130 CMR 456.404
Requirements for Provider Participation: In-state
To be eligible to participate in MassHealth, a nursing facility located in Massachusetts must
(A) be licensed by the Massachusetts Department of Public Health to operate such a facility;
(B) be continuously certified by the Massachusetts Department of Public Health as meeting the
federal requirements for participation in MassHealth in accordance with Title XIX of the Social
Security Act and the Medicare program under Title XVIII of the Social Security Act to the extent
required under 130 CMR 456.406;
(C) participate in the Medicare program under Title XVIII of the Social Security Act to the
extent required under 130 CMR 456.406;
(D) enter into a provider agreement with MassHealth;
(E) accept MassHealth payments as payment in full for nursing facility services pursuant to 130
CMR 450.203: Payment in Full; and
(F) agree to periodic inspections, by MassHealth or its designee, that assess compliance with 130
CMR 456.000.