Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 610.000 - MassHealth: Fair Hearing Rules
Section 610.027 - Timely Notice Exceptions

Universal Citation: 130 MA Code of Regs 130.610

Current through Register 1531, September 27, 2024

The MassHealth agency need not send a timely notice, as defined at 130 CMR 610.015(A), but must send an adequate notice, as defined in 130 CMR 610.026, no later than the date of an appealable action when

(A) the MassHealth agency receives a clear written statement signed by the member that

(1) the member no longer wishes to receive assistance; or

(2) gives information that requires termination or reduction of services and indicates that termination or reduction of services must be the result of supplying that information;

(B) the member has been admitted or committed to an institution and he or she is not eligible for further payments or service under any category of assistance;

(C) the member has been placed in a nursing facility or chronic hospital;

(D) a member's whereabouts are unknown and the mail from the MassHealth agency to the member has been returned by the Postal Service indicating there is no known forwarding address;

(E) the MassHealth agency renders a decision on a request for prior authorization of services;

(F) the MassHealth agency establishes the fact that the member has been accepted for Medicaid services by another local jurisdiction, state, territory, or commonwealth; or

(G) the MassHealth agency has factual information confirming the death of the member.

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