Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 438.000 - Continuous Skilled Nursing Agency
Section 438.408 - Services Provided under Contract
Universal Citation: 130 MA Code of Regs 130.438
Current through Register 1531, September 27, 2024
(A) Introduction. A CSN agency may provide CSN agency services directly or through contractual arrangements made by the CSN agency. Whether the services are provided directly or through contracts, the CSN agency is responsible for submitting claims for services and for meeting the requirements in 130 CMR 438.000 and all other applicable state and federal requirements.
(B) Contract Requirements.
(1) If the CSN agency contracts with another
provider participating in MassHealth (e.g., hospital, nursing
facility, a home health agency, another CSN agency, or hospice), a written
contract must document the services to be provided and the corresponding
financial arrangements.
(2) If the
CSN 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 CSN
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.
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