Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 421.000 - Family Planning Agency Services
Section 421.438 - Sterilization Services: Introduction
Current through Register 1531, September 27, 2024
(A) Covered Services. The MassHealth agency pays for a sterilization provided to a member only if all of the following conditions are met.
(B) Assurance of Member Rights. No provider may use any form of coercion in the provision of sterilization services. No provider, or agent or employee of a provider, may mislead any member into believing that a decision to have or not to have a sterilization will adversely affect the member's entitlement to benefits or services for which the member would otherwise be eligible. The MassHealth agency has strict requirements for confidentiality of member records for sterilization services as well as for all other medical services covered by MassHealth.
(C) Retroactive Eligibility. The MassHealth agency does not pay for a sterilization performed during the period of a member's retroactive eligibility unless all conditions for payment listed in 130 CMR 421.438(A) are met.
(D) Location in Which Sterilizations May Be Performed. Sterilizations must be performed by a licensed physician at the family planning agency's site.
