130 CMR, § 450.202 - Nondiscrimination
(A) M.G.L. c. 151B,
§ 4, clause 10 prohibits discrimination against any individual who is a
recipient of federal, state, or local public assistance, including MassHealth,
because the individual is such a recipient or because of any requirement of
such an assistance program. Accordingly, except as specifically permitted or
required by law, no provider may deny any medical service to a member eligible
for such service unless the provider would, at the same time and under similar
circumstances, deny the same service to a patient who is not a MassHealth
member (for example, no new patients are being accepted, or the provider does
not provide the desired service to any patient). A provider may not specify a
particular setting for the provision of services to a member that is not also
specified for nonmembers in similar circumstances.
(B) No provider may engage in any practice,
with respect to any member, that constitutes unlawful discrimination under any
other state or federal law or regulation, including, but not limited to,
practices that violate the provisions of Section 1557 of the Affordable Care
Act prohibiting discrimination on the basis of race, color, national origin,
sex (including pregnancy, gender identity and sex stereotyping), age, or
disability; Title VI of the Civil Rights Act of 1964; Title IX of the Education
Amendments of 1972; Section 504 of the Rehabilitation Act of 1973; and the Age
Discrimination Act of 1975.
(C)
Pursuant to
42 U.S.C.
1396u-2 and 42 CFR 438.3(d), MCOs,
Accountable Care Partnership Plans, Primary Care ACO's participating primary
care providers (participating PCPs), PCCs, the behavioral health contractor,
SCOs, and ICOs may not unlawfully discriminate and will not use any policy or
practice that has the effect of unlawfully discriminating against a MassHealth
member eligible to enroll in the contractor's MassHealth plan on the basis of
health status, need for health-care services, race, color, national origin,
sex, sexual orientation, gender identity, or disability. MCOs, Accountable Care
Partnership Plans, Primary Care ACO's participating primary care providers
(participating PCPs), PCCs, the behavioral health contractor, SCOs, and ICOs
will accept for enrollment and reenrollment all members referred by the
MassHealth agency in the order in which they are referred without restriction,
provided that PCCs and participating PCPs will accept members for enrollment
and reenrollment up to the limits for PCC panel capacity set under the contract
between EOHHS and PCCs and the limits for participating PCP panel capacity set
under the contract between EOHHS and participating PCPs.
(D) Violations of 130 CMR 450.202(A), (B),
and (C) may result in administrative action, referral to the Massachusetts
Commission Against Discrimination, or referral to the U.S. Department of Health
and Human Services, or any combination of these.
Notes
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