Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 610.000 - MassHealth: Fair Hearing Rules
Section 610.037 - Notice Requirements for PASRR Determinations
Universal Citation: 130 MA Code of Regs 130.610
Current through Register 1531, September 27, 2024
(A) When DMH or DDS issues a PASRR determination, it must provide written notice of the PASRR determination to the following:
(1) the evaluated individual and
his or her legal representative;
(2) the admitting or retaining nursing
facility;
(3) the attending
physician; and
(4) the discharging
hospital, if the individual is seeking nursing facility admission from a
hospital.
(B) Notice of the PASRR determination must include the following:
(1) whether a nursing facility level of
service is needed;
(2) whether
specialized services, as defined by
42 CFR
483.120, are needed;
(3) the placement options available to the
individual consistent with the determination and in accordance with
42 CFR
483.130(M);
(4) a statement indicating that the
individual's PASRR determination is based on the individual's PASRR and that
the individual was evaluated in accordance with
42 CFR
483.128;
(5) a statement informing the individual of
his or her right to request a fair hearing before the BOH to appeal a PASRR
Determination and that provides
(a) the
address to send a request for a hearing;
(b) the time frame for requesting a hearing
as provided for under
130 CMR 610.015;
and
(c) a statement that the
individual may represent himself or herself or be represented by legal counsel,
a relative, a friend or other spokesperson.
(C) Notice must be mailed no later than the date of the PASRR determination.
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