130 CMR, § 410.412

Current through Register 1531, September 27, 2024
Section 410.412 - Utilization Management Program and Mental Health and Substance Use Disorder Admission Screening Requirements
(A)Utilization Management Program. The MassHealth agency pays for procedures and acute hospital stays that are subject to the acute hospital Utilization Management Program only if the applicable requirements of the program as described in 130 CMR 450.207 through 450.209 are satisfied. Appendices A and D of the Acute Outpatient Hospital Manual contains the name, address, and telephone number of the contact organization for the Utilization Management Program and describes the information that must be provided during the review process.
(B)Mental Health and Substance Use Disorder Admissions. The MassHealth agency will pay for mental health and substance use disorder services provided in an acute inpatient setting only if the admitting provider has satisfied the screening requirements established by MassHealth policy, bulletin or other issuance.

130 CMR, § 410.412

Amended by Mass Register Issue 1344, eff. 7/28/2017.