Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 450.000 - Administrative and Billing Regulations
Section 450.106 - Emergency Aid to the Elderly, Disabled and Children Program

Universal Citation: 130 MA Code of Regs 130.450

Current through Register 1531, September 27, 2024

(A) Covered Services. The following services are covered for EAEDC recipients:

(1) physician services specified in 130 CMR 433.000: Physician Services;

(2) community health center services specified in 130 CMR 405.000: Community Health Center Services;

(3) prescription drugs (those drugs that require a prescription under federal or state law) specified in 130 CMR 406.000: Pharmacy Services;

(4) insulins (the only over-the-counter drugs that are covered) and diabetic supplies;

(5) infusion (intravenous) therapy, including chemotherapy, pain management, antibiotics, chelation, and cardiac management;

(6) oxygen and respiratory therapy services specified in 130 CMR 427.000: Oxygen and Respiratory Therapy Equipment;

(7) substance use disorder treatment services as specified in 130 CMR 418.000: Substance Abuse Treatment Services if provided in public detoxification and outpatient substance use disorder treatment centers; and

(8) diagnostics and testing (such as laboratory, radiology, magnetic resonance imaging, or psychological testing) necessary for the determination or redetermination of eligibility for the EAEDC Program, upon referral from a physician or a community health center.

(B) Responsibilities of Acute Hospitals. Acute outpatient and inpatient hospitals are obligated under M.G.L. c. 118E, § 13H to provide medically necessary services to recipients of the EAEDC Program. EAEDC recipients are entitled to receive the services described in 130 CMR 410.000: Outpatient Hospital Services and 415.000: Acute Inpatient Hospital Services to the same extent that such services are provided to MassHealth members under M.G.L. c. 118E.

(C) Prior Authorization. Any covered services that require prior authorization in the MassHealth regulations ( 130 CMR 400.000 through 499.000) require prior authorization for the EAEDC Program.

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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