Optional Reimbursable Services

A CHC may elect to provide the following services on site or by referral, but it is not required to do so under 130 CMR 405.000. The CHC must notify the MassHealth agency in writing of each service listed in 130 CMR 405.471(A) through (E) that the CHC will provide on site and must enroll with MassHealth as that provider type. All services provided on site must be furnished by practitioners qualified to provide the service that are employees or contactors of the CHC, and associated payment claimed by the CHC, in compliance with the applicable MassHealth regulations and Subchapter 6 for each service, including applicable fee schedules. All services listed below that are provided by referral must be based on written agreements between the CHC and each referral provider to ensure continuity of care, exchange of relevant health information such as test results and records, and avoidance of service duplication. Each referral provider must be a participating provider in MassHealth, and payment for the services provided by the referral provider must be claimed by the referral provider in compliance with the applicable MassHealth regulations for such service. All referrals must include follow up to ensure that the referral process is successfully completed. Services the CHC may elect to provide include (A) adult day health services; (B) adult foster care; (C) day habilitation; (D) psychiatric day treatment; and (E) home health services.