413.405 - Services Provided by Out-of-state Providers

413.405. Services Provided by Out-of-state Providers

Inaccordance with 42 CFR 431.52(b), the MassHealth agency pays for out-of-state speech and hearing center services only in the following circumstances.

(A) Services are needed and the member's health would be endangered if the member were required to travel to his or her state of residence.

(B) The MassHealthagency determines, on the basis of medical advice, that the needed services, or necessary supplementary resources, are more readily available in another state.

(C) As a general practice, members in a particular locality use medical resources in another state.

The following state regulations pages link to this page.