State Bookstore Catalog

114 CMR - Health Care Finance and Policy, Division of (formerly the Rate Setting Commission)

114.1 CMR 1.00 - 12.00

Procedure for Processing Blue Cross Audits and Final Settlements for Non-acute Hospitals; the Determination of Reasonable Operating  Costs and Exclusions for Third-party Reimbursement to Be Followed in the Preparation of Rate Setting Commission Reporting Forms. $1.05 

114.1 CMR 13.00 - 20.00

Requirement for the Submission of Hospital Case Mix and Charge Data. $1.05  

114.1 CMR 21.00 - 42.00

Criteria for Credit/Collection Policies for Acute Care Hospitals; Acute Care Hospital Charges & Rates of Payment for Publicly Assisted Individuals; Chronic & Rehabilitation Hospital Rates of Payment & the Fee for Residential Alcoholism Treatment Programs; Non-acute Hospital Rates of Payment & Fee for Residential Alcoholism Treatment Programs; Rates of Payment for Services Provided to Industrial Accident Patients by Hospitals; Hospital Financial Reports. $6.15

114.2 CMR 1.00-6.00

Rates of Payment to Long-term Care Facilities; Rates of Payment to Resident Care Facilities; Prospective Rates of Payment to Nursing Facilities; Standard Payments to Nursing Facilities. $7.85

114.3 CMR 8.00 - 55.00 

Outpatient Tuberculosis Control Services; Independent Living services for the Personal Care Attendant Program; Adult Day Care; Rehabilitation Clinic Services, Audiological Services, Restorative Services; Temporary Nursing Services; Adult Foster Care; Payment for Primary Care Clinician Plan Services Including Pay for Performance Program; Rates for Aquired Brain Injury Waiver & Related Services; Free standing Birth Center Services. $4.35

114.3 CMR 6.00, 7.00, 12.00, 29.00 and 30.00

Rates of Payment For Mental Health Services Provided in Community Health Centers and Mental Health Centers; Psychiatric Day Treatment Centers Services; Family Planning Services; Psychological Services; Team Evaluation Services; Rates of Payment for Certain Children's Behavioral Health Services. $2.45

114.3 CMR 13.00, 20.00 and 46.00 - 50.00

Rates for Free-standing Clinics Providing Abortion and Sterilization Services; Clinical Laboratory Services; Rates for Certain Substance Abuse Programs; Freestanding Ambulatory Surgical Facilities; Day Habilitation Program Services; Rates for Early Intervention Program Services; Home Health Services. $9.65

114.3 CMR 14.00, 15.00 and 26.00 - 28.00

Dental Services; Vision Care and Opthalmic Materials; Podiatric Care; Ambulance Services; Chiropractic Services. $3.15

114.3 CMR 16.00 - 18.00

Surgery and Related Anesthesia Care; Medical and Related Anesthesia Care; Radiology. $25.40

114.3 CMR 22.00, 23.00, 31.00, 34.00, and 37.00

Durable Medical Equipment, Oxygen and Respiratory Therapy Equipment; Hearing Aid Dispensers; Prescribed Drugs; Chronic Maintenance Dialysis Treatments and Home Dialysis Supplies. $11.35

114.3 CMR 40.00

Rates for Services under M.G.L. c. 152, the Worker's Compensation Act. $22.40

114.4 CMR

Rates for Competitive Integrated Employment Services; Rates for Certain Placement and Support Services; Rates for Family Transitional Suport Services; Rates for Youth Intermediate Term Stabilization Services; Rates for Family Stabilization Services;Rates for Community-Based Day Support Services; Rates for Clubhouse Services; Rates for Certain Elder Care Services. $4.35

114.5 CMR 1.00 -23.00

Disclosure of Hospital Case Mix and Charge Data; Rates for Certain Social, Rehabilitative and Health Consultant Services; Criteria and Procedures for Awarding Hardship Relief Grants; Criteria and Procedures for Awarding One-Time Grants to Non-Profit Providers of Elder Care Services; Criteria and Procedures for the Submission of Health Plan Data; Nursing Facility User Fee; Pharmacy User Fee; Determination of the Employer Fair Share Contribution; Employer Surcharge for State Funded Health Costs; Insurer Assessment; Health Care Payer Claims Submission; Health Care Claims Date Release: Payor Reporting of Total Medical Expenses & Relative Prices. $7.85

114.6 CMR 1.00 - 14.00

Student Health Insurance Program; Labor Shortage Fund; Administration of Acute Hospital Uncompensated Care Pool under M.G.L. c. 118G; Participation of the Community Health Centers in the Acute Hospital Uncompensated Care Pool under M.G.L. c. 118G; Criteria for Determining Eligibility for Free Care at Acute Care Hospitals and Freestanding Community Health Centers; Administration of the Uncompensated Care Pool. Services eligible for payment from the Uncompensated Care Trust Fund; Health Safety Net Payments and Funding. $6.15