Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 457.000 - Freestanding Birth Center Services
Section 457.410 - Recordkeeping Requirements
Current through Register 1531, September 27, 2024
FBCs are governed by recordkeeping provisions at MassHealth regulations 130 CMR 457.410 and 130 CMR 450.000: Administrative and Billing Regulations, and DPH regulations at 105 CMR 140.000: Licensure of Clinics.
(A) Payment for any service listed in 130 CMR 457.000 is conditioned upon its full and complete documentation in the member's medical record. An FBC must maintain a record of all medical services provided to a member for at least six years following the date of service. Payment for maintaining the member's medical record is included in the fee for the FBC service. Each medical record must contain sufficient information to document fully the nature, extent, quality, and necessity of the care furnished to the member for each date of service claimed for payment. If the documentation is not sufficient to justify the service for which payment is claimed by the FBC, the MassHealth agency will not pay for the service or, if payment has been made, may consider such payment to be an overpayment subject to recovery in accordance with 130 CMR 450.000: Administrative and Billing Regulations.
(B) The medical record for each member must contain, at a minimum, the following information: