105 CMR, § 164.009 - Evaluation of Application and Suitability of Applicant or Licensed or Approved Provider

(A) Upon receipt of a complete application the Department shall evaluate the suitability of the applicant or Licensed or Approved Provider including, but not limited to, the following factors. A negative determination with respect to any one of the factors constitutes an adequate ground for deeming an applicant or Licensed or Approved Provider unsuitable to establish or maintain a substance use disorder treatment program and upon which the Department may deny an initial or renewal application for a License or Approval.

(1) Past performance as a provider of substance use disorder treatment services, based upon documentation of applicant's or Licensed or Approved Provider's:

(a) history of compliance with 105 CMR 164.000;

(b) history of providing substance use disorder treatment services or other health care services, including provision of services in other states;

(c) ability to provide substance use disorder treatment services;

(d) history of response to correction orders issued under 105 CMR 164.016;

(e) history of failure to provide services to any individual when licensed or approved to provide such services; and

(f) history of patient or resident abuse, mistreatment or neglect in any licensed health care program or facility.

(2) Whether the applicant's or Licensed or Approved Provider's financial resources are sufficient to provide substance use disorder treatment services for which the applicant seeks a license.

(3) Whether the Licensed or Approved Provider or applicant is in compliance with all laws of the Commonwealth including, but not limited to, laws relating to taxes and child support and whether the applicant has workers compensation and professional and commercial insurance coverage.

(4) The record of compliance for health care facilities in the Commonwealth or other jurisdictions, including any limitation on, suspension or revocation of, or refusal to grant or renew a health care license or certification for Medicaid or Medicare to the applicant or Licensed or Approved Provider.

(5) The adequacy of the applicant's or Licensed or Approved Provider's legal capacity to operate, as demonstrated by such documents as articles of incorporation and corporate by-laws.

(6) Any attempt to obtain a License or Approval by fraud, misrepresentation, or the submission of false information.

(7) Whether a new applicant can demonstrate the capacity to meet the requirements for licensing or approval as a substance use disorder treatment program.

(8) Whether the applicant is able to provide services to residents of the Commonwealth with public health insurance on a nondiscriminatory basis and able to report the facility's payer mix to the Department on a quarterly basis.

(9) Whether the applicant can demonstrate need for the services in accordance with 105 CMR 164.011(A).

(10) Such other information as the Department may require.

(B) The application shall also include an attestation from the applicant confirming that any substance use disorder treatment program subject to licensure or approval under 105 CMR 164.000 operated by said applicant will:

(1) Provide services on a nondiscriminatory basis to residents of the Commonwealth with public health insurance and report the substance use disorder treatment program's payer mix to the Department in a format prescribed by the Department on a quarterly basis, as required by M.G.L. c. 111E, § 7;

(2) Provide medications for treatment of addiction, including all FDA-approved medications for addiction treatment, directly or through a QSOA;

(3) Provide overdose prevention education as part of evidence-based practices; and

(4) Provide data and other information as requested by the Department pursuant to 105 CMR 164.022.

Notes

105 CMR, § 164.009

Amended by Mass Register Issue 1305, eff. 1/29/2016. Amended by Mass Register Issue 1482, eff. 11/11/2022.