Provider Enrollment Process

(A) A separate, complete application for enrollment as a MassHealth CSP provider must be submitted for each CSP. If the CSP is a parent CSP operating satellite locations, the parent CSP must identify all locations of operation in their application, including indicating which site will serve as the parent CSP location and identifying all satellite CSPs and their locations. The applicant must submit the appropriate provider enrollment application to the MassHealth agency. The MassHealth agency may request additional information or perform a site inspection to evaluate the applicant's compliance with the regulations in 130 CMR 461.000. (1) Based on the information in the enrollment application, information known to the MassHealth agency about the applicant, and the findings from any site inspection deemed necessary, the MassHealth agency will determine whether the applicant is eligible for enrollment. In the event of an application by a parent CSP with satellite CSP locations, MassHealth may evaluate each identified satellite CSP location for eligibility prior to enrollment. MassHealth determinations of ineligibility of a parent CSP will apply to all its component satellite CSP locations. MassHealth determinations of ineligibility of a constituent satellite CSP location may not result in determination of ineligibility for the parent CSP location or all related satellite CSP locations. (2) The MassHealth agency will notify the applicant of the determination in writing within 60 days of the MassHealth agency receiving a completed application. An application will not be considered complete until the applicant has responded to all MassHealth requests for additional information, and MassHealth has completed any required site inspection. (B) If the MassHealth agency determines that the applicant, parent CSP location, or any satellite location is not eligible for enrollment, the notice will contain a statement of the reasons for that determination, including but not limited to incomplete application materials and recommendations for corrective action, if appropriate, so that the applicant may reapply for enrollment once corrective action has been taken. (C) The enrollment is valid only for the provider types and locations described in the application and is not transferable to other programs operated at other locations by the applicant. Any CSP program seeking to establish an additional satellite CSP program must reapply for enrollment pursuant to 130 CMR 461.405(A). Each location must be identified in the provider application to receive payment for services provided at that location.