reglab/housing_qa huggingface dataset:
MA Gen L ch 118e § 10d (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 10d - Required Coverage for Treatment of Breast and Cervical Cancer

Section 10D. The division shall, within the limits of the funds appropriated for such purpose, provide coverage to eligible women who require medical treatment for either breast or cervical cancer in accordance with 1902(a)(10)(A)(ii)(XVIII) of the breast and cervical cancer prevention and treatment act of 2000 (PL 106–354). Said coverage shall be provided to women who meet the requirements of said federal act and any cost sharing prerequisites that said division may impose. Said division shall collaborate with the department of public health in order to incrementally implement said program, efficiently administer such benefits, and verify recipient eligibility and income information. Said program shall take effect upon written certification by the division to the secretary of administration and finance and the house and senate committees on ways and means that the federal Health Care Financing Administration has granted said division the approval to implement and administer such program.
MA Gen L ch 118e § 10e (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 10e - Healthy Start Program; Medical Assistance for Pregnant Women and Infants; Eligibility; Types of Assistance; Protection From Billing and Collection Practices

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.
MA Gen L ch 118e § 10g (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 10g - Coverage for Children Under Age 18 for Cleft Lip and Cleft Palate

[Text of section applicable as provided by 2012, 234, Sec. 8.]  Section 10G. For children under the age of 18, the division shall cover the cost of treating cleft lip and cleft palate. The coverage shall include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to ensure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology and nutrition services, if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip, cleft palate or both. The coverage required by this section shall be subject to the terms and conditions applicable to other benefits. Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this section.
MA Gen L ch 118e § 10i (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 10i - Coverage for Administration of All Federal Food and Drug Administration Approved Drugs for Opioid or Alcohol Dependence Treatment

Section 10I. The division and its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms and third-party administrators under contract to a Medicaid managed care organization or primary care clinician plan shall provide coverage for the administration of all federal Food and Drug Administration approved drugs for the treatment of opioid or alcohol dependence and shall establish billing codes and rates of payment for providers of licensed clinical stabilization services to administer the approved drugs to individuals in need of treatment.  For the purposes of this section, ''clinical stabilization services'' shall mean a 24–hour clinically managed post detoxification treatment for adults or adolescents, as defined by the department of public health, usually following acute treatment services for substance abuse, which may include intensive education and counseling regarding the nature of addiction and its consequences, relapse prevention, outreach to families and significant others and aftercare planning, for individuals beginning to engage in recovery from addiction.
MA Gen L ch 118e § 10j (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 10j - Coverage for Medical or Drug Treatments to Correct or Repair Disturbances of Body Composition Caused by HIV Associated Lipodystrophy Syndrome

Section 10J. The division shall provide coverage for medical or drug treatments to correct or repair disturbances of body composition caused by HIV associated lipodystrophy syndrome including, but not limited to, reconstructive surgery, such as suction assisted lipectomy, other restorative procedures and dermal injections or fillers for reversal of facial lipoatrophy syndrome. Coverage shall be subject to a statement from a treating provider that the treatment is necessary for correcting, repairing or ameliorating the effects of HIV associated lipodystrophy syndrome. The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefit provided by the division.
MA Gen L ch 118e § 10l (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 10l - Filling of Remaining Portion of Prescription for Covered Drug That Is a Narcotic Substance Earlier Filled in Lesser Quantity

Section 10L. The division and its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms and third party administrators under contract to a Medicaid managed care organization or primary care clinician plan shall provide, for any covered drug that is a narcotic substance contained in schedule II pursuant to chapter 94C and subject to cost sharing, that if a person receives a prescription filled in a lesser quantity pursuant to section 18 of said chapter 94C, said person shall not be subject to an additional payment obligation, including, but not limited, to co-payments, if said person fills the remaining portion of the prescription.
MA Gen L ch 118e § 10m (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 10m - Coverage for Tobacco Use Cessation Counseling and Products

[Text of section applicable to policies, contracts and subscription certificates delivered, issued or renewed in the commonwealth on or after January 1, 2020. See 2019, 133, Sec. 26.]  Section 10M. (a) The division and its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms and third-party administrators under contract to a Medicaid managed care organization or primary care clinician plan shall provide coverage for: (i) tobacco use cessation counseling; and (ii) all generic United States Food and Drug Administration-approved tobacco cessation products without cost sharing when prescribed by a health care provider.  (b) The division shall be permitted to employ reasonable managed care techniques consistent with state and federal law to determine the frequency, method, treatment or setting for the recommended item or service; provided, however, that covered persons shall have access to at least 1 tobacco cessation product without preauthorization.
MA Gen L ch 118e § 10n (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 10n - Urgent Care Facilities; Referrals; Primary Care Providers

Section 10N. (a) For the purposes of this section, the following words shall, unless the context clearly requires otherwise, have the following meanings:-  ''Division'', the division of medical assistance within the executive office of health and human services.  ''Urgent care facility'', any entity, however organized, whether conducted for profit or not for profit, which is advertised, announced, established or maintained for the purpose of providing urgent care services in an office or a group of offices, or any portion thereof, or an entity which is advertised, announced, established or maintained under a name which includes the words ''urgent care'' or which suggests that urgent care services are provided therein; provided, however, that an urgent care facility shall not serve as a patient's primary care provider.  ''Urgent care services'', delivery of episodic care for the diagnosis, treatment, management or monitoring of acute and chronic disease or injury that is: (i) for the treatment of illness or injury that is immediate in nature but does not require emergency services; (ii) generally provided on a walk-in basis without a prior appointment; (iii) available to the general public; and (iv) not intended as the patient's primary care provider.  (b) The division and its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms and third-party administrators under contract to a Medicaid managed care organization or primary care clinician plan shall not require an enrollee to obtain a referral from a primary care provider prior to obtaining health care services from an urgent care facility; provided, however, that any urgent care facility providing health care services to an enrollee shall provide the enrollee with names of primary care providers contracted with MassHealth and practicing in the municipality of residence of the enrollee or an adjacent municipality.  Any urgent care facility that provides health care services to an enrollee shall notify the division, in a manner to be determined by the division, that the urgent care facility provided such services to the enrollee. The urgent care facility shall also notify the division, in a manner to be determined by the division, if the enrollee does not have a designated primary care provider, and the division shall send a notice to the enrollee that shall contain guidance on how to choose a primary care provider.  The division may promulgate regulations to implement this section.
MA Gen L ch 118e § 11 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 11 - Cooperation With Federal Authorities

Section 11. The division shall, within the limits of the funds which have been appropriated for the purposes of this chapter, cooperate with the appropriate federal authorities in the administration of Title XIX, under which federal funds are available to the commonwealth for Medicaid, and accept for the commonwealth any benefits thereof. The state treasurer shall be the custodian of such funds allocated to the commonwealth.
MA Gen L ch 118e § 13 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 13 - Rate Changes; Review

Section 13. The commissioner shall review, and approve or disapprove, any change in Title XIX rates or Title XIX rate methodology proposed by the executive office of health and human services, which shall be called the ''executive office'' only for the purposes of this section or by a governmental unit designated by the executive office. The commissioner shall review such proposed rate changes for consistency with agency policy and federal requirements, and within the level of funding available as authorized by the general appropriation act prior to the certification of such rates by the executive office; provided, that the commissioner shall not disapprove a rate increase solely based on the availability of funding if the federal health care financing administration provides written documentation that federal reimbursement would be denied as a result of said disapproval and said documentation is submitted to the house and senate committees on ways and means. The commissioner shall, when disapproving a rate increase, submit the reasons for disapproval to the executive office together with any recommendations for changes. Such disapproval and recommendations, if any, shall be submitted after the commissioner is notified that the executive office intends to propose a rate increase for any class of provider under Title XIX; but in no event later than the date of the public hearing held by the executive office regarding such rate change; provided, that no rates shall take effect without the approval of the commissioner. The executive office and the commissioner shall provide documentation on the reasons for increases in any class of approved rates that exceed the medical component of the consumer price index to the house and senate committees on ways and means. The center for health information and analysis shall supply the commissioner with all statistical information necessary to carry out his duties under this section. Notwithstanding the foregoing, the commissioner shall not review, approve, or disapprove any such rate set pursuant to chapter twenty-three of the acts of nineteen hundred and eighty-eight. If projected payments from rates necessary to conform to applicable requirements of Title XIX are estimated by the commissioner to exceed the amount of funding appropriated for such purpose in the general appropriation act in any fiscal year, the executive office and the commissioner shall jointly prepare and submit to the Governor a proposal for the minimum amount of supplemental funding necessary to satisfy the requirements of the under Title XIX state plan.
MA Gen L ch 118e § 13b (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 13b - Hospital Rate Increases; Quality Standards and Benchmarks

Section 13B. Hospital rate increases shall be made contingent upon hospital adherence to quality standards and achievement of performance benchmarks, including the reduction of racial and ethnic disparities in the provision of health care. Such benchmarks shall be developed or adopted by the executive office of health and human services so as to advance a common national framework for quality measurement and reporting, drawing on measures that are approved by the National Quality Forum and adopted by the Hospitals Quality Alliance and other national groups concerned with quality, in addition to the Boston Public Health Commission Disparities Project Hospital Working Group Report Guidelines. The office of Medicaid shall consult with the MassHealth payment policy advisory board established under section 16M of said chapter 6A, during the process of developing these quality standards and performance benchmarks.
MA Gen L ch 118e § 13e1/2 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 13e1/2 - Contractual Arrangements With Acute and Non-Acute Hospitals

Section 13E1/2. All purchasers and third party payers, excluding purchasers and payers under the workers' compensation act, except as provided in chapter 152, may enter into contractual arrangements with acute and non-acute hospitals for services. No such arrangement, including, but not limited to, prices or charges which may be charged for non-contracted services or which may be negotiated in individual contracts between such purchasers or third party payers and such acute or non-acute hospitals, shall be subject to prior approval by any public agency; provided, however, that nothing in this chapter shall limit the authority of the executive office to establish rates of payment for all health care services adjudged compensable under chapter 152, and provided, further, that charges established by an acute or non-acute hospital for health care services rendered shall be uniform for all patients receiving comparable services.  Any acute or non-acute hospital that makes a charge or accepts payment based upon a charge in excess of that filed, required or approved by the executive office or that fails to file any data, statistics or schedules or other information required under this chapter or by any regulation promulgated by the executive office or which falsifies the same, shall be subject to a civil penalty of not more than $1,000 for each day on which such violation occurs or continues, which penalty may be assessed in an action brought on behalf of the commonwealth in any court of competent jurisdiction. The attorney general shall bring any appropriate action, including injunctive relief, as may be necessary for the enforcement of this chapter.
MA Gen L ch 118e § 13g (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 13g - Hospital Assets Not to Be Considered as Resources for Purpose of Establishing Rates

Section 13G. The executive office, or a governmental unit designated to perform ratemaking functions by the executive office, shall not consider the following as resources of such hospitals in the establishment, review or approval of acute and non-acute hospital rates and charges: restricted and unrestricted grants; gifts; contributions; bequests; fund principle; term endowments and endowment balances; restricted gifts; unrestricted gifts; and all income from any of the foregoing, including unrestricted income from endowment funds and income and gains from investment of unrestricted funds. The following words shall have the following meanings as used in this paragraph:  ''Income and gains from investment of unrestricted funds'', interest, dividends, rents or other income on investments, including net gains or losses resulting from investment transactions.  ''Term endowment'', funds available upon termination of restrictions.  ''Unrestricted gifts'', gifts, grants, contributions and bequests, upon which there are no restrictions imposed by the donor.  ''Unrestricted income from endowment funds'', income earned on investment of endowment funds which have no restrictions on income.  An acute or non-acute care hospital aggrieved by any action or failure to act by the executive office under this chapter may file an appeal under section 13E.
MA Gen L ch 118e § 13h (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 13h - Recipients of Benefits Under Chapter 117a

Section 13H. No acute hospital shall deny access to care and services which the hospital would provide under this chapter to recipients of benefits under chapter 117A.
MA Gen L ch 118e § 13i (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 13i - Patients With Foreign Residency

Section 13I. Notwithstanding any provisions of this chapter to the contrary, all costs and charges for patients who are residents of other countries shall, as provided herein, be exempted from the limitations imposed by this chapter. Any hospital shall be allowed to impose a surcharge on the normal charges that would otherwise be allowed for such residents of other countries. Such surcharges shall not be included in the calculation of gross patient service revenues. The normal charge and the patient discharge statistics shall otherwise be included under this chapter.
MA Gen L ch 118e § 13j (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 13j - Health Maintenance Organizations; Contracting Rights

Section 13J. A health maintenance organization organized under chapter 176G may; (i) negotiate directly with any hospital with respect to such health maintenance organization's rate of payment for hospital services; and (ii) enter into an agreement with such hospital reflecting such rate of payment without the approval of the executive office. The specification in this section of contracting rights of health maintenance organizations shall not be construed as affirming or denying such rights with respect to any other third party payer.
MA Gen L ch 118e § 13k (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XVII - Public Welfare|Chapter 118e - Division of Medical Assistance|Section 13k - Adjustment of Facility's Rate

Section 13K. Upon petition of a receiver appointed under section 72N of chapter 111, the executive office shall, under regulations to be promulgated hereunder, adjust the facility's rate, if necessary, to insure compensation of the receiver and payment for a bond. Such adjustment shall not be in effect if the licensee is under the jurisdiction of the United States Bankruptcy Court.