Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 517.000 - MassHealth: Universal Eligibility Requirements
Section 517.009 - Assignment of Rights to Medical Support and Third-party Payments
Universal Citation: 130 MA Code of Regs 130.517
Current through Register 1531, September 27, 2024
(A) Every legally able applicant or member must assign to the MassHealth agency his or her rights to medical support and third-party payments for medical benefits provided under Mass-Health as well as the rights of applicants or members for whom he or she can legally assign medical support and third-party payments.
(B) The applicant or member must fully cooperate with the MassHealth agency in
(1)
establishing paternity;
(2)
obtaining any medical support and payments; and
(3) identifying and providing information to
assist the MassHealth agency in pursuing third parties, including a
noncustodial parent, who may be legally obligated to pay for care and services
for the applicant or member, or person on whose behalf benefits are requested,
unless the applicant or member has grounds to waive cooperation as described in
130 CMR
517.010 or
505.002(D):
Eligibility Requirements for Pregnant
Women.
(C)
(1) The MassHealth agency will deny
eligibility for any applicant who does not attest to a willingness to cooperate
and terminate eligibility for any member who refuses to cooperate, unless the
applicant or member demonstrates good cause, as described in
130 CMR
517.010, or is a pregnant woman who meets the
requirements of
130 CMR
505.002(D):
Eligibility Requirements for Pregnant Women.
(2) The MassHealth agency will not deny or
terminate eligibility of any applicant or member who cannot legally assign his
or her own rights, including, but not limited to, a minor child, and who would
otherwise be eligible but for the refusal, by a person legally able to assign
the child's rights, to assign the child's rights or to cooperate as required in
130 CMR 517.009.
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