Requirements for Provider Participation: Out-of-state

To be eligible to participate in MassHealth, an out-of-state nursing facility must (A) be licensed by the appropriate state licensing authority to operate such a facility; (B) be continuously certified by the state survey agency as meeting the federal requirements for participation in Medicaid 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.