101 CMR, § 343.01 - General Provisions

(1) Scope and Purpose. 101 CMR 343.00 governs the rates of payment used by all governmental units to eligible providers for hospice services provided to publicly aided individuals. The rates set forth in 101 CMR 343.00 also apply to individuals covered by M.G.L. c. 152 (the Workers' Compensation Act).

(2) Applicable Dates of Service. Rates in 101 CMR 343.00 apply for dates of service provided on or after October 1, 2023, unless otherwise indicated.

(3) Disclaimer of Authorization of Services. 101 CMR 343.00 is not authorization for or approval of the services for which rates are determined pursuant to 101 CMR 343.00. Governmental units that purchase care are responsible for the definition, authorization, and approval of care and services extended to publicly aided clients.

(4) Coding Updates and Corrections. EOHHS may publish service code updates and corrections in the form of an administrative bulletin. The publication of such updates and corrections will list:

(a) codes for which the code numbers only changed, with a corresponding crosswalk;

(b) codes for which the code remains the same, but the description has changed;

(c) deleted codes for which there is no crosswalk; and

(d) new codes that require new pricing. For such new codes, EOHHS applies individual consideration in reimbursement until appropriate rates can be developed.

(5) Administrative Bulletins. EOHHS may issue administrative bulletins to clarify the substantive provisions of 101 CMR 343.00 and to notify interested parties of payment updates pursuant to 101 CMR 343.04(3)(b).

Notes

101 CMR, § 343.01

Amended by Mass Register Issue 1324, eff. 10/21/2016. Amended by Mass Register Issue 1329, eff. 10/21/2016. Amended by Mass Register Issue 1372, eff. 10/1/2017. Amended by Mass Register Issue 1424, eff. 8/21/2020. Amended by Mass Register Issue 1480, eff. 10/14/2022. Amended by Mass Register Issue 1526, eff. 7/19/2024.