14- 197 C.M.R. ch. 11, § 05

Current through 2025-03, January 15, 2025

Section 197-11-05 - NON COVERED SERVICES

The following services are not reimbursable under this Section:

(A)Rent and food;

(B)Services for which the cost exceeds the limits described in Section 11.03;

(C)Personal assistance services (defined in 11.01(BB) delivered in an Adult Family Care Home setting or other licensed Assisted Living Facility which is reimbursed for providing personal assistance services;

(D)Services provided by a Personal Assistant who is found to have convictions or complaints set forth under criminal background check requirements of Section 11.01(M);

(E)Homemaker and handyman/chore services not directly related to medical need;

(F)Those services which can be reasonably obtained by the consumer by going outside his/her place of residence;

(G)Travel time and mileage by the Authorized Agent, Authorized Agent's staff, and/or the assistant to and from the consumer's residence;

(H)Mileage for Personal Assistants;

(I)Household tasks except when delivered as an integral part of the Authorized Plan of Service as described in Section 11.04;

(J)Custodial, supervisory or respite care;

(K)Off-site services, except in the provision of covered IADLs;

(L)On call services;

(M)Any reimbursement for hours of services in excess of the Maximum Authorized Service amount.

14- 197 C.M.R. ch. 11, § 05