Rate Provisions

(1) Services Included in the Rate. The approved rate includes payment for all care and services that are part of the program of services of an eligible provider, as explicitly set forth in the terms of the purchase agreement between the eligible provider and the purchasing governmental unit(s). (2) Reimbursement as Full Payment. Each eligible provider must, as a condition of acceptance of payment made by any purchasing governmental units for services rendered, accept the approved program rate as full payment and discharge of all obligations for the services rendered. Payment from any other source will be used to offset the amount of the purchasing governmental unit's obligation for services rendered to the publicly assisted client. (3) Payment Limitations. No purchasing governmental unit may pay less than or more than the approved program rate. (4) Certain Unit Contract Payment Rates for Certain Sexual and Domestic Violence Services. The payment rate for certain sexual and domestic violence services established in 101 CMR 429.03(6)(a), provided pursuant to contracts purchasing only one unit in total, is at the rate established in 101 CMR 429.03(6)(a) times a factor of 1.18. The payment rate for certain sexual and domestic violence services established in 101 CMR 429.03(6)(a), provided pursuant to contracts purchasing only two units in total, is at the rate established in 101 CMR 429.03(6)(a) times a factor of 1.06. (5) Administrative Adjustment for Extraordinary Circumstances. A method whereby, subject to availability of funds, a purchasing governmental unit may provide additional resource allocations to a qualified provider in response to unusual and unforeseen circumstances that substantially increase the cost of service delivery in ways not contemplated in the development of current rates. It must be demonstrated that such cost increases gravely threaten the stability of service provision such that client or consumer access to necessary services is at risk. The purchasing governmental unit will evaluate the need for the administrative adjustment, determine whether funding is available, and convey that information to EOHHS for review to determine the amount of any adjustment. (6) Approved Rates. The approved rate is the lower of the provider’s charge or amount accepted as payment from another payer or the rate listed in 101 CMR 429.03. (a) Rates for Certain Sexual and Domestic Violence Services. Program Unit Rate Frequency Domestic Violence Community-based Services .25 Direct Care FTE Monthly Child Exposed to Domestic Violence Services .25 Direct Care FTE Monthly Supervised Visitation Services .25 Direct Care FTE Monthly Sexual and Domestic Violence Equity Services .25 Direct Care FTE Monthly Sexual and Domestic Violence Equity Legal Services .25 Direct Care FTE Monthly Intimate Partner Abuse Education Services Per cohort Monthly (b) Rates for Rape Crisis Centers and for Certain Sexual and Domestic Violence Service Add-ons. Program Unit Rate Frequency Rape Crisis Centers – Dual Agency Monthly Monthly Monthly Monthly Monthly Monthly Monthly Monthly Rape Crisis Centers – Stand-alone Agency Monthly Monthly Monthly Monthly Monthly Monthly Monthly Monthly Add-on Rates Service Rate Frequency Rape Crisis Satellite Center $49.52 Hourly Rape Crisis Statewide Specialized Hotline Monthly Rape Crisis Direct Care .25 FTE Monthly Housing Stabilization IC N/A Extraordinary Circumstances/Flex Funding IC N/A New SANE or SANE Telemedicine Site Development IC N/A Supervised Visitation Security Add-on per Site $978.73 Monthly Intimate Partner Abuse Education Services - Outreach and Development $547 Monthly