Code of Massachusetts Regulations › 130 CMR - DIVISION OF MEDICAL ASSISTANCE › Title 130 CMR 450.000 - Administrative and Billing Regulations › Section 450.202 - Nondiscrimination

Current through Register 1525, July 5, 2024
(A) M.G.L. c. 151B, § 4, clause 10
			 prohibits discrimination against any individual who is a recipient of federal,
			 state, or local public assistance, including MassHealth, because the individual
			 is such a recipient or because of any requirement of such an assistance
			 program. Accordingly, except as specifically permitted or required by law, no
			 provider may deny any medical service to a member eligible for such service
			 unless the provider would, at the same time and under similar circumstances,
			 deny the same service to a patient who is not a MassHealth member (for example,
			 no new patients are being accepted, or the provider does not provide the
			 desired service to any patient). A provider may not specify a particular
			 setting for the provision of services to a member that is not also specified
			 for nonmembers in similar circumstances.
(B) No provider may engage in any practice,
			 with respect to any member, that constitutes unlawful discrimination under any
			 other state or federal law or regulation, including, but not limited to,
			 practices that violate the provisions of Section 1557 of the Affordable Care
			 Act prohibiting discrimination on the basis of race, color, national origin,
			 sex (including pregnancy, gender identity and sex stereotyping), age, or
			 disability; Title VI of the Civil Rights Act of 1964; Title IX of the Education
			 Amendments of 1972; Section 504 of the Rehabilitation Act of 1973; and the Age
			 Discrimination Act of 1975.
(C)
			 Pursuant to
			 42 U.S.C.
			 1396u-2 and 42 CFR 438.3(d), MCOs,
			 Accountable Care Partnership Plans, Primary Care ACO's participating primary
			 care providers (participating PCPs), PCCs, the behavioral health contractor,
			 SCOs, and ICOs may not unlawfully discriminate and will not use any policy or
			 practice that has the effect of unlawfully discriminating against a MassHealth
			 member eligible to enroll in the contractor's MassHealth plan on the basis of
			 health status, need for health-care services, race, color, national origin,
			 sex, sexual orientation, gender identity, or disability. MCOs, Accountable Care
			 Partnership Plans, Primary Care ACO's participating primary care providers
			 (participating PCPs), PCCs, the behavioral health contractor, SCOs, and ICOs
			 will accept for enrollment and reenrollment all members referred by the
			 MassHealth agency in the order in which they are referred without restriction,
			 provided that PCCs and participating PCPs will accept members for enrollment
			 and reenrollment up to the limits for PCC panel capacity set under the contract
			 between EOHHS and PCCs and the limits for participating PCP panel capacity set
			 under the contract between EOHHS and participating PCPs.
(D) Violations of 130 CMR 450.202(A), (B),
			 and (C) may result in administrative action, referral to the Massachusetts
			 Commission Against Discrimination, or referral to the U.S. Department of Health
			 and Human Services, or any combination of these.