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Notices of Public Hearing (Published 10/11/2024)

Administration and Finance, Executive Office for
801 CMR 4.00

Notice of Public Hearing

Notice is hereby given pursuant to M.G.L. c. 30A, §2 that the Executive Office for Administration and Finance, along with the Board of Registration in Speech Language Pathology and Audiology (Board) within the Department of Public Health (Department), will hold a public hearing on amendments to the following regulations: 801 CMR 4.02 (260): Fees for Licenses, Permits, and Services to be Charged by State Agencies.

The proposed amendment will establish the application/original license fee for the new Provisional Speech-Language Pathologist License issued by the Board. The hearing will be concurrent with the Board’s public hearing on proposed amendments to 260 CMR 1.00 and 260 CMR 2.00.

The public hearing will be held at 10:00 a.m. on Thursday, October 31st 2024. The hearing will be conducted on a moderated conference call. The information for the moderated conference call is:

Dial-in Telephone Number: 800-988-9538
Participant Passcode: 5999893

A copy of the proposed amendments to 801 CMR 4.02 (260) may be viewed on the Department’s website at http://mass.gov/dph/proposed-regulations or requested from the Office of the General Counsel by calling 617-624-5220,.

Speakers who testify at the public hearing are requested to provide a copy of their oral testimony. The Department encourages all interested parties to submit testimony electronically to the following address: Reg.Testimony@mass.gov, or by mail to William Anderson, Office of the General Counsel, Department of Public Health, 250 Washington Street, Boston, MA 02108. All submissions must include the sender’s full name and address. When electronically submitting comments, type “SLP/AUD Board Regulations” in the subject line and attach a Word document with your comments or type your comments in the body of your email. All submissions must include the sender’s full name and address.

The Department will post all testimony that complies with these instructions on its website. All comments must be submitted by 5:00 p.m. on Thursday, October 31st 2024. All comments received by the Department may be released in response to a request for public records.

If you are deaf or hard of hearing, or are a person with a disability who requires accommodation, please contact Alex Gomez at least 5 days before the hearing at Tel # 617-624-5928,, Fax # 617-624-5075, email Alex.Gomez@mass.gov, or TTY # 617-624-6001,.

801 CMR 4.00
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:

6,326 Speech-Language Pathologists
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.
Do any other regulations duplicate or conflict with the proposed regulation?

No, the Board has exclusive authority over the licensing and regulation of Provisional Speech-Language Pathologist Licensees
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?

Yes, provisional licensure may encourage the formation of small business by codifying an additional license type
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 - the amended regulation outlines fees for licensure of Provisional Speech-Language Pathologist Licensees.
Are there alternative regulatory methods that would minimize the adverse impact on small businesses?

No, state law requires the Board to license and establish minimum practice standards for licensees. M.G.L. c. 13, §86.

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Center for Health Information and Analysis
957 CMR 2.00, 3.00, 6.00, 7.00, 8.00, 9.00, 10.00 & 11.00

NOTICE OF PUBLIC HEARING

Pursuant to the provisions of M.G.L. c. 12C and in accordance with M.G.L. c. 30A, as amended, the Center for Health Information and Analysis (CHIA) located at 501 Boylston Street, Suite 5100, Boston, MA 02116 will hold a public hearing in-person and remotely on Thursday, November 7, 2024 at 10:00 A.M. relative to the adoption of amendments to regulations:

957 CMR 2.00 - Payer Data Reporting
957 CMR 3.00 - Assessment On Certain Health Care Providers & Surcharge Payers
957 CMR 6.00 – Cost Reporting
957 CMR 7.00 – Nursing Facility Cost Reporting
957 CMR 8.00 - Apcd And Case Mix Data Submission
957 CMR 9.00 - Hospital Financial Data Reporting Requirements
957 CMR 10.00 - Health Care Payers Premiums And Claims Data Reporting Requirements
957 CMR 11.00 - Registered Provider Organizations Reporting Requirements

The amended regulations govern CHIA’s enforcement of requirements that payers, providers, and others make data submissions to CHIA. The proposed amendments provide additional information to data submitters about CHIA’s process for imposing monetary penalties when organizations fail to submit data as required, including organizations’ right to an adjudicatory hearing. These amendments are consistent with M.G.L. c. 30A, § 10 and the decision in Steward Healthcare System LLC v. Center for Health Information and Analysis et al., No. 1784CV03481, (Super. Ct. Jan. 27, 2022). The amended regulations also clarify certain nursing facility cost reporting requirements and update deadlines for hospital financial data reporting.

It is anticipated that payers, providers, and others that make data submissions to CHIA will incur no additional administrative costs resulting from the proposed changes to this regulation. There is no fiscal impact on cities and towns and no fiscal impact on small businesses.

Individuals that notify CHIA of their intent to testify at the hearing will be afforded an earlier opportunity to speak. Speakers may notify CHIA of their intention to testify at the hearing by emailing regulations@chiamass.gov. Individuals may also submit written testimony to the same email address. Please submit electronic testimony as an attached Word document or as text within the body of the email with the name of the regulation in the subject line. All submissions must include the sender’s full name and address. Individuals who are unable to submit testimony by email should mail written testimony to the Center for Health Information and Analysis, 501 Boylston Street, Suite 5100, Boston, MA 02116. Written testimony must be submitted by 5:00 P.M. on Monday, November 18, 2024. Copies of the proposed regulation may be requested in writing from CHIA at the email address above or may be viewed on CHIA’s website at www.chiamass.gov/regulations.

Individuals may attend the hearing in person (at the location above) or remotely on the date and time specified. Details and instructions for participating and testifying remotely (such as through phone line or online connection) at the remote public hearing are included in this notice below. This notice and copies of the proposed regulations may be viewed on CHIA’s website at www.chiamass.gov/regulations. If you plan to testify at the hearing, CHIA strongly encourages you to register in advance; see above for instructions. CHIA encourages you to submit written testimony in addition to, or instead of, providing testimony at the hearing; see above for instructions. Additionally, requests for copies of the proposed regulation will not be accepted in person. Details for obtaining copies of proposed regulations are set forth above.

To join the remote hearing online, go to https://us02web.zoom.us/j/85182195779?pwd=KK3vZ05KNoYobzEWSBjQRhfXI0yNm3.1, and enter Meeting ID: 851 8219 5779 and Passcode: 700150. To join the remote hearing by phone, call 1-646-518-9805, or 1-646-558-8656,, and enter Meeting ID: 851 8219 5779 and Password: 700150 when prompted.

CMR No: 130 CMR 450.000
Small Business Impact Statement

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

In order to accurately predict the impact the adoption, amendment, or repeal of a regulation will have on small businesses, the promulgating authority must conduct a thorough analysis that not only considers the potential effects of the action but also quantifies the costs, if any, associated with each. The questions below are designed to aid promulgating authorities in conducting their analysis.

Agency submitting regulation: center for health information and analysis (“chia”)
Subject Matter of Regulation: Monetary Penalties; Cost Reporting Deadlines; Financial Statement Reporting Requirements
Regulation No: 957 C.M.R. 2.00, 3.00, 6.00, 7.00, 8.00, 9.00, 10.00, and 11.00.
Statutory Authority: M.G.L. c.12C
Other Agencies Affected: None
Other Regulations That May Duplicate or Conflict with the Regulation: None
Describe the Scope and Objectives of the Regulation: The Sections to be amended in each regulation titled, “Compliance and Penalties,” detail the process that CHIA will undertake when imposing monetary penalties, under M.G.L. c. 12C, § 11 and otherwise, on entities that have failed to submit data as required. Additional changes to 957 CMR 7.00 clarify the requirements associated with reporting certain financial statements. Additional changes to 957 CMR 9.00 give reporting entities additional time to submit certain cost reports.
Business Industry(ies) Affected by the Regulation: Health care
Types of Businesses Included in the Industry(ies): Private health care payers, providers, and provider organizations who submit data to CHIA.
Total Number of Small Businesses Included in the Regulated Industry(ies) Please see the attached guidance documents for assistance determining the total number of small businesses: None.
Number of Small Businesses Potentially Subject to the Proposed Regulation: None.
Effective Date Used In Cost Estimate: September 10, 2024

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.
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.
Will the regulation have the effect of creating additional taxes and/or fees for small businesses?
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.
Can the regulation establish less stringent schedules or deadlines for compliance or reporting requirements for small businesses?

No.
Can 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.
Were any small businesses or small business organizations contacted during the preparation of this document? If so, please describe
No.

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Health and Human Services, Executive Office of
101 CMR 206.00

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 Friday, November 1, at 10 a.m. relative to the emergency adoption of amendments to the following regulation.

101 CMR 206.00: Standard Payments to Nursing Facilities

The amendments to 101 CMR 206.00 implement Fiscal Year 2025 (FY25) budget requirements. The following adjustments are being made to the rates, consistent with the FY25 budget:

applying an updated cost adjustment factor of 23.50% to 2019 nursing and operating costs and of 8.02% to 2019 capital payments;
increasing the maximum increase cap on capital payment rates from 30% to 50% of the capital payment rates in effect on September 30, 2021; and amending certain aspects of existing rate adjustments, add-ons, including but not limited to removing the description of the COVID-19 Testing Supplemental Payment program that has ended;
establishing a new Add-on for Dialysis Services Provided at an Affiliated Inpatient Chronic Disease and Rehabilitation Hospital to allow nursing facilities to receive payment when members receive dialysis services at an affiliated inpatient chronic disease and rehabilitation hospital; and
establishing a Supplemental Payment for Qualified Nursing Facilities Located Near North Adams to allocate supplemental payments to facilities located within 17 miles of 71 Hospital Avenue in North Adams, MA in proportion to qualified facilities’ Massachusetts Medicaid days.

The regulation will go into effect as an emergency on October 1, 2024.

The annual fiscal impact of these amendments for the MassHealth Nursing Facility program is estimated to be $43,000,000.

To register to testify at the hearings and to get instructions on how to join the hearings online, go to www.mass.gov/info-details/executive-office-of-health-and-human-servicespublic-hearings. To join the hearings 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 Friday, November 1. EOHHS specifically invites comments as to how the amendments may affect beneficiary access to care.

To review the emergency regulation, go to www.mass.gov/infodetails/ 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.

September 27, 2024

CMR No: 101 CMR 206.00: Standard Payments to Nursing Facilities
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:

SBA database searches returned 28 results for NAICS code 623110 (“Nursing Care Facilities”) and no results for 623311 (“Continuing Care Retirement Communities”).
Will small businesses have to create, file, or issue additional reports?

No. The regulation requires nursing facilities to submit cost and financial statements, but this is not a new requirement. The regulation also requires nursing facilities seeking certain additional payment add-ons and adjustments to submit reports demonstrating their eligibility and/or compliance.
Will small businesses have to implement additional recordkeeping procedures?

No. Certain additional payment add-ons and adjustments require nursing facilities to maintain up-to-date records on eligibility and/or compliance; but there are no new requirements as a result of this regulation.
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. Compliance does not require hiring additional employees.
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.
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 all nursing facilities to comply with audits and produce records requested by EOHHS, but this is not a new requirement. The regulation does not distinguish between small and other businesses.
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.

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Health and Human Services, Executive Office of
101 CMR 322.00

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 Monday, October 21, 2024, at 10:30 a.m. relative to the emergency adoption of amendments to the following regulation.

101 CMR 322.00: Rates for Durable Medical Equipment, Oxygen and Respiratory Therapy Equipment

The regulation will take effect as an emergency on October 1, 2024. There is no fiscal impact on cities and towns.

Effective for dates of service provided on or after October 1, 2024, the Executive Office of Health and Human Services (EOHHS) has implemented, via emergency adoption, add-on payments to MassHealth-enrolled DME mobility providers for certain mobility system repairs, and supplemental payments to ceiling lift providers who serve fee-for service (FFS) dual eligible members (members with Medicare and MassHealth coverage). The methodologies and applicable payments are described in 101 CMR 322.00. There are also supporting amendments with a concurrent public hearing and comment process proposed for the DME program services regulation,130 CMR 409.000: Durable Medical Equipment Services.

To alleviate member challenges and promote shorter turnaround for mobility system repairs, EOHHS has implemented an add-on payment for certain mobility system repairs. The $1,000 add-on payment with reinvestment and reporting requirements is available to providers who perform mobility system repairs within a defined time period.

There is a difference in total payment for ceiling lifts provided to FFS dual eligible members and total payment for ceiling lifts provided to non-dual eligible members. EOHHS has established a supplemental payment methodology for ceiling lifts to address this difference and promote access to this service for dual eligible members. The supplemental payment is calculated by subtracting the total Medicare allowed amount for ceiling lift services provided to a dual eligible member from the MassHealth total payment for the services provided to a non-dual eligible member.

EOHHS has also made necessary revisions and updates to correct or clarify provisions within 101 CMR 322.00, including a correction for an inadvertent incorrect duplicative provision regarding standard markups for patient lift systems.

All other rates remain at their current levels.

The estimated annual aggregate fiscal impact of the proposed amendments to 101 CMR 322.00 is between $3.4 and $3.6 million, $3.3 million for the repair rate add-on and between $100,000 and $300,000 for the supplemental payment for ceiling lift services. The estimated annual fiscal impact for aligning MassHealth maintenance repair coverage with Medicare in 130 CMR 409.000 is $725,000.

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 October 28, 2024. EOHHS specifically invites comments as to how the amendments may affect beneficiary access to care for MassHealth-covered services.

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.

September 26, 2024

CMR No: 101 CMR 322.00: Rates for Durable Medical Equipment, Oxygen and Respiratory Therapy Equipment
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:

There are 102 Durable Medical Equipment (DME) providers, 22 Oxygen and Respiratory (O2) therapy equipment providers, and 738 pharmacy providers that offer DME or O2 equipment and supplies as a subspecialty service.
Will small businesses have to create, file, or issue additional reports?

Yes.
Will small businesses have to implement additional recordkeeping procedures?

No.
Will small businesses have to provide additional administrative oversight?

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

Yes. Providers are required to reinvest 80% of the add-on payments received back into the mobility system repair components of their business. In order to comply, this could include hiring additional employees to support program development and implementation.
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.)
Yes. Performance standards for repair turnaround times are more appropriate than design/operational standards to accomplish the regulatory objective.
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 continues to require providers to periodically comply with audits, inspections, and other regulatory activities.
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 DME and O2 services provided to publicly aided individuals and is applied uniformly among providers.
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 DME and O2 services provided to publicly aided individuals and is applied uniformly among providers.
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 upon request to enable EOHHS to develop rates for health care services and is applied uniformly regardless of whether the provider is a small business.
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 upon request to enable EOHHS to develop rates for health care services and is applied uniformly regardless of whether 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. The regulation is applied uniformly regardless of whether the provider is a small business
Can performance standards for small businesses replace design or operational standards without hindering delivery of the regulatory objective?

Yes. Performance standards for repair turnaround times are more appropriate than design/operational standards to accomplish the regulatory objective
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. It governs payments for DME and O2 services to publicly aided individuals and is applied uniformly regardless of whether the provider is a small business.

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Health and Human Services, Executive Office of
101 CMR 346.00 & 418.00

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 two remote public hearing on Friday, October 18, 2024, at the times listed below relative to the adoption of amendments to the following regulations.

Pursuant to M.G.L. Chapter 118E, Section 13D, EOHHS is required to establish, by regulation, and biennially review rates to be paid by governmental units to providers of social service programs. There is no fiscal impact on cities and towns.

1. 10:00 a.m.: 101 CMR 346.00: Rates for Certain Substance-Related and Addictive Disorders Programs

The regulation will take effect as an emergency on October 1, 2024. There is no fiscal impact on cities and towns.

101 CMR 346.00 governs the payment rates for certain substance-related and addictive disorders programs provided to publicly aided individuals by governmental units.

The proposed amendments to 101 CMR 346.00 establish the rates for residential rehabilitation co-occurring enhanced services. These services are purchased by the Department of Public Health and MassHealth and provide organized substance-related and addictive disorders treatment and education services in a 24-hour residential setting for individuals with a moderate-to-severe substance use and mental health disorder.

The rates for residential rehabilitation co-occurring enhanced services include a cost adjustment factor (CAF) of 2.58%. 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 this service 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 total estimated FY25 cost to state government from the increase in the residential rehabilitation co-occurring enhanced services rates established by this proposed regulation is $9,569,376. The estimated fiscal impact to the MassHealth program is $8,463,082 and the estimated fiscal impact to DPH is $1,106,294. This amendment represents an increase of approximately 24.46% over FY23 spending. The increase to DPH spending will be covered through a combination of the Chapter 257 reserve account and DPH’s FY25 budget.

The proposed regulation contains rates effective for dates of service on or after July 1, 2024.

2. 10:30 a.m.: 101 CMR 418.00: Payments for Youth Short-Term Stabilization and Emergency Placement Services

101 CMR 418.00 establishes the payment rates for youth short-term stabilization and emergency placement services provided to publicly aided individuals by governmental units and under EOHHS’s regulatory authority. These services are purchased by the Department of Youth Services (DYS) and the Department of Public Health (DPH).

The rates for youth short-term stabilization and emergency placement services, specific to staffing support and youth detoxification and stabilization program rates, are being updated to include an increase by a cost adjustment factor (CAF) of 1.97%. The CAF was determined by using baseline and prospective Massachusetts Economic Indicator data from IHS Economics – Spring 2024 Forecast, optimistic scenario data. The CAF reflects the period between the rates’ base period (Calendar Year 2024 Q3) and the prospective period (Calendar Year 2024 Q4 through Calendar Year 2026 Q3). The staff salaries have been benchmarked to the Massachusetts Bureau of Labor Statistics (BLS) median wages as dated May 2023 at the 53rd percentile. The tax and fringe rate has been benchmarked to 24.97%. This benchmark is derived from the MA Comptrollers FY24 approved rate less terminal leave and retirement. The administrative allocation has been benchmarked to 12% to remain consistent across all Chapter 257 regulations. The language in the Severability section has also been updated for consistency across EOHHS rate regulations.

The total annualized cost to state government from the increase in rates amended by this regulation is $620,156, which represents an increase of 11.51% over FY24 projected spending of approximately $5.3 million. This cost will not be realized until October 1, 2024, at which point the FY25 cost to state government will be $465,117. This will be covered through a combination of the Chapter 257 Reserve Account and the purchasing agencies’ FY25 budgets.

The proposed regulation contains rates effective for dates of service on or after October 1, 2024.

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 Friday, October 18, 2024. EOHHS specifically invites comments as to how the amendments may affect beneficiary access to care for MassHealth-covered services.

To review the current drafts of the proposed regulations, go to www.mass.gov/infodetails/ 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.

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.

September 27, 2024

CMR No: 101 CMR 346.00:
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:

6
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?

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.

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Health and Human Services, Executive Office of
101 CMR 351.00

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 Friday, October 18, at 1 p.m. relative to the emergency adoption of amendments to the following regulation.

101 CMR 351.00: Rates for Certain Adult Foster Care Services

The regulation went into effect as an emergency on September 20, 2024. There is no fiscal impact on cities and towns.

The Executive Office of Health and Human Services (EOHHS) is proposing an emergency amendment to regulation 101 CMR 351.00: Rates for Certain Adult Foster Care services to increase the current per diem rate by 14.86%, from $43.53 to $50. This rate increase is proposed to enhance access to group adult foster care (GAFC) services, and in response to provider feedback and fiscal health of the provider network based on the profitability analysis of the reported FY 2022 cost data. Based on the cost report analysis, EOHHS considers the proposed per diem of $50 adequate to improve the provider fiscal stability and ensure continued access to GAFC services.

The proposed rate presented above is in accordance with M.G.L. Chapter 118E Section 13C, which requires that rates established by EOHHS for health care services be “adequate to meet the costs incurred by efficiently and economically operated facilities providing care and services in conformity with applicable state and federal laws and regulations and quality and safety standards and which are within the financial capacity of the commonwealth.” The amendment was adopted on an emergency basis for the preservation of the public health, safety or general welfare and to ensure continued access to these services and to ensure provider fiscal stability and continued access to GAFC services.

The estimated aggregate annual fiscal impact of the proposed amendment is $8.4 million, or 14.86% increase, relative to the base spending of $56.7 million.

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 October 25, 2024. EOHHS specifically invites comments as to how the amendments may affect beneficiary access to care for MassHealth-covered services.

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.

September 20, 2024

CMR No: 101 CMR 351.00
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:

115 group adult foster care 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, § 13D, and establishes the rates to be paid by governmental units to providers of non-institutional health care 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 group adult foster care 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 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 group adult foster care services 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 group adult foster care services 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 group adult foster care 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 group adult foster care 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 health care services by regulation is a statutory requirement under M.G.L. Chapter 118E, § 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 adult foster care service providers are to be paid when services are purchased by governmental units. The establishment of rates for these health care services by regulation is a statutory requirement under M.G.L. Chapter 118E, § 13D.

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Medical Assistance, Division of
130 CMR 409.000

Notice of Public Hearing

Under the authority of M.G.L. c. 6A, section 16 and in accordance with M.G.L. c. 30A, the Division of Medical Assistance (the Division) will hold a remote public hearing on Monday, October 21, 2024, at 9 a.m. relative to the emergency adoption of amendments to the following regulation.

130 CMR 409.000: Durable Medical Equipment Services

The regulation will take effect as an emergency on October 1, 2024. There is no fiscal impact on cities and towns.

Effective for dates of service provided on or after October 1, 2024, the Executive Office of Health and Human Services (EOHHS) has implemented, via emergency adoption, add-on payments to MassHealth-enrolled DME mobility providers for certain mobility system repairs and to align coverage for maintenance repairs with Medicare policy. The amendments to 130 CMR 409.000 support amendments made to 101 CMR 322.00: Rates for Durable Medical Equipment, Oxygen and Respiratory Therapy Equipment. There is a concurrent public comment and hearing process for 101 CMR 322.00.

To alleviate member challenges and promote shorter turnaround for mobility system repairs, EOHHS has implemented an add-on payment for certain mobility system repairs. The amendments to 130 CMR 409.000 clarify the types of covered and noncovered maintenance repairs, align MassHealth maintenance repair coverage with Medicare, and clarify the types of repairs that will be eligible for the add-on payment.

The $1,000 add-on payment with reinvestment and reporting requirements is available to providers who perform certain types of mobility system repairs within a defined time period. The proposed payment methodologies and applicable payments are described in 101 CMR 322.00 and have a concurrent public comment period.

EOHHS has also made necessary revisions and updates to correct or clarify provisions within 130 CMR 409.000.

The estimated annual aggregate fiscal impact of the proposed amendments to 130 CMR 409.000 to align MassHealth maintenance repair coverage with Medicare is $725,000. The additional estimated impact of the related amendments to 101 CMR 322.00 for a repair rate add-on is $3.3 million. The estimated annual fiscal impact for unrelated amendments to 101 CMR 322.00 for the supplemental payment for ceiling lift services is between $100,000 and $300,000.

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 October 28, 2024. The Division specifically invites comments as to how the amendments may affect beneficiary access to care.

The Division may adopt a final, revised version of the emergency regulation taking into account relevant comments and any other practical alternatives that come to its attention.

September 26, 2024

CMR No: 130 CMR 409.000: Durable Medical Equipment Services
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:

There are 102 Durable Medical Equipment (DME) providers and 738 pharmacy providers that offer DME as a subspecialty service.
Will small businesses have to create, file, or issue additional reports?

Yes.
Will small businesses have to implement additional recordkeeping procedures?

No.
Will small businesses have to provide additional administrative oversight?

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

Yes. Providers are required to reinvest 80% of the add-on payments received back into the mobility system repair components of their business. In order to comply, this could include hiring additional employees to support program development and implementation.
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.)
Yes, performance standards are more appropriate than design/operational standards to accomplish the regulatory objective.
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 continues to require providers to periodically comply with audits, inspections, and other regulatory activities.
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. It governs MassHealth providers of DME, provides program requirements and conditions of payment for the provision of DME to MassHealth members, and is applied uniformly among all such MassHealth providers.
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. It governs MassHealth providers of DME, provides program requirements and conditions of payment for the provision of DME to MassHealth members, and is applied uniformly among all such MassHealth providers.
Does the regulation provide for less stringent compliance or reporting requirements for small businesses?

No. The regulation requires DME providers to submit documentation requested by MassHealth for purposes of utilization and provider review to ensure compliance with MassHealth requirements. The regulations are applied uniformly among all MassHealth providers.
Does the regulation establish less stringent schedules or deadlines for compliance or reporting requirements for small businesses?

No. The regulation requires DME providers to submit documentation requested by MassHealth for purposes of utilization and provider review to ensure compliance with MassHealth requirements, including the timelines for reporting. The regulations are applied uniformly among all MassHealth providers of DME.
Did the agency consolidate or simplify compliance or reporting requirements for small businesses?

No. The regulation requires DME providers to submit documentation requested by MassHealth for purposes of utilization and provider review to ensure compliance with MassHealth requirements, including the timelines for reporting. The regulations are applied uniformly among all MassHealth providers.
Can performance standards for small businesses replace design or operational standards without hindering delivery of the regulatory objective?

Yes. Performance standards for repair turnaround times are more appropriate than design/operational standards to accomplish the regulatory objective.
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 provider participation requirements and conditions of payment regardless of whether the provider is a small business.

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Medical Assistance, Division of
130 CMR 464.000

Notice of Public Hearing

Under the authority of M.G.L. c. 6A, section 16 and in accordance with M.G.L. c. 30A, the Division of Medical Assistance (the Division) will hold a remote public hearing on Friday, October 18, 2024, at 9:00 a.m. relative to the adoption of the following new regulation:

130 CMR 464.000: Program of Assertive Community Treatment Services

The proposed new regulation is planned to go into effect no sooner than February 1, 2025. There is no fiscal impact on cities and towns.

The proposed regulation establishes the requirements for Program of Assertive Community Treatment (PACT) service providers to enroll as MassHealth providers and establishes PACT programs as a new fee-for-service provider type. The proposed regulation will:

Establish PACT service providers as a provider type that may bill MassHealth through fee-for-service.
Define MassHealth’s fee-for-service program for PACT and other relevant terms.
Establish the following payable services: intake, initial assessment and initial treatment planning, comprehensive assessment, Program of Assertive Community Treatment services, employment and vocational services, housing services and supports, pharmacotherapy, referral services including crisis intervention referrals, and discharge planning.
Establish fee-for-service PACT program administration and programmatic requirements, including member and provider eligibility, nonpayable services, nonpayable circumstances, telehealth, staffing and supervision requirements, recordkeeping requirements, and maximum allowable fees.

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 Friday, October 18, 2024. The Division specifically invites comments as to how the amendments may affect beneficiary access to care.

The Division may adopt a final, revised version of the emergency regulation taking into account relevant comments and any other practical alternatives that come to its attention.

September 27, 2024

CMR No: 130 CMR 464.000
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:

15
Will small businesses have to create, file, or issue additional reports?

Yes. Small businesses may have to create, file, or issue additional reports as a result of the proposed new chapter, 130 CMR 464.000.
Will small businesses have to implement additional recordkeeping procedures?

Yes. Small businesses may have additional responsibilities to keep records as a result of the proposed new chapter, 130 CMR 464.000.
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. Performance standards are not more appropriate than design or operational standards to accomplish the regulatory objective of establishing provider participation requirements for EOHHS health care services, as the proposed regulation is required by statute under M.G.L. Chapter 118E, Sections 7 and 12.
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. Small businesses will need to cooperate with audits, inspections, or other regulatory enforcement activities.
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. 130 CMR 464.000 is not likely to deter or encourage the formation of small businesses in Massachusetts as the proposed regulation establishes provider participation requirements for PACT treatment services providers.
Is the regulation likely to encourage the formation of small businesses in Massachusetts?

No. 130 CMR 464.000 is not likely to deter or encourage the formation of small businesses in Massachusetts as the proposed regulation establishes provider participation requirements for PACT treatment services providers.
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. 130 CMR 464.000 establishes uniform provider participation requirements for the provision of PACT services to MassHealth members. These requirements are applied uniformly in order to maintain consistency in the care provided by PACT providers to MassHealth members.
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.

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Mental Health, Department of
104 CMR 25.00

NOTICE OF COMMENT PERIOD

Notice is hereby given that the Department of Mental Health is proposing regulations under the authority of M.G.L. c. 19, ss. 1, 16 and 18. A public hearing will be held for the purpose of receiving written and oral testimony on its proposed actions. The Department describes the substance of the actions as follows:

The Department of Mental Health will be holding a Comment Period, ending on November 1, 2024, to receive written comments on proposed regulatory changes to 104 CMR 25.00 Authority, Vision, Mission, Definitions and Computation of Time. The primary purpose of the proposed amendment is to establish regulatory authority, define terms used throughout DMH regulations and provide consistency throughout DMH regulations.

The Department of Mental Health is proposing an amendment to regulation 104 CMR 25.00 to remove its Vision and Mission statements from regulation, but to maintain the requirement that it establish, periodically review and publish such statements. DMH has determined that its past practice of promulgating its vision and mission statements in regulation hinders its ability to innovate and to engage in strategic planning, which from time to time compels modification of its vision and mission statements. DMH has included a provision for stakeholder consultation in development and revision of statements.

COMMENT PERIOD

Comment Period will be held by the Department of Mental Health, ending on November 1, 2024

SUBMISSION OF COMMENTS

Please submit all written comments and testimony by sending in an email to: DMH-regulations@state.ma.us 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 or comments 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: Office of the General Counsel, Department of Mental Health, 25 Staniford Street, Boston, MA 02114. Written testimony/comments must be received NO LATER THAN END OF THE COMMENT PERIOD ON NOVEMBER 1, 2024, at 5:00 P.M.

INFORMATION:

The proposed regulations are posted on the DMH website and can be viewed at: https://www.mass.gov/service-details/dmh-proposed-regulations or request a copy in writing from DMH Regulations, 25 Staniford Street, Boston, MA 02114 or email: DMH-regulations@state.ma.us. DMH may adopt a revised version of the proposed actions, in consideration of relevant comments and any other practical alternatives that come to its attention.

By Order of the Department of Mental Health
Brooke Doyle, Commissioner
September 24, 2024

CMR No.: 104 CMR 25.00: Authority, Vision, Mission, Definitions, and Computation of Time
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:

0
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.
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.

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Public Health, Department of
105 CMR 130.00, 140.00 & 142.00

Notice of Public Hearing

Notice is hereby given pursuant to M.G.L. c. 30A, §2, that the Department of Public Health will hold a public hearing and comment period on the proposed amendments to 105 CMR 140.000 Licensure of Clinics regarding birth centers and 105 CMR 130.000: Hospital Licensure regarding birth centers and tiering of stroke services and on the proposed rescission of 105 CMR 142.000 Operation and maintenance of birth centers. These proposed amendments and proposed recission were filed on September 20, 2024.

In August 2024, An Act promoting access to midwifery care and out-of-hospital birth options was passed and include a number of requirements for “freestanding birth centers” for the Department to include in the clinic licensure regulations. The proposed amendments to both the hospital and clinic licensure regulations, consistent with the statutory changes, update the requirements for hospitals and clinics providing birth center services.

Additionally, the Department is proposing to rescind the now obsolete regulations 105 CMR 142.000, Operation and maintenance of birth centers, as all content of 105 CMR 142.000 was lifted and integrated into 105 CMR 130.000 in 2017 and into 105 CMR 140.000 in 2021.

The Department is further proposing changes to 105 CMR 130.000: Hospital Licensure, in accordance with Section 90 of the Massachusetts FY24 budget, approved August 2023, which requires the Department to promulgate regulations that create statewide criteria for designating hospitals in a tiered system.

The public hearing will be held on October 28, 2024, at 1:00p.m. The hearing will be conducted on a moderated conference call. The information for the moderated conference call is:

Dial-in Telephone Number: 800-619-7796,
Participant Passcode: 1474860
To Testify Press: *1

A copy of the proposed amendments to 105 CMR 130.000 and 105 CMR 140.000, as well as the proposed rescission of 105 CMR 142.000, may be viewed on the Department’s website at http://mass.gov/dph/proposed-regulations or requested from the Office of the General Counsel by calling 617-624-5220,

Speakers who testify at the public hearing are requested to provide a copy of their oral testimony. The Department encourages all interested parties to submit written testimony electronically to Reg.Testimony@mass.gov, or by mail to William Anderson, Office of the General Counsel, Department of Public Health, 250 Washington Street, Boston, MA 02108. Please submit electronic testimony as an attached Word document and type “Healthcare Facility Licensure Regulations” in the subject line of the email. All submitted testimony must include the sender’s full name and address.

The Department will post all electronic testimony that complies with these instructions on its website. All comments must be submitted by 5:00 p.m. on October 28, 2024. All comments received by the Department may be released in response to a request for public records.

If you are deaf or hard of hearing, or are a person with a disability who requires accommodation, please contact Stacy Hart at least 5 days before the hearing at Tel 857-274-1120, , or email Stacy.Hart@mass.gov.

CMR No: 105 CMR 130.000: Hospital licensure
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:

Presently, there are approximately 96 hospitals in Massachusetts. It is unlikely that any of these businesses qualify as a small business
Will small businesses have to create, file, or issue additional reports?

No.
Will small businesses have to implement additional recordkeeping procedures?

Yes, if these updates were to apply to a small business, they would have to maintain new minimum records for each pregnant and birthing person served at a birth center.
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?

Yes, if these updates were to apply to a small business, they may have to hire additional employees in order to comply with new minimum standards for stroke services.
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.
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, if these updates were to apply to a small business, they would require small businesses to cooperate with inspections and other regulatory enforcement activities in order for DPH to ensure the health and safety of residents.
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.

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Speech-language Pathology and Audiology, Board of Registration
260 CMR 1.00 & 2.00

Notice of Public Hearing

Notice is hereby given pursuant to M.G.L. c. 30A, §2 and M.G.L. c. 13, §87, that the Board of Registration in Speech-Language Pathology and Audiology (Board) within the Department of Public Health (Department), will hold a public hearing on amendments to the following regulations: 260 CMR 1.00: Standards, Complaint and Grievance Procedure and 260 CMR 2.00: Application and Licensing Requirements.

The proposed amendments update the regulations that govern the practice of speech-language pathology and audiology in the Commonwealth. The proposed amendments implement Chapter 263 of the acts of 2022, which authorize the Board to issue a provisional speech-language pathologist license and requires that applicants pay a fee to the Board. The proposed amendments establish licensure requirements for the new license category of Speech-Language Pathologist Provisional Licensee and align the new license type with existing regulation. The proposed amendments also update language in the regulation.

The hearing will be concurrent with the Executive Office for Administration and Finance’s public hearing regarding proposed changes to 801 CMR 4.02: Fees for Licenses, Permits and Services to be Charged by State Agencies. The proposed changes to 801 CMR 4.02 set the application fee for the new provisional speech-language pathologist license issued by the Board.

The public hearing will be held at 10:00 a.m. on Thursday, October 31st 2024. The hearing will be conducted on a moderated conference call. The information for the moderated conference call is:

Dial-in Telephone Number: 800-988-9538
Participant Passcode: 5999893

A copy of the proposed amendments to 260 CMR 1.00: Standards, Complaint and Grievance Procedure and 260 CMR 2.00: Application and Licensing Requirements may be viewed on the Department’s website at http://mass.gov/dph/proposed-regulations or requested from the Office of the General Counsel by calling 617-624-5220.

If you are deaf or hard of hearing, or are a person with a disability who requires accommodation, please contact Alex Gomez at least 5 days before the hearing at Tel # 646-558-8656, Fax # 617-624-5928, email Alex.Gomez@mass.gov, or TTY #617-624-6001.

CMR No.: 260 CMR 1.00
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:

6,326 Speech-Language Pathologists
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- state law requires the Board of Registration for Speech-Language Pathology and Audiology to license and establish minimum practice standards for licensees. M.G.L. c. 13, § 86
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, Speech-Language Pathologists will continue to be required to meet continuing education requirements, but the regulation does not require small businesses to provide these educational services to licensees.
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?

Yes, provisional licensure may encourage the formation of small business by codifying an additional license type.
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?

Yes - the amended regulation sets performance standards, not design or operation standards.
Are there alternative regulatory methods that would minimize the adverse impact on small businesses?

No.

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Telecommunications and Cable, Department of
207 CMR 1.00, 3.00 & 12.0

Notice of Public Comment Period For Proposed Amendments To 207 Cmr 1.00, 3.00 And 12.00

Notice is hereby given in accordance with Massachusetts General Laws Chapter 30A that the Department of Telecommunications and Cable (“DTC”) will hold a public comment period relative to proposed amendments to 207 CMR 1.00, 3.00 and 12.00. These minor procedural amendments would 1) allow the Department to prescribe notice posting methods for public hearings on cable licensing, 2) allow businesses to file tariffs electronically with the Department, and 3) remove outdated references.

Written comments will be accepted from September 27, 2024, until 5:00 pm on Friday, October 18, 2024, and may be submitted via email to Shonda Green, Secretary of the DTC, at dtc.efiling@mass.gov or mailed to: Shonda Green, Department of Telecommunications and Cable, 1000 Washington Street, Suite 600, Boston, MA 02118. Copies of the proposed regulations may be obtained from the DTC website available at https://www.mass.gov/doc/notice-of-proposed-207-cmr-amendments/download.

By Commissioner Karen Charles Department of Telecommunications and Cable

CMR No.: 207 CMR 1.00, 3.00 & 12.00
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:

0
Will small businesses have to create, file, or issue additional reports?

No. The change in 207 CMR 12.00 is intended to change tariff filings from paper submissions to electronic submissions, but the filings themselves are substantively similar. The changes to the remaining regulations are minor and will not require additional reports.
Will small businesses have to implement additional recordkeeping procedures?

No. The changes to these regulations are minor and will not require additional recordkeeping.
Will small businesses have to provide additional administrative oversight?

No. The changes to these regulations are minor and will not require additional recordkeeping.
Will small businesses have to hire additional employees in order to comply with the proposed regulation?

No. The changes to these regulations are minor and will not require additional recordkeeping.
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.
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. The changes to these regulations are minor and will have no substantive effect on small businesses
Does the regulation require small businesses to provide educational services to keep up to date with regulatory requirements?

No. The changes to these regulations are minor and will have no substantive effect on small businesses
Is the regulation likely to deter the formation of small businesses in Massachusetts?

No. The changes to these regulations are minor and will have no substantive effect on small businesses
Is the regulation likely to encourage the formation of small businesses in Massachusetts?

No. The changes to these regulations are minor and will have no substantive effect on small businesses
Does the regulation provide for less stringent compliance or reporting requirements for small businesses?

No. The changes to these regulations are minor and will have no substantive effect on compliance or reporting requirements
Does the regulation establish less stringent schedules or deadlines for compliance or reporting requirements for small businesses?

No. The changes to these regulations are minor and will have no substantive effect on compliance or reporting requirements
Did the agency consolidate or simplify compliance or reporting requirements for small businesses?

No. The changes to these regulations are minor and will have no substantive effect on compliance or reporting requirements
Can performance standards for small businesses replace design or operational standards without hindering delivery of the regulatory objective?

This question is not applicable to the proposed changes in these regulations.
Are there alternative regulatory methods that would minimize the adverse impact on small businesses?

No.

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Veterans' Services, Executive Office of
108 CMR 10.00

NOTICE OF PUBLIC HEARING

Please be advised that, in accordance with M.G.L. c. 30A, §2, Notice is hereby given that the Commonwealth of Massachusetts Executive Office of Veterans Services (“EOVS”) will hold a public hearing for the purpose of hearing any comments in connection with the proposed Regulations at 108 CMR 10.22: Medical Care – Psychiatric Care. The Regulation proposes a change in the existing regulation 108 CMR 10.22. This is required pursuant to Section 72 of an Act Honoring, Empowering, and Recognizing our Servicemembers and Veterans (HERO Act) (Chapter 178 of the Acts of 2024), which changes M.G.L. Chapter 115 Section 2. The existing regulation says we cannot reimburse for mental health treatment, while the HERO Act says that we must.

EOVS will hold this public hearing remotely on Friday, October 25, 2024 at 10:00 AM via Microsoft Teams at the following link: LINK!

or Meeting ID: 284 216 415 606
Passcode: T55tbg

A copy of the proposed Regulations referenced above may be viewed by visiting Notice of Public Hearing Executive Office of Veterans’ Services – 108 CMR 10.22 – Medical Care Regulation – Psychiatric Care | Mass.gov. Any person who would like to offer comments may participate in the public hearing at the date and time indicated above or submit written comments. Those who wish to receive a written copy of the proposed Regulations, or to submit written comments, may do so by sending an email to jenna.buonopane5@mass.gov or by mail to:

Jenna Buonopane - Paralegal
Commonwealth of Massachusetts
Executive Office of Veterans’ Services
600 Washington Street, 2nd Floor
Boston, MA 02111

Written comments must be received by 5:00 p.m. on November 8, 2024. Attached please find the accompanying Small Business Impact Statement in accordance with M.G.L. c. 30A, §2.

CMR No.: 108 CMR 10.22: Medical Care – Psychiatric Care
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:

0
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.
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.

Notices of Public Hearing (Published 10/11/2024)

Administration and Finance, Executive Office for 801 CMR 4.00

Notice of Public Hearing

801 CMR 4.00 Small Business Impact Statement

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

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

Will small businesses have to implement additional recordkeeping procedures?

Will small businesses have to provide additional administrative oversight?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Center for Health Information and Analysis 957 CMR 2.00, 3.00, 6.00, 7.00, 8.00, 9.00, 10.00 & 11.00

NOTICE OF PUBLIC HEARING

CMR No: 130 CMR 450.000 Small Business Impact Statement

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

Will small businesses have to implement additional recordkeeping procedures?

Will small businesses have to provide additional administrative oversight?

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

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

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

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

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

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

Will the regulation have the effect of creating additional taxes and/or fees for small businesses?

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

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

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

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

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

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

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

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

Were any small businesses or small business organizations contacted during the preparation of this document? If so, please describe

Health and Human Services, Executive Office of 101 CMR 206.00

Notice of Public Hearing

CMR No: 101 CMR 206.00: Standard Payments to Nursing Facilities Small Business Impact Statement

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

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

Will small businesses have to implement additional recordkeeping procedures?

Will small businesses have to provide additional administrative oversight?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Health and Human Services, Executive Office of 101 CMR 322.00

Notice of Public Hearing

CMR No: 101 CMR 322.00: Rates for Durable Medical Equipment, Oxygen and Respiratory Therapy EquipmentSmall Business Impact Statement

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

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

Will small businesses have to implement additional recordkeeping procedures?

Will small businesses have to provide additional administrative oversight?

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

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

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

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

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

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

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

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

Administration and Finance, Executive Office for
801 CMR 4.00

801 CMR 4.00
Small Business Impact Statement

Center for Health Information and Analysis
957 CMR 2.00, 3.00, 6.00, 7.00, 8.00, 9.00, 10.00 & 11.00

CMR No: 130 CMR 450.000
Small Business Impact Statement

Health and Human Services, Executive Office of
101 CMR 206.00

CMR No: 101 CMR 206.00: Standard Payments to Nursing Facilities
Small Business Impact Statement

Health and Human Services, Executive Office of
101 CMR 322.00

CMR No: 101 CMR 322.00: Rates for Durable Medical Equipment, Oxygen and Respiratory Therapy Equipment
Small Business Impact Statement

Health and Human Services, Executive Office of
101 CMR 346.00 & 418.00

CMR No: 101 CMR 346.00:
Small Business Impact Statement

Health and Human Services, Executive Office of
101 CMR 351.00

CMR No: 101 CMR 351.00
Small Business Impact Statement

Medical Assistance, Division of
130 CMR 409.000

CMR No: 130 CMR 409.000: Durable Medical Equipment Services
Small Business Impact Statement

Medical Assistance, Division of
130 CMR 464.000