Section 425.409 - Nonreimbursable ServicesThe following services are not reimbursable:
(A) drugs and durable medical equipment prescribed for take-home use that are readily available from pharmacies or medical providers;(B) the cost of any treatment or testing of a member or of a specimen from a member who is not an inpatient in the psychiatric inpatient hospital;(C) room-and-board services on the day of discharge (unless the day of discharge is also the day of admission);(D) leave-of-absence days;(E) research or the provision of experimental or unproven procedures;(F) private hospital rooms, except when medically necessary; and(G) services furnished by the emergency room or outpatient department on the day of admission, during the inpatient stay, or on the day of discharge.Amended by Mass Register Issue 1341, eff. 6/16/2017.