Section 457.404 - Provider EligibilityThe MassHealth agency pays only freestanding birth centers who are participating in MassHealth on the date of service. Freestanding birth centers must meet the following eligibility requirements.
(A)In-state Providers. To be eligible for participation as a MassHealth FBC provider, the applicant must meet the MassHealth and DPH requirements specified as follows:(1) for each service location, complete and submit the application for enrollment to MassHealth on the form provided for this purpose by MassHealth;(2) be located and legally doing business in the Commonwealth of Massachusetts;(3) operate under an FBC clinic license issued by DPH, in accordance with 105 CMR 140.000: Licensure of Clinics;(4) be accredited by the Commission for the Accreditation of Birth Centers (CABC).(B)Out-of-state Providers. To participate in MassHealth, an out-of-state FBC must meet the requirements specified as follows: (1) obtain a MassHealth provider number from the MassHealth agency;(2) participate in its own state's Medicaid program; and(3) operate as a provider of freestanding birth center services as authorized by the governing or licensing agency in its state.Adopted by Mass Register Issue 1517, eff. 3/15/2024.