101 CMR, § 429.03

Current through Register 1536, December 6, 2024

Section 429.03 - Rate Provisions

(1)Services Included in the Rate. The approved rate includes payment for all care and services that are part of the program of services of an eligible provider, as explicitly set forth in the terms of the purchase agreement between the eligible provider and the purchasing governmental unit(s).

(2)Reimbursement as Full Payment. Each eligible provider must, as a condition of acceptance of payment made by any purchasing governmental units for services rendered, accept the approved program rate as full payment and discharge of all obligations for the services rendered. Payment from any other source will be used to offset the amount of the purchasing governmental unit's obligation for services rendered to the publicly assisted client.

(3)Payment Limitations. No purchasing governmental unit may pay less than or more than the approved program rate.

(4)Certain Unit Contract Payment Rates for Certain Sexual and Domestic Violence Services. The payment rate for certain sexual and domestic violence services established in 101 CMR 429.03(6)(a), provided pursuant to contracts purchasing only one unit in total, is at the rate established in 101 CMR 429.03(6)(a) times a factor of 1.18. The payment rate for certain sexual and domestic violence services established in 101 CMR 429.03(6)(a), provided pursuant to contracts purchasing only two units in total, is at the rate established in 101 CMR 429.03(6)(a) times a factor of 1.06

(5)Administrative Adjustment for Extraordinary Circumstances. A method whereby, subject to availability of funds, a purchasing governmental unit may provide additional resource allocations to a qualified provider in response to unusual and unforeseen circumstances that substantially increase the cost of service delivery in ways not contemplated in the development of current rates. It must be demonstrated that such cost increases gravely threaten the stability of service provision such that client or consumer access to necessary services is at risk. The purchasing governmental unit will evaluate the need for the administrative adjustment, determine whether funding is available, and convey that information to EOHHS for review to determine the amount of any adjustment.

(6)Approved Rates. The approved rate is the lower of the provider's charge or amount accepted as payment from another payer or the rate listed in 101 CMR 429.03.

(a)Rates of Payment for Certain Sexual and Domestic Violence Services.

Program	Unit	Rate	Frequency
Domestic Violence Community-based Services	.25 Direct Care FTE	$2,201	Monthly
Child Exposed to Domestic Violence Services	.25 Direct Care FTE	$2,310	Monthly
Supervised Visitation Services	.25 Direct Care FTE	$2,201	Monthly
Sexual and Domestic Violence Equity Services	.25 Direct Care FTE	$2,201	Monthly
Sexual and Domestic Violence Equity Legal Services	.25 Direct Care FTE	$3,282	Monthly
Intimate Partner Abuse Education Services	Per cohort	$2,973	Monthly

(b)Rates of Payment for Rape Crisis Centers and for Certain Sexual and Domestic Violence Service Add-ons.

Program	Unit	Rate	Frequency
Rape Crisis Centers - Dual Agency	Tier 1	$74,503	Monthly
	Tier 2	$65,419	Monthly
	Tier 3	$56,335	Monthly
	Tier 4	$47,252	Monthly
	Tier 5	$38,168	Monthly
	Tier 6	$29,084	Monthly
	Tier 7	$20,001	Monthly
	Tier 8	$10,917	Monthly
Rape Crisis Centers - Stand-alone Agency	Tier 1	$77,240	Monthly
	Tier 2	$67,821	Monthly
	Tier 3	$58,403	Monthly
	Tier 4	$48,984	Monthly
	Tier 5	$39,566	Monthly
	Tier 6	$30,147	Monthly
	Tier 7	$20,729	Monthly
	Tier 8	$11,310	Monthly

Add-on Rates	Rate	Frequency
Rape Crisis Satellite Center	$45.18	Hourly
Rape Crisis Statewide Specialized Hotline	$1,949	Monthly
Rape Crisis Direct Care.25 FTE	$2,201	Monthly
Housing Stabilization	I.C.	N/A
Extraordinary Circumstances/Flex Funding	I.C.	N/A
New SANE or SANE Telemedicine Site Development	I.C.	N/A
Supervised Visitation Security Add-on per Site	$952.26	Monthly
Intimate Partner Abuse Education Services - Outreach and Development	$488	Monthly