Section 432.406 - Provider Responsibilities(A)Therapy Provider Service Location Site Visits. An unscheduled therapy service location site visit may be conducted by MassHealth or its designee, to assess compliance with MassHealth rules and regulations including, but not limited to, those described in 130 CMR 432.406(B) and (C), under the following circumstances:(1) for a physical therapy services group practice or individual physical therapist that is not a Medicare provider and is newly enrolled in MassHealth; or(2) for any MassHealth enrolled therapy provider at the sole discretion of the MassHealth agency or its designee. See130 CMR 450.212: Provider Eligibility: Eligibility Criteria.(B)Therapy Provider Service Location Requirements. A therapy provider service location must meet all of the following requirements:(1) there must be a sign posted identifying the business name and hours that the service location is open;(2) the location must be staffed with an employee during posted business hours;(3) the location must be available to members during regular, posted business hours;(4) all licenses, certifications, accreditations, and permits are active and visible in areas accessible to members at each provider service location;(5) the therapy provider service location must be physically accessible to all members that are receiving therapy services at the service location;(6) there must be a business telephone line with a voice message system that members are able to call;(7) there must be written procedures and policies for maintaining and ensuring that equipment is inspected annually and is in a safe operating condition;(8) the therapy provider service location must provide privacy to members during any therapy visit, as requested, and also offer a private space for a member and therapy provider to discuss the member's needs; and(9) the therapy provider service location must be in compliance with applicable federal, local, and state regulations.(C)Policy and Procedure Manual. Each therapy provider must develop, maintain, review, and comply with a comprehensive policies and procedures manual governing the delivery of therapy services, which at a minimum must address the following: (1) human resources and personnel;(2) a plan for ascertaining that all therapy assistants and group therapy practice health care providers have current, valid licenses;(3) therapy group practice staff and staffing requirements;(4) the methods for providing initial and ongoing training of personnel regarding the group therapy practice's standards, procedures, and policies including, but not limited to, standard hazardous waste disposal, emergency procedures, proper documentation, members' rights, and proper billing;(5) staff evaluation and supervision;(6) the mechanisms used to report and respond to violations, incident reporting, accident reports, or complaints in an appropriate manner;(7) recognizing and reporting abuse (physical, sexual, emotional, psychological), neglect, self-neglect, and financial exploitation;(8) Health Insurance Portability and Accountability Act (HIPAA);(9) privacy and confidentiality;(10) infection control and communicable disease control; and(11) first aid and cardiopulmonary resuscitation requirements.(D)Financial Viability Documentation. A therapy provider must, upon request, submit to the MassHealth agency or its designee a statement of fiscal soundness attesting to the financial viability of the therapy provider, supported by documentation to demonstrate that the therapy provider has adequate resources to finance the provision of services in accordance with 130 CMR 432.000.Adopted by Mass Register Issue 1457, eff. 11/26/2021.