Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 444.00 - Rates for Certain Substance Use Disorder Services
Section 444.02 - Definitions

As used in 101 CMR 444.00, terms shall have the following meanings, unless the context requires otherwise.

Approved Program Rate. The rate per service unit approved by EOHHS and filed with the Secretary of the Commonwealth.

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

Eligible 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 or may be adopted by a purchasing governmental unit.

EOHHS. The Executive Office of Health and Human Services established under M.G.L. c. 6A.

Established Charge. The lowest fee that is charged or accepted as payment by the eligible provider to the general public or any third-party payer, other than a governmental unit, for the provision of services. Fees based upon the client's ability to pay, as in the case of a sliding fee scale, and fees subject to EOHHS review and approval are not deemed to be established charges.

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

Individualized Treatment and Stabilization Services. Acute Treatment Services (ASAM Level 3.7) and Clinical Stabilization Services (ASAM Level 3.5) provided in an appropriately licensed facility and in accordance with all applicable specifications.

Medical Evaluation. An initial and annual one hour drug assessment conducted by a physician, advanced nurse practitioner, or other licensed medical practitioner.

Opioid Treatment Program (OTP). A program that provides opioid treatment services. An opioid treatment programs must be federally certified by the Substance Abuse Mental Health Services Administration and must be licensed as an Opioid Treatment Programs by the Department of Public Health under 105 CMR 164.000: Licensure of Substance Use Disorder Treatment Programs. Opioid Treatment Programs must conform to the federal opioid treatment standards set forth in 42 CFR 8.12.

Opioid Treatment Services. Supervised assessment and treatment of an individual, using FDA approved medications (including methadone, buprenorphine, buprenorphine/naloxone, and naltrexone), along with a comprehensive range of medical and rehabilitative services, when clinically necessary, to alleviate the adverse medical, psychological, or physical effects incident to opiate use disorders. This term encompasses withdrawal management and maintenance treatment.

Publicly Assisted Client. A person who receives program services for which a governmental unit is liable, in whole or in part, under a statutory program of financial assistance.

Purchasing Governmental Unit. A governmental unit that has purchased or is purchasing service units from an eligible provider.

Recovery Support Navigator. A paraprofessional or peer specialist who receives specialized training in the essentials of substance use disorder and evidence-based techniques such as motivational interviewing, and who supports members in accessing and navigating the substance use disorder treatment system through activities that can include care coordination, case management, and motivational support.