130 CMR, § 450.224 - Provider Contract: Exclusion and Ineligibility of Convicted Parties
The MassHealth agency may terminate, or refuse to enter into or to renew a provider contract if:
(A)
the provider, any party in interest in such provider, an agent or managing
employee of such provider, or in the case of a group practice, any individual
practitioner enrolled as a member of the group, has been convicted of a
criminal offense relating to that person's involvement in any program
established under Title XVIII, XIX, or XXI of the Social Security Act, or of a
crime of such a nature that, in the judgment of the MassHealth agency, the
participation of such provider will compromise the integrity of MassHealth;
or
(B) the provider or an
individual practitioner enrolled as a member of a group practice has been a
party in interest, a managing employee, or an agent of a provider that has been
convicted of a criminal offense relating to that person's involvement in any
program established under Title XVIII, XIX, or XXI of the Social Security Act,
or of a crime of such a nature that, in the judgment of the MassHealth agency,
the participation of such provider will compromise the integrity of
MassHealth.
Notes
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