Code of Massachusetts Regulations › 130 CMR - DIVISION OF MEDICAL ASSISTANCE › Title 130 CMR 410.000 - Outpatient hospital services › Section 410.413 - Medical Services Required on Site at a Hospital-Licensed Health Center

Current through Register 1525, July 5, 2024
In order to be reimbursed at the rates established for
				hospital-licensed health centers (HLHCs), an HLHC must provide on site the
				medical services specified in 130 CMR 410.413(D), (E), and (F), and at least
				two of the medical services described in 130 CMR 410.413(A), (B), and (C). It
				is not necessary that all of these services be available during all hours of
				the HLHC's operation, but all services must be available to members on a
				regularly scheduled basis with sufficient frequency to ensure access to care
				and continuity of care.
(A)
Pediatric Services
. The HLHC must provide pediatric
			 services.
(B)
Internal
			 Medicine
. The HLHC must provide internal medicine
			 services.
(C)
Obstetrics/Gynecology
. The HLHC must provide
			 obstetrical and gynecological services. When a family practitioner is employed
			 in place of a medical specialist in obstetrics/gynecology, the family
			 practitioner must have admitting privileges to a hospital for delivery and
			 obstetrical and gynecological backup.
(D)
Health
			 Education
. The HLHC must provide health education designed to
			 prepare members for their participation in and reaction to specific medical
			 procedures, and to instruct members in self-management of medical problems and
			 in disease prevention. Health education may be provided by any health
			 practitioner or by any other individual approved by the HLHC's professional
			 services director as possessing the qualifications and training necessary to
			 provide health education to members.
(E)
Medical Social
			 Services
. The HLHC must provide medical social services designed
			 to assist members in their adjustment to and management of social problems
			 resulting from medical treatment, specific disease episodes, or chronic
			 illness. Medical social services must be provided by a clinical social worker
			 who is licensed by the Massachusetts Board of Registration. This individual
			 must be on site sufficient hours and with sufficient frequency to provide
			 medical social services to members.
(F)
Nutrition
			 Services
. The HLHC must provide counseling in the purchase,
			 preparation, and consumption of proper nutrients to members who have been
			 determined to require such counseling because of their health problems or
			 because they have a high potential for developing health problems that might be
			 avoided or made less severe through proper nutrition. Each HLHC must employ
			 either a nutrition professional with a bachelor's or master's degree in public
			 health nutrition, community nutrition, or human nutrition, or a dietitian who
			 is currently registered by the American Dietetic Association. This individual
			 is responsible for planning, directing, and evaluating the nutrition services
			 provided at the HLHC; for educating the HLHC's staff about nutrition; for
			 supervising any nutrition aides; for consulting with practitioners and other
			 staff members of the HLHC; and for counseling members referred for nutrition
			 information. The nutrition professional or registered dietitian must be on site
			 at least one day per calendar month.