Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 435.000 - Chronic Disease And Rehabilitation Inpatient Hospital Services
Section 435.416 - Fair Hearings

Universal Citation: 130 MA Code of Regs 130.435

Current through Register 1531, September 27, 2024

(A) A member may request a fair hearing before the Division in cases when the Division or its agent determines, as the result of a review, that there is no administrative necessity for a continued stay due to the availability of an appropriate placement as described in 130 CMR 435.413.

(B) A hospital may request a fair hearing before the Division when the Division or its agent determines, as the result of a review, that an admission or a continued stay, or any part thereof, is not medically necessary but is administratively necessary.

(C) A member or a hospital may request a fair hearing before the Division when the Division or its agent determines, as the result of a review, that an admission or continued stay, or any part thereof, is not medically or administratively necessary.

(D) Written notice of the right to a fair hearing and the manner in which and time within which a hearing must be requested will be provided at the time of the determination by the Division or its agent.

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