Notices of Public Hearing (Published 06/07/2024)

Developmental Services, Department of
115 CMR 14.00

NOTICE OF PUBLIC HEARING AND OPPORTUNITY FOR PUBLIC COMMENT

Pursuant to the authority of G.L. c. 19B, §§ 1 and 14, and G. L. c. 123B, § 2 and in accordance with G.L. c. 30A, the Department of Developmental Services (“DDS”) will hold public hearings and accept public comments pertaining to its proposed regulations at: 115 CMR 14.00: Self- Determination and Self-Directed Services.

115 CMR 14.00 implements G.L. c.19B, §19 - Self-determination option for individuals eligible for services (“Real Lives Bill,” Chapter 255 of the Acts of 2014). “Self-determination” is the statutory term that encompasses “an approach to service delivery in which the participant is given control over the decision-making process for the participant's supports or services and budget and the participant may tailor the support to meet the participant's needs.” G.L. c. 19B, § 19(a). Proposed 115 CMR 14.00 implements DDS’ self-directed services, which offer eligible individuals an alternative to traditional services operated, certified, licensed, or contracted for or otherwise funded by the Department. Self-directed services promote independence in service planning while providing equitable access to the Department’s resources.

A public hearing will be held remotely via Zoom on Tuesday, June 18, 2024 from 1:00 p.m. – 3:00 p.m.

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You may pre-register to testify at this hearing by email at dds.regs.comments@mass.gov with your first and last name, preferred email address, and organization or affiliation, if any. Preregistration is not required to attend or testify at the hearing.

You may also submit written comments electronically instead of, or in addition to, live testimony at the hearing, to the Department at the following address: dds.regs.comments@mass.gov. Submissions should include the sender’s full name, mailing address, and organization or affiliation, if any. Individuals also may submit written testimony to the Office of the General Counsel, 1000 Washington Street, Boston, MA 02118. All written comments submitted to the Department may be posted on the Department’s website and released in response to a request for public records. All written testimony must be received by 5:00 p.m. on June 18, 2024. Please note that all comments received in response are considered part of the public record.

A current draft of the proposed regulations may be viewed on the Department’s website at: https://www.mass.gov/service-details/dds-notice-of-public-hearing-and-opportunity-for-publiccomment or obtained from the Office of the General Counsel at (617) 624-7702. Special accommodation requests may be made by telephone to the Office of the General Counsel at (617) 624-7702 or videophone at (857) 366-4179 (for persons who are deaf, hard of hearing or speech disabled). Requests for a sign language or other interpreter must be made at least two weeks in advance of the hearing.

The Department may adopt a revised version of the proposed regulations taking into account relevant comments and other practical alternatives that come to its attention.

By Order of the Department of Developmental Services, JANE F. RYDER, COMMISSIONER

May 23, 2024

CMR No: 115 CMR 14.00
Small Business Impact Statement

(As required by M.G.L. c. 30A §§ 2, 3 & 5) 

• Estimate of the Number of Small Businesses Impacted by the Regulation:

  Less than 35.
  The Department’s February 12, 2024, review of the North American Industry Classification System (“NAICS”) and Small Business Administration (“SBA”) online database(s) indicated there were approximately 34 self-certified small businesses included in the regulated industries (NAICS Code: 623210 Residential MR Facilities e.g. group homes, hospitals, intermediate care facilities, and NAICS Code: 624310 Vocational Rehabilitation Services). None are DDS service providers. 115 CMR 14.00 implements M.G.L. c. 19B, §19 by defining key terms and providing regulatory guidance to individuals and providers of the Department’s self-directed services. Self-directed services offer DDS eligible individuals an alternative to traditional services provided by the Department and an opportunity to exercise more choice and control, and promote independence in service planning. DDS projects that any impact the amended regulation will have on small businesses will be minimal.

• Will small businesses have to create, file, or issue additional reports?

  No.

• Will small businesses have to implement additional recordkeeping procedures?

  No.

• Will small businesses have to provide additional administrative oversight?

  No.

• Will small businesses have to hire additional employees in order to comply with the proposed regulation?

  No.

• Does compliance with the regulation require small businesses to hire other professionals (e.g. a lawyer, accountant, engineer, etc.)?

  No.

• Does the regulation require small businesses to purchase a product or make any other capital investments in order to comply with the regulation?

  No.

• Are performance standards more appropriate than design/operational standards to accomplish the regulatory objective?

  No.
  (Performance standards express requirements in terms of outcomes, giving the regulated party flexibility to achieve regulatory objectives and design/operational standards specify exactly what actions regulated parties must take.)
  

• Do any other regulations duplicate or conflict with the proposed regulation?

  No.

• Does the regulation require small businesses to cooperate with audits, inspections or other regulatory enforcement activities?

  No.

• Does the regulation require small businesses to provide educational services to keep up to date with regulatory requirements?

  No.

• Is the regulation likely to deter the formation of small businesses in Massachusetts?

  No.

• Is the regulation likely to encourage the formation of small businesses in Massachusetts?

  No.

• Does the regulation provide for less stringent compliance or reporting requirements for small businesses?

  No.

• Does the regulation establish less stringent schedules or deadlines for compliance or reporting requirements for small businesses?

  No.

• Did the agency consolidate or simplify compliance or reporting requirements for small businesses?

  No.

• Can performance standards for small businesses replace design or operational standards without hindering delivery of the regulatory objective?

  No.

• Are there alternative regulatory methods that would minimize the adverse impact on small businesses?

  No.

Health and Human Services, Executive Office of 
101 CMR 423.00 & 426.00 - 101 CMR 446.00

NOTICE OF PUBLIC HEARING

Under the authority of M.G.L. c. 118E and in accordance with M.G.L. c. 30A, the Executive Office of Health and Human Services (EOHHS) will hold remote public hearings on Friday, June 14, 2024, at the respective times listed below, relative to the adoption of amendments to the following two regulations.

Pursuant to M.G.L. Chapter 118E, Section 13D (f/k/a Chapter 257 of the Acts of 2008), EOHHS is required to establish by regulation and biennially review rates to be paid by governmental units to providers of social service programs. All amendments to the regulations below are proposed in accordance with this statute.

For the proposed amendments to the regulations listed below, a cost adjustment factor (CAF) of 2.58% was applied for all increased rates. The CAF was determined by using baseline and prospective Massachusetts Economic Indicator data from IHS Economics – Fall 2023 Forecast, optimistic scenario data. The CAF reflects the period between the rates’ base period (calendar year 2024 Q2) and the prospective period of fiscal years 2025 and 2026. The rates for these services have been updated with the weighted average expenses from the FY22 Uniform Financial Reports (UFRs) for services’ programmatic costs. Staff salaries have been benchmarked to the Massachusetts Bureau of Labor Statistics (BLS) median wages as dated May 2022 at the 53rd percentile. The tax and fringe rate has been benchmarked to 27.38%. This benchmark is derived from the MA Comptrollers FY24 approved rate less terminal leave and retirement. The administrative allocation has been benchmarked to 12%, consistent with other Chapter 257 programs. The language in the severability section has also been updated for consistency across EOHHS rate regulations.

The proposed amended regulations contain rates effective for dates of service on or after July 1, 2024. There is no fiscal impact on cities and towns.

1. 9:00 a.m.: 101 CMR 423.00: Rates for Certain In-Home Basic Living Supports
101 CMR 423.00 governs the rates paid by governmental units for certain in-home basic living supports provided to publicly aided individuals. Services with rates established by this regulation are purchased by the Department of Developmental Services (DDS), the Massachusetts Commission for the Blind (MCB), and the Massachusetts Rehabilitation Commission (MRC). The total estimated annualized cost to state government from the increase in rates established by this proposed amended regulation is $14.65 million, which represents an increase of 22.6% over FY23 spending of approximately $64.85 million. The increase in spending in FY25 will be covered through the Chapter 257 Reserve Account.

2. 10:00 a.m.: 101 CMR 426.00: Rates for Certain Adult Community Mental Health Services
101 CMR 426.00 establishes the payment rates for certain adult community mental health services provided to publicly aided individuals by governmental units. These services are purchased by the Department of Mental Health (DMH). The total estimated annualized cost to state government from the increase in rates established by this proposed amended regulation is $78.6 million, which represents an increase of 21.52% over projected FY23 spending of approximately $365.2 million. The increase in spending in FY25 will be covered through the Chapter 257 Reserve Account.

To register to testify at the hearing and to get instructions on how to join the hearing online, go to www.mass.gov/service-details/executive-office-of-health-and-human-services-public-hearings.
To join the hearing by phone, call (646) 558-8656 and enter meeting ID 935 397 8200# when prompted. 

You may also submit written testimony instead of, or in addition to, live testimony. To submit written testimony, please email your testimony to ehs-regulations@mass.gov as an attached Word or PDF document or as text within the body of the email with the name of the regulation in the subject line. All written testimony must include the sender’s full name, mailing address, and organization or affiliation, if any. Individuals who are unable to submit testimony by email should mail written testimony to:
 
EOHHS, c/o D. Briggs
100 Hancock Street, 6th Floor
Quincy, MA 02171.

Written testimony will be accepted through 5:00 p.m. on June 14, 2024. EOHHS specifically invites comments as to how the amendments may affect beneficiary access to care for MassHealthcovered services.

To review the current draft of the proposed regulation, go to www.mass.gov/service-details/executive-office-of-health-and-human-services-public-hearings or request a copy in writing from MassHealth Publications, 100 Hancock Street, 6th Floor, Quincy, MA 02171. To view or download related supporting materials, go to www.mass.gov/infodetails/ proposed-regulations-supporting-materials.

Special accommodation requests may be directed to the Disability Accommodations Ombudsman by email at ADAAccommodations@mass.gov or by phone at (617) 847-3468 (TTY: (617) 847-3788 for people who are deaf, hard of hearing, or speech disabled). Please allow two weeks to schedule sign language interpreters.

EOHHS may adopt a revised version of the proposed regulation taking into account relevant comments and any other practical alternatives that come to its attention.

In case of inclement weather or other emergency, hearing cancellation announcements will be posted on the MassHealth website at www.mass.gov/service-details/executiveoffice- of-health-and-human-services-public-hearings.

May 24, 2024

Health and Human Services, Executive Office of
101 CMR 446.00

NOTICE OF PUBLIC HEARING

Under the authority of M.G.L. c. 118E and in accordance with M.G.L. c. 30A, the Executive Office of Health and Human Services (EOHHS) will hold a remote public hearing on June 14, 2024, at 11:00 a.m. relative to the adoption of amendments to the following regulation.

101 CMR 446:00: Public Health Emergency Payment Rates for Certain Community Health Care Providers.

The proposed regulation contains rates effective for dates of service on or after October 1, 2024. The estimated aggregate annual fiscal impact for MassHealth is $21.1 million. There is no fiscal impact on cities and towns.

The proposed amendments will match Medicare pricing for COVID-19 vaccines and treatment. If there are further Medicare price changes, EOHHS will match them automatically. Obsolete COVID-19 vaccine codes (e.g., for monovalent vaccines) will be deleted. The amendments also provide that if rates for any codes in 101 CMR 446.00 conflict with those in 101 CMR 317.00: Rates for Medicine Services, then the fee structure in 101 CMR 317.00 will control.

In addition, the proposed amendments remove references to expired rate provisions including isolation and recovery and 2021 supplemental payments to community health centers and certain durable medical equipment and transportation codes, as well as pricing for certain pooled and individual COVID-19 testing, typically done on site for facilities. In each case, the services are no longer being used.

To register to testify at the hearing and to get instructions on how to join the hearing online, go to www.mass.gov/service-details/executive-office-of-health-and-human-services-public-hearings.
To join the hearing by phone, call (646) 558-8656 and enter meeting ID 935 397 8200# when prompted. 

You may also submit written testimony instead of, or in addition to, live testimony. To submit written testimony, please email your testimony to ehs-regulations@mass.gov as an attached Word or PDF document or as text within the body of the email with the name of the regulation in the subject line. All written testimony must include the sender’s full name, mailing address, and organization or affiliation, if any. Individuals who are unable to submit testimony by email should mail written testimony to:
 
EOHHS, c/o D. Briggs
100 Hancock Street, 6th Floor
Quincy, MA 02171.

Written testimony will be accepted through 5:00 p.m. on June 14, 2024. EOHHS specifically invites comments as to how the amendments may affect beneficiary access to care for MassHealth-covered services.

To review the current draft of the proposed regulation, go to www.mass.gov/service-details/executive-office-of-health-and-human-services-public-hearings or request a copy in writing from MassHealth Publications, 100 Hancock Street, 6th Floor, Quincy, MA 02171. 

Special accommodation requests may be directed to the Disability Accommodations Ombudsman by email at ADAAccommodations@mass.gov or by phone at (617) 847-3468 (TTY: (617) 847-3788 for people who are deaf, hard of hearing, or speech disabled). Please allow two weeks to schedule sign language interpreters.

EOHHS may adopt a revised version of the proposed regulation taking into account relevant comments and any other practical alternatives that come to its attention.

In case of inclement weather or other emergency, hearing cancellation announcements will be posted on the MassHealth website at www.mass.gov/service-details/executiveoffice- of-health-and-human-services-public-hearings.

May 24, 2024

CMR No: 101 CMR 423.00
Small Business Impact Statement

(As required by M.G.L. c. 30A §§ 2, 3 & 5)

• Estimate of the number of small businesses subject to the proposed regulation:

  168

• Will small businesses have to create, file, or issue additional reports?

  No.

• Will small businesses have to implement additional recordkeeping procedures?

  No.

• Will small businesses have to provide additional administrative oversight?

  No.  

• Will small businesses have to hire additional employees in order to comply with the proposed regulation?

  No.  

• Does compliance with the regulation require small businesses to hire other professionals (e.g. a lawyer, accountant, engineer, etc.)?

  No.  

• Does the regulation require small businesses to purchase a product or make any other capital investments in order to comply with the regulation?

  No.  

• Are performance standards more appropriate than design/operational standards to accomplish the regulatory objective?

  (Performance standards express requirements in terms of outcomes, giving the regulated party flexibility to achieve regulatory objectives and design/operational standards specify exactly what actions regulated parties must take.)

  No. The regulation is required by statute under M.G.L. Chapter 118E, Section 13D, and establishes the rates to be paid by governmental units to providers of certain social service programs.

• Do any other regulations duplicate or conflict with the proposed regulation?

  No.  

• Does the regulation require small businesses to cooperate with audits, inspections or other regulatory enforcement activities?

  Yes. The regulation requires providers to periodically file cost data to enable EOHHS to develop rates for certain social service programs. This cost reporting requirement is applied uniformly to all providers to enable EOHHS to develop accurate rates that reflect cost data from all providers.

• Does the regulation require small businesses to provide educational services to keep up to date with regulatory requirements?

  No.  

• Is the regulation likely to deter the formation of small businesses in Massachusetts?

  No. The regulation is not likely to deter or encourage the formation of small businesses in Massachusetts as this regulation establishes rates by which providers of certain social service programs are to be paid when services are purchased by governmental units.

• Is the regulation likely to encourage the formation of small businesses in Massachusetts?

  No. The regulation is not likely to deter or encourage the formation of small businesses in Massachusetts as this regulation establishes rates by which providers of certain social service programs are to be paid when services are purchased by governmental units.

• Does the regulation provide for less stringent compliance or reporting requirements for small businesses?

  No. The regulation contains requirements to report cost data to EOHHS to enable EOHHS to develop rates for certain social services. This cost reporting requirement is applied uniformly to all providers to enable EOHHS to develop accurate rates that reflect cost data from all providers.

• Does the regulation establish less stringent schedules or deadlines for compliance or reporting requirements for small businesses?

  No. The regulation contains requirements to report cost data to EOHHS to enable EOHHS to develop rates for certain social services. The time frame for cost reporting is applied uniformly to all providers to enable EOHHS to timely develop accurate rates that reflect cost data from all providers.

• Did the agency consolidate or simplify compliance or reporting requirements for small businesses?

  No. The agency did not consolidate or simplify compliance or reporting requirements for small businesses. The requirement to report cost data to EOHHS is applied uniformly to enable EOHHS to timely develop accurate rates that reflect cost data from all providers.

• Can performance standards for small businesses replace design or operational standards without hindering delivery of the regulatory objective?

  No. The establishment of rates for certain social service providers by regulation is a statutory requirement under M.G.L. Chapter 118E, Section 13D.

• Are there alternative regulatory methods that would minimize the adverse impact on small businesses?

  Are there alternative regulatory methods that would minimize the adverse impact on small businesses? No. The regulation does not have an adverse impact on small businesses. The regulation establishes rates by which certain social service providers are to be paid when services are purchased by governmental units. The establishment of rates for these social services by regulation is a statutory requirement under M.G.L. Chapter 118E, Section 13D.

CMR No: 101 CMR 426.00
Small Business Impact Statement

(As required by M.G.L. c. 30A §§ 2, 3 & 5)

• Estimate of the number of small businesses subject to the proposed regulation:

  36

• Will small businesses have to create, file, or issue additional reports?

  No.

• Will small businesses have to implement additional recordkeeping procedures?

  No.

• Will small businesses have to provide additional administrative oversight?

  No.  

• Will small businesses have to hire additional employees in order to comply with the proposed regulation?

  No.

• Does compliance with the regulation require small businesses to hire other professionals (e.g. a lawyer, accountant, engineer, etc.)?

  No.  

• Does the regulation require small businesses to purchase a product or make any other capital investments in order to comply with the regulation?

  No.  

• Are performance standards more appropriate than design/operational standards to accomplish the regulatory objective?

  (Performance standards express requirements in terms of outcomes, giving the regulated party flexibility to achieve regulatory objectives and design/operational standards specify exactly what actions regulated parties must take.)

  No. The regulation is required by statute under M.G.L. Chapter 118E, Section 13D, and establishes the rates to be paid by governmental units to providers of certain social service programs.

• Do any other regulations duplicate or conflict with the proposed regulation?

  No. There are no other regulations that duplicate or conflict with the proposed regulation.

• Does the regulation require small businesses to cooperate with audits, inspections or other regulatory enforcement activities?

  Yes. The regulation requires providers to periodically file cost data to enable EOHHS to develop rates for certain social service programs. This cost reporting requirement is applied uniformly to all providers to enable EOHHS to develop accurate rates that reflect cost data from all providers.

• Does the regulation require small businesses to provide educational services to keep up to date with regulatory requirements?

  No.  

• Is the regulation likely to deter the formation of small businesses in Massachusetts?

  No. The regulation is not likely to deter or encourage the formation of small businesses in Massachusetts as this regulation establishes rates by which providers of certain social service programs are to be paid when services are purchased by governmental units.

• Is the regulation likely to encourage the formation of small businesses in Massachusetts?

  No. The regulation is not likely to deter or encourage the formation of small businesses in Massachusetts as this regulation establishes rates by which providers of certain social service programs are to be paid when services are purchased by governmental units.

• Does the regulation provide for less stringent compliance or reporting requirements for small businesses?

  No. The regulation contains requirements to report cost data to EOHHS to enable EOHHS to develop rates for certain social services. This cost reporting requirement is applied uniformly to all providers to enable EOHHS to develop accurate rates that reflect cost data from all providers.

• Does the regulation establish less stringent schedules or deadlines for compliance or reporting requirements for small businesses?

  No. The regulation contains requirements to report cost data to EOHHS to enable EOHHS to develop rates for certain social services. The time frame for cost reporting is applied uniformly to all providers to enable EOHHS to timely develop accurate rates that reflect cost data from all providers.

• Did the agency consolidate or simplify compliance or reporting requirements for small businesses?

  No. The agency did not consolidate or simplify compliance or reporting requirements for small businesses. The requirement to report cost data to EOHHS is applied uniformly to enable EOHHS to timely develop accurate rates that reflect cost data from all providers.

• Can performance standards for small businesses replace design or operational standards without hindering delivery of the regulatory objective?

  No. The establishment of rates for certain social service providers by regulation is a statutory requirement under M.G.L. Chapter 118E, Section 13D.

• Are there alternative regulatory methods that would minimize the adverse impact on small businesses?

  No. The regulation does not have an adverse impact on small businesses. The regulation establishes rates by which certain social service providers are to be paid when services are purchased by governmental units. The establishment of rates for these social services by regulation is a statutory requirement under M.G.L. Chapter 118E, Section 13D.

CMR No: 101 CMR 446.00
Small Business Impact Statement

(As required by M.G.L. c. 30A §§ 2, 3 & 5)

• Estimate of the number of small businesses subject to the proposed regulation:

  20,000 potential physician providers; 250 pharmacy providers

• Will small businesses have to create, file, or issue additional reports?

  No.

• Will small businesses have to implement additional recordkeeping procedures?

  No.

• Will small businesses have to provide additional administrative oversight?

  No.  

• Will small businesses have to hire additional employees in order to comply with the proposed regulation?

  No.

• Does compliance with the regulation require small businesses to hire other professionals (e.g. a lawyer, accountant, engineer, etc.)?

  No.  

• Does the regulation require small businesses to purchase a product or make any other capital investments in order to comply with the regulation?

  No.  

• Are performance standards more appropriate than design/operational standards to accomplish the regulatory objective?

  (Performance standards express requirements in terms of outcomes, giving the regulated party flexibility to achieve regulatory objectives and design/operational standards specify exactly what actions regulated parties must take.)

  No. The regulation is required by statute under M.G.L. Chapter 118E Section 13C, and establishes the rates to be paid by governmental units to providers of non-institutional health care services, including community health center services and COVID-19-related community health care services such as COVID-19 vaccines and vaccine administration to publicly aided individuals.

• Do any other regulations duplicate or conflict with the proposed regulation?

  No. There are no other regulations that duplicate or conflict with the proposed regulation.

• Does the regulation require small businesses to cooperate with audits, inspections or other regulatory enforcement activities?

  Yes. The regulation requires providers to periodically comply with audits, inspections, and other regulatory activities. The proposed amendments do not expand these provisions.

• Does the regulation require small businesses to provide educational services to keep up to date with regulatory requirements?

  No.  

• Is the regulation likely to deter the formation of small businesses in Massachusetts?

  No. The regulation is unlikely to deter or encourage the formation of small businesses in Massachusetts as this regulation governs payments for COVID-19 vaccines and vaccine administration to publicly aided individuals. It is applied uniformly regardless of whether or not the provider is a small business.

• Is the regulation likely to encourage the formation of small businesses in Massachusetts?

  No. The regulation is unlikely to deter or encourage the formation of small businesses in Massachusetts as this regulation governs payments for COVID-19 vaccines and vaccine administration to publicly aided individuals. It is applied uniformly regardless of whether or not the provider is a small business.

• Does the regulation provide for less stringent compliance or reporting requirements for small businesses?

  No. This regulation requires providers to submit documentation requested by the Commonwealth for purposes of utilization and provider review to ensure compliance with requirements, including the timelines for reporting, and the regulation is applied uniformly regardless of whether or not the provider is a small business.

• Does the regulation establish less stringent schedules or deadlines for compliance or reporting requirements for small businesses?

  No. This regulation requires providers to submit documentation requested by the Commonwealth for purposes of utilization and provider review to ensure compliance with requirements, including the timelines for reporting, and the regulation is applied uniformly regardless of whether or not the provider is a small business.

• Did the agency consolidate or simplify compliance or reporting requirements for small businesses?

  No. This regulation requires providers to submit documentation requested by the Commonwealth for purposes of utilization and provider review to ensure compliance with requirements, including the timelines for reporting, and the regulation is applied uniformly regardless of whether or not the provider is a small business.

• Can performance standards for small businesses replace design or operational standards without hindering delivery of the regulatory objective?

  No. The regulation establishes uniform conditions of payment for COVID-19 vaccines and vaccine administration to publicly aided individuals. These conditions of payment are applied uniformly, regardless of the size of the provider’s business, to maintain consistency in the care provided to publicly aided individuals.

• Are there alternative regulatory methods that would minimize the adverse impact on small businesses?

  No. The regulation does not have an adverse impact on small businesses and governs payments for COVID-19 vaccines and vaccine administration to publicly aided individuals. It is applied uniformly regardless of whether or not the provider is a small business.