101 CMR, § 353.01 - General Provisions
(1)
Scope and Purpose. 101 CMR 353.00 governs certain
payments to Primary Care Clinicians (PCCs) for Primary Care Clinician (PCC)
services provided to MassHealth members as part of the MassHealth PCC Plan, and
to Primary Care ACO-participating Primary Care Providers (participating PCPs)
for participating PCP services provided to members enrolled in MassHealth
Primary Care ACOs. The enhancement rate payments described in 101 CMR 353.00
are in addition to payments issued under the Acute Hospital Request for
Applications, and 101 CMR 304.00: Rates for Community Health
Centers; 101 CMR 316.00: Surgery and Anesthesia
Services; 101 CMR 317.00: Medicine; and 101 CMR
318.00: Radiology.
(2)
Disclaimer of Authorization
of Services. 101 CMR 353.00 is not authorization for or approval
of the procedures for which payments are determined pursuant to 101 CMR 353.00.
Purchasing agencies and insurers are responsible for the definition,
authorization, and approval of care and services extended to publicly aided
individuals.
(3)
Administrative Bulletins. EOHHS may issue
administrative bulletins to clarify its policy on and understanding of
substantive provisions of 101 CMR 353.00.
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.