Definitions

The following terms used in 130 CMR 421.000 have the meanings given in 130 CMR 421.402 unless the context clearly requires a different meaning. The reimbursability of services defined in 130 CMR 421.000 is not determined by these definitions, but by application of regulations elsewhere in 130 CMR 421.000 and in 130 CMR 450.000: Administrative and Billing Regulations. Annual Visit – a yearly visit during which comprehensive services, including medical, laboratory, and counseling services are provided. HIV Pre- and Post-Test Counseling Visit – a face-to-face meeting between the member and a counselor for the purpose of providing counseling before and after HIV testing. Such counseling includes information about the implications of positive and negative test results, risk-reduction techniques, partner notification, and referral to medical and support services, in accordance with established protocols of the Massachusetts Department of Public Health. Initial Visit – a member’s first visit during which comprehensive services, including medical, laboratory, and counseling services are provided. Institutionalized Individual – an individual who is (1) involuntarily confined or detained, under a civil or criminal statute, in a correctional or rehabilitative facility, including a psychiatric hospital or other facility for the care and treatment of mental illness; or (2) confined, under a voluntary commitment, in a psychiatric hospital or other facility for the care and treatment of mental illness. Mentally Incompetent Individual – an individual who has been declared mentally incompetent by a federal, state, or local court of competent jurisdiction for any purpose, unless the individual has been declared competent for purposes that include the ability to consent to sterilization. Minimal Visit – a brief visit during which a family planning agency provides counseling services only or brief medical and counseling services. Routine Visit – a return visit, follow-up visit, or other visit that is neither an annual nor an initial visit. Sterilization – any medical procedure, treatment, or operation for the purpose of rendering an individual permanently incapable of reproducing. MassHealth Subchapter Number and Title 4. Program Regulations Page Family Planning Agency Manual Transmittal Letter Date