Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 421.000 - Family Planning Agency Services
Section 421.412 - Medical and Laboratory Services

Universal Citation: 130 MA Code of Regs 130.421

Current through Register 1531, September 27, 2024

(A) For an initial or annual visit, a family planning agency must provide all of the following medical and laboratory services:

(1) a complete medical history (including family and interval);

(2) a physical examination:
(a) for a member who is female, this includes thyroid, breast, heart, abdominal, speculum, pelvic, and rectal examinations, and measurements of height, weight, and blood pressure;

(b) for a member who is male, this includes thyroid, heart, genital, abdominal, and rectal examinations, and measurements of height, weight, and blood pressure;

(3) a Pap smear (for a female member) as indicated by current nationally recommended protocols, such as American College of Obstetrics and Gynecology (ACOG), American Cancer Society (ACS), or the US Preventive Services Task Force (USPSTF);

(4) any laboratory test indicated by the member's history or examination (such a test may be provided directly or by referral);

(5) a medically approved method of contraception, if appropriate; and

(6) referrals for the screening, diagnosis, prevention, or treatment of general as well as reproductive medical conditions.

(B) For a routine visit, a family planning agency must provide medical and laboratory services necessary to monitor the member's contraceptive care or to follow-up on conditions requiring medical attention by agency personnel. These services must include, but are not limited to, the following:

(1) update of medical history;

(2) a physical examination that may include pelvic or genital examination;

(3) measurements of blood pressure and weight;

(4) any laboratory test indicated by the member's history or examination (such a test may be provided directly or by referral);

(5) identification of any symptoms, conditions, or side effects that may contraindicate the method of contraception used;

(6) assessment of the member's use of the method of contraception; and

(7) referrals for the screening, diagnosis, prevention, or treatment of general as well as reproductive medical conditions.

(C) For a minimal visit, a family planning agency must provide counseling services only or brief medical and counseling services. The purpose of a minimal service visit is to reinforce contraceptive instructions, to monitor the member's use of a contraceptive method, or to provide education and counseling.

(D) A family planning agency must make available all methods of contraception listed in Subchapter 6 of the Family Planning Agency Manual.

(E) Physical examinations must be performed by a physician, a nurse practitioner, or a physician assistant. A physician must examine all members with medical problems and members who request to be seen by a physician. A nurse practitioner or physician assistant may examine members during an initial, annual, or routine visit. A physician must be on site or on call during all hours of operation.

(F) The family planning agency must have written medical protocols that include a periodicity schedule for return visits, procedures for follow-up for each method of contraception, procedures for care of high-risk patients, and emergency drug protocols.

Disclaimer: These regulations may not be the most recent version. Massachusetts may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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