Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 403.000 - Home Health Agency
Section 403.407 - Services Provided under Contract
Universal Citation: 130 MA Code of Regs 130.403
Current through Register 1531, September 27, 2024
(A) Introduction. A home health agency may provide home health services directly or through contractual arrangements made by the home health agency. Whether the services are provided directly or through contracts, the home health agency is responsible for submitting claims for services and for meeting the requirements in 130 CMR 403.000 and all other applicable state and federal requirements. A home health agency may provide services through contracts in the following situations:
(1)
when a home health agency, in order to be approved to participate in
MassHealth, makes arrangements with another agency or organization to provide
the nursing, home health aide, or other therapeutic services that it does not
provide directly; or
(2) when a
home health agency that is already approved for participation in MassHealth
makes arrangements with others to provide services it does not
provide.
(B) Contract Requirements.
(1) If the home health agency contracts with
another provider participating in MassHealth (e.g., hospital,
nursing facility, another home health agency, or hospice), a written contract
must document the services to be provided and the corresponding financial
arrangements.
(2) If the home
health agency contracts with a provider that does not participate in
MassHealth, the written contract must include
(a) a description of the services to be
provided;
(b) the duration of the
agreement and how frequently it is to be reviewed;
(c) a description of how personnel are
supervised;
(d) a statement that
the contracting organization will provide its services in accordance with the
plan of care established by the member's physician in conjunction with the home
health agency's staff;
(e) a
description of the contracting organization's standards for personnel,
including qualifications, functions, supervision, and in-service
training;
(f) a description of the
method of determining reasonable costs and payments by the home health agency
for the specific services to be provided by the contracting organization;
and
(g) an assurance that the
contracting organization will comply with Title VI of the Civil Rights Act and
all relevant MassHealth provider requirements.
Disclaimer: These regulations may not be the most recent version. Massachusetts may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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