Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 416.00 - Rates For Clubhouse Services
Section 416.03 - Rate Provisions

(1) Services Included in the Rate. The approved rate includes payment for all care and services that are part of the program of services of an eligible provider, as explicitly set forth by the purchasing governmental unit(s).

(2) Reimbursement as Full Payment. Each eligible provider must, as a condition of payment by any purchasing governmental unit, accept the approved rate as full payment and discharge of all obligations for the services rendered. Payment by the purchasing governmental unit for services rendered to the client will be reduced by the amount of any payment from any other source.

(3) Payment Limitations. No purchasing governmental unit may pay less than, or more than, the approved rate.

(4) Approved Rates. The approved rate is the lower of the provider's charge or amount accepted as payment from another payer, or the rate listed in 101 CMR 416.03(4).