130 CMR, § 435.405 - Rates of Payment
(A) Payments to
in-state hospitals for services furnished to MassHealth members are equal to
the rate established in the signed provider agreement with the MassHealth
agency.
(B) Payments to
out-of-state hospitals are made in accordance with
130 CMR
450.233. The Medicaid program rate
methodology of that state will apply when such methodology is compatible with
the MassHealth agency's claims-processing system. Otherwise, the MassHealth
agency and the out-of-state facility will negotiate a rate comparable to the
median or weighted average in-state rate for similar facilities.
(C) The hospital must accept the amount of
payment established by 130 CMR 435.405 as payment in full for all care and
services provided by the hospital for which payment is available under
MassHealth.
Notes
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