130 CMR, § 610.003
130 CMR 610.000 sets out the processes for fair hearing requests and proceedings started by applicants or members to review certain actions or inactions by the MassHealth agency or a MassHealth managed care contractor relating to programs administered by the MassHealth agency, including determinations of eligibility for low-income subsidies under Medicare Part D (as set forth in the Medicare Prescription Drug and Improvement and Modernization Act of 2003, as described in federal regulations at 42 CFR Part 423, Subpart P). In addition, appeals pursuant to the Executive Office of Elder Affairs Supplementary Rules to the Adjudicatory Rules of Practice and Procedures, 651 CMR 1.00: Adjudicatory Rules of Practice and Procedure are governed by the procedures set forth in 130 CMR 610.000. Appeals by residents of a nursing facility who are to be discharged or transferred at the initiation of the nursing facility, appeals regarding a nursing facility's failure to readmit, and appeals pertaining to PASRR determinations are also governed by 130 CMR 610.000. Adjudicatory proceedings initiated by MassHealth providers are governed by 130 CMR 450.241 through 450.248 or, with regard to appeals of erroneously denied claims, by 130 CMR 450.323: Appeals of Erroneously Denied or Underpaid Claims.
130 CMR, § 610.003