General Definitions

Meaning of Terms. Terms used in 101 CMR 353.00 will have the meaning ascribed in 101 CMR 353.02. Accountable Care Organization (ACO). An entity that enters into a population-based payment model contract with EOHHS as an accountable care organization, wherein the entity is held financially accountable for the cost and quality of care for an attributed or enrolled member population. ACOs include Accountable Care Partnership Plans, Primary Care ACOs, and MCO-administered ACOs. Center. The Center for Health Information and Analysis established under M.G.L. c. 12C. EOHHS. The Executive Office of Health and Human Services established under M.G.L. c. 6A. Final Adoption May 14, 2021 101 CMR: EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES 101 CMR 353.00: PAYMENT FOR PRIMARY CARE CLINICIAN PLAN SERVICES AND PRIMARY CARE ACO PARTICIPATING PRIMARY CARE PROVIDER SERVICES Primary Care ACO. A type of ACO with which the MassHealth agency contracts under its ACO program. Primary Care Clinician (PCC). Any MassHealth provider that participates as a primary care provider for MassHealth members enrolled in the PCC Plan, as described in 130 CMR 450.118: Primary Care Clinician (PCC) Plan. Publicly Aided Individual. A person whose medical and other services is paid for in whole or in part by the Commonwealth of Massachusetts or any of its departments, agencies, boards, commissions, or political subdivisions.