Provider Reporting Requirements

(A) Each program must comply with all reporting requirements that may pertain to the practice, facility, policies or staffing of the program as directed by the MassHealth agency, and in compliance with 130 CMR 450.000: Administrative and Billing Regulations and 130 CMR 461.000. (B) Adverse Incident Reports. Each provider must report adverse incidents to the MassHealth agency within 24 hours of discovery of the incident, or, if the incident occurs on a holiday or weekend, on the next business day, in a format specified by the MassHealth agency. (C) Additional Information. Eligible providers must file such additional information as EOHHS may from time to time reasonably require. 429.407: Revocation of Enrollment and Sanctions (A) The MassHealth agency has the right to review a CSP’s continued compliance with the conditions for enrollment referred to in 130 CMR 461.405 and the reporting requirements in 130 CMR 461.406 upon reasonable notice and at any reasonable time during the CSP's hours of operation. The MassHealth agency has the right to revoke the enrollment, subject to any applicable provisions of 130 CMR 450.000: Administrative and Billing Regulations if such review reveals that the CSP has failed to or ceased to meet such conditions. (B) If the MassHealth agency determines that there exists good cause for the imposition of a lesser sanction than revocation of enrollment, it may withhold payment, temporarily suspend the CSP from participation in MassHealth, or impose some other lesser sanction as the MassHealth agency sees fit, pursuant to the processes set forth in 130 CMR 450.000, as applicable.