Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 448.00
Section 448.03 - 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 in the terms of the purchase agreement between the eligible provider and the purchasing governmental unit(s).

(2) Reimbursement as Full Payment. Each eligible provider must, as a condition of acceptance of payment made by any purchasing governmental units for services rendered, accept the approved program rate as full payment and discharge of all obligations for the services rendered. Payment from any other source will be used to offset the amount of the purchasing governmental unit's obligation for services rendered to the publicly assisted client.

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

(4) Lump Sum Payment. Purchasing governmental units may pay a lump sum payment limited to the equivalent of six monthly units. The lump sum payment will be calculated according to the following formula: Sum of {[(total May 2021 (one month) State spend on the services listed in 101 CMR 448.01(5) *(Add-on rate of 10%)*(6 units)]}.

(5) Approved Rates with Applicable Dates of Service Provided from July 1, 2021 through June 30, 2022. 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 448.03(5). Effective July 1, 2022, the rates revert to the rates in the parent regulations listed in 101 CMR 448.01(5).