Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 408.000 - Adult Foster Care Services
Section 408.404 - Provider Eligibility
Universal Citation: 130 MA Code of Regs 130.408
Current through Register 1531, September 27, 2024
(A) An organization seeking to participate in MassHealth as an AFC provider must
(1) enter into a contract with the MassHealth
agency;
(2) maintain a business
office in Massachusetts and be duly authorized to conduct a business in
Massachusetts that delivers health and human services to elders or people with
disabilities. Such business offices must:
(a)
be available to members during regular, posted business hours;
(b) be physically accessible to members with
disabilities;
(c) have clear access
and space for storing of business records;
(d) have a sign visible from outside the
facility identifying the business name and hours that the business office is
open;
(e) have a publicly listed
business name, address, and local toll-free telephone number that is answered
by customer service staff during business hours and that has Telecommunication
Device for the Deaf/Teletype (TTY/TDD) transmission and reception capability;
provided, that during business hours, this number cannot be a pager, answering
service, voice message system, or cell phone; and
(f) maintain a 24-hour voice message
system;
(3) accept
MassHealth payments as payment in full for all AFC;
(4) establish, maintain, and comply with
written policies and procedures to comply with 130 CMR 408.000;
(5) agree to periodic inspections, by the
MassHealth agency or its designee, that assess the quality of member care and
ensure compliance with 130 CMR 408.000;
(6) agree to comply with all the provisions
of 130 CMR 408.000, 450.000: Administrative and Billing
Regulations, and all other applicable MassHealth rules and
regulations.
(7) participate in any
AFC provider orientation required by EOHHS;
(8) meet all provider participation
requirements described in 130 CMR 408.000 and 130 CMR 450.000:
Administrative and Billing Regulations;
(9) agree to pay AFC caregivers on a timely
basis for services provided at applicable compensation levels.
(10) be accredited by the National Committee
for Quality Assurance (NCQA), the Council on Accreditation (COA), the
Commission on Accreditation of Rehabilitation Facilities (CARF), or other
nationally recognized accreditation organizations determined acceptable by the
MassHealth agency. AFC providers must provide evidence of accreditation in
accordance with
130
CMR 408.404(A)(10) in the
form and format as required by the MassHealth agency; and
(11) submit to the MassHealth agency or its
designee a statement of fiscal soundness attesting to the financial viability
of the AFC provider supported by documentation to demonstrate that the provider
has adequate resources to finance the provision of services in accordance with
130 CMR 408.000 in the form and format as required by the MassHealth
agency.
(B) The MassHealth agency requires documentation from applicants seeking to become AFC providers. All required application documentation must be submitted and approved in order to participate as an AFC provider in MassHealth. All required MassHealth application documentation will be specified by the MassHealth agency.
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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