101 CMR, § 337.01 - General Provisions
(1)
Scope and Purpose. 101 CMR 337.00 governs the payment
rates to be used by all governmental units and purchasers under M.G.L. c. 152,
§ 1 (the Workers' Compensation Act) for dialysis treatments, treatment for
acute kidney injuries (AKIs), and home dialysis supplies provided to publicly
aided and industrial accident patients.
(2)
Applicable Dates of
Service. Rates contained in 101 CMR 337.00 apply for dates of
service provided on or after April 1, 2024.
(3)
Disclaimer of Authorization
of Services. 101 CMR 337.00 is not authorization for or approval
of the services for which rates are determined pursuant to 101 CMR 337.00. The
governmental purchasers and purchasers under M.G.L. c. 152 of these services
are responsible for
(a) the definitions and
authorization of services for their beneficiaries; and
(b) providing information as to program
policies and benefit limitations.
(4)
Rate as Full
Payment. The rates of payment under 101 CMR 337.00 are full
compensation for all services rendered by the provider in connection with the
provision of dialysis treatments and home dialysis supplies . Any patient
resources or third-party payments on behalf of a publicly aided patient,
e.g., Medicare payments, will reduce the amount of the
obligation for these services to the governmental purchaser or purchaser under
M.G.L. c. 152 .
(5)
Coding Updates and Corrections. EOHHS may publish
service code updates and corrections in the form of an Administrative Bulletin.
Updates may reference coding systems including, but not limited to, the
American Medical Association's Current Procedural Terminology® (CPT). The
publication of such updates and corrections will list
(a) codes for which the code numbers change,
with the corresponding cross references between new codes and the codes being
replaced. Rates for such new codes are set at the rate of the code that is
being replaced;
(b) codes for which
the code number remains the same but the description has changed;
(c) deleted codes for which there are no
corresponding new codes; and
(d)
codes for entirely new services that require pricing. EOHHS will list these
codes and apply individual consideration (I.C.) payment for these codes until
appropriate rates can be developed.
(6)
Administrative
Bulletins. EOHHS may issue administrative bulletins to clarify its
policy on, and interpretation of, substantive provisions of 101 CMR
337.00.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.