limits; and (3) provide the statistical data necessary for effective utilization review.  A medical professional employee of the division, or person providing medical professional counsel or services to the division on a voluntary or paid basis or an employee of a division subcontractor, shall not be liable in a civil action for damages arising out of any act, omission, proceeding or undertaking in the performance, in good-faith, of duties or responsibilities relative to any utilization related activities authorized or established by this chapter or by regulations promulgated by the secretary.
MA Gen L ch 118e § 52 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 52 - Maintenance of Standards for Providers; Development of New Programs

Section 52. The division, in cooperation with the department of public health, shall establish and maintain standards and conditions of participation for providers of all medical care and services for which medical assistance is available under this chapter.  The department of public health, in cooperation with the division shall: (1) plan for and stimulate the development of new medical resources and the expansion of existing resources; (2) stimulate and assist providers of health care and services to develop new and improved methods of delivery of services and payment for services; and (3) expand and increase the services of the department of public health to extend and improve, as far as is practicable, the availability and accessibility of the care and services for which medical assistance is available under this chapter to all recipients of medical assistance, and the coordination of these services in such manner that the best interests of the recipients are served.
MA Gen L ch 118e § 53 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 53 - Covered Services

Section 53. The division shall include within its covered services for adults all federally optional services that were included in its state plan or demonstration program in effect on January 1, 2002. Covered services for adults in the MassHealth Essential program shall include dental services to the same extent as such services were covered for adults in the MassHealth Basic program as of January 1, 2002. To the extent permitted by the demonstration program approved under 42 U.S.C. 1315(a), covered services in the MassHealth Basic and MassHealth Essential programs shall include hospice services to the extent such services are covered in the MassHealth Standard program.