Nonreimbursable Administrative Days

Administrative days after the 45-day period described in 130 CMR 435.407(G) are not reimbursable when: (A) a hospitalized member is awaiting services or an appropriate placement is currently available, but the hospital has not transferred or discharged the member because of the hospital's administrative or operational delays; (B) the MassHealth agency or its agent determines that appropriate noninstitutional or institutional placement or services are available within a reasonable distance of the member's noninstitutional (customary) residence and the member, the member's family, or any person legally responsible for the member refuses the placement or services; or (C) the MassHealth agency or its agent determines that appropriate noninstitutional or institutional placement or services are available within a reasonable distance of the member's noninstitutional (customary) residence and advises the hospital of the determination, and the hospital or the physician refuses or neglects to discharge the member.