Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 356.00 - Rates For Money Follows The Person Demonstration Services
Section 356.02 - Definitions

(a) devices, controls, or appliances, that enable an individual to increase their ability to perform activities of daily living;

(b) devices, controls, or appliances that enable an individual to perceive, control, or communicate with the community environment in which they live;

(c) items necessary for life support or to address physical conditions along with ancillary supplies and equipment necessary to the proper functioning of such items;

(d) such other durable and non-durable medical equipment that is necessary to address an individual's functional limitations; and

(e) necessary medical supplies.

Service may also include: evaluations necessary for the selection, design, fitting or customization of assistive technology to meet the needs of the individual; customization, adaptation, fitting, set-up, maintenance or repairs of assistive technology; the temporary replacement of assistive technology; and, training or technical assistance with the use of assistive technology.

Center. The Center for Health Information and Analysis established under M.G.L. c. 12C.

(a) accompaniment and transportation from facilities to community housing and service options;

(b) supporting service exploration and linkage; and

(c) assistance with connections to and engagement with community services.

(a) comprehensive assessments and periodic reassessments of an individual to determine the need for any medical, educational, social, or other services;

(b) development of a care plan that is based on the comprehensive assessments;

(c) referral and related activities (such as scheduling appointments) to help the individual obtain necessary services and identified needs specified in his or her care plan;

(d) development of a back-up plan of care; and

(e) monitoring and follow-up activities that are necessary to ensure that the individual's care plan is effectively implemented and adequately addresses the needs of the individual.

Executive Office of Health and Human Services (EOHHS). The executive agency within Massachusetts government that is the single state agency responsible for the administration of the MassHealth program (Medicaid), pursuant to M.G.L. c. 118E, Titles XIX and XXI of the Social Security Act, and other applicable laws and waivers thereto.

Governmental Unit. The Commonwealth, any board, commission, department, division, or agency of the Commonwealth and any political subdivision of the Commonwealth.

(a) the amount of time required to complete the service or item;

(b) the degree of skill required to complete the service or item;

(c) the severity or complexity of the service or item;

(d) the lowest price charged or accepted from any payer for the same or similar service or item, including, but not limited to any shelf price, sale price, advertised price, or other price reasonably obtained by a competitive market for the service or item; and

(e) the established rates, policies, procedures, and practices of any other purchasing governmental unit in purchasing the same or similar services or items.

MassHealth. The Medicaid program of the Commonwealth of Massachusetts, administered by EOHHS pursuant to M.G.L. c. 118E, Titles XIX and XXI of the Social Security Act, and other applicable laws and waivers thereto.

Money Follows the Person Demonstration. A MassHealth demonstration program authorized pursuant to a federal grant received by EOHHS that seeks to assist eligible MassHealth members residing in facility-based long term care settings to transition to a community-based setting, where they can receive home and community-based services.

Money Follows the Person Demonstration Services. Services that are either allowable Medicaid services not currently included in the state's array of home and community-based services (HCBS) or qualified services above what would be available to non-MFP Demonstration Medicaid beneficiaries, and which include assistive technology, Community Engagement Navigation, and transitional assistance.

Money Follows the Person Demonstration Supplemental Services. One-time services to support the transition of MFP Demonstration participants that are otherwise not allowable under the Medicaid program. Services address critical barriers to transition for MFP Demonstration participants, including the lack of affordable and accessible housing, food insecurity, and financial and administrative barriers to transitions.

Orientation and Mobility Services (O&M Services). Services that teach an individual with vision impairment or legal blindness how to move or travel safely and independently in his/her home and community and which include direct training, environmental evaluations and caregiver/direct care staff training on sensitivity to blindness/low vision. O&M Services are tailored to the individual's need and may extend beyond residential settings to other community settings as well as public transportation systems. There are three rates for Orientation and Mobility services. The three rates are based on the one-way distance traveled to initiate provision of the service: Level I for distances of one-30 miles; Level II for distances 31-60 miles and Level III for distances over 61 miles.

Provider. Any individual, group, partnership, trust, corporation or other legal entity that offers services for purchase by a governmental unit and that meets the conditions of purchase or licensure that have been adopted by a purchasing governmental unit.

Reporting Year. The Provider's fiscal year for which costs incurred are reported to the appropriate entity, as determined by EOHHS.

Transitional Assistance. Non-recurring set-up expenses and short-term services necessary to facilitate an individual's transition from a facility-based long term care setting to the community. Allowable expenses are those that are necessary to enable a person to establish a basic household and do not constitute room and board.