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Mass. Gen. Laws. Ann. ch. 118E, §51 - Utilization review of care and services; data processing and collection procedures; liability in civil actions
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Current as of June 2015
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“Utilization review of care and services; data processing and collection procedures; liability in civil actions”
The division, in cooperation with the department of public health is responsible for establishing processes of utilization review for care or services for which medical assistance is available under this chapter.The division shall establish data processing and collection procedures which will: (1) monitor eligibility of recipients; (2) assure that providers are neither paid twice for the same care or service nor paid in amounts in excess of fee schedules or other applicable limits; and (3) provide the statistical data necessary for effective utilization review. A medical professional employee of the division or person providing services to the division on a voluntary or paid basis shall not be liable in civil actions for damages arising of any act related to utilization activities authorized by this chapter.
Current as of June 2015
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