Section 36. Participation in the medical assistance programs established under this chapter shall be limited to providers of services who have not been convicted of larceny or fraud or any other crime in connection with such services, or the billing therefor and who:
(1) indicate their intention to the division to so participate;
(2) present evidence, satisfactory to the division, of their qualifications to provide such services;
(3) agree to accept, as payment in full, the amounts paid in accordance with the fee schedules provided for under this chapter;
(4) agree to comply with all laws, rules and regulations governing the operation of the programs;
(5) agree to be responsible for all overpayments owed to the division, including, in the case of transfer of ownership, the overpayments of any and all previous owners.
If any individual or entity has an ownership interest in more than one institutional provider, the division may offset any monetary liability of such individual or entity to the division under this section or otherwise from any amounts the division owes to any such institutional provider. Any individual or entity having an ownership interest in an institutional provider shall be liable to the division for all monetary liabilities of such provider to the division to the extent of such individual's or entity's ownership interest. For purposes of this paragraph, an ''ownership interest'' shall include both direct ownership interests and ownership interests in any entity which has an ownership interest in an institutional provider, and an ''institutional provider'' shall mean any entity which participates in any medical assistance program under this chapter as a provider of nursing facility services or acute, chronic, or rehabilitation hospital services.
Structure Massachusetts General Laws
Part I - Administration of the Government
Chapter 118e - Division of Medical Assistance
Section 2 - Established Authority
Section 2a - Director of Dental Services
Section 6 - Medical Care Advisory Committee; Member; Staff; Report From Office of Medicaid
Section 8a - Definitions for Secs. 13c to 13k and Secs. 64 to 70
Section 9a - Masshealth; Beneficiaries; Eligibility; Payment; Information Applications
Section 9f - Duals Demonstration; Review of Request for Financial Solvency
Section 10 - Medical Care Assistance Program for Pregnant Women and Infants
Section 10a - Required Coverage for Prenatal Care, Childbirth and Postpartum Care
Section 10b - Required Coverage for Newborn Hearing Screening Tests
Section 10d - Required Coverage for Treatment of Breast and Cervical Cancer
Section 10g - Coverage for Children Under Age 18 for Cleft Lip and Cleft Palate
Section 10k - Coverage for Certain Services and Contraceptive Methods
Section 10m - Coverage for Tobacco Use Cessation Counseling and Products
Section 10n - Urgent Care Facilities; Referrals; Primary Care Providers
Section 11 - Cooperation With Federal Authorities
Section 12 - Policies; Procedures; Rules and Regulations; Contracts
Section 12a - Pharmaceutical Drugs; Negotiation of Supplemental Rebate Agreements
Section 13 - Rate Changes; Review
Section 13a - Non-Acute Hospitals; Rates and Terms of Payment
Section 13b - Hospital Rate Increases; Quality Standards and Benchmarks
Section 13c - Establishment of Rates of Payment for Health Care Services
Section 13d - Duties of Ratemaking Authority; Criteria for Establishing Rates
Section 13e - Appeals of Interim or Final Rates
Section 13e1/2 - Contractual Arrangements With Acute and Non-Acute Hospitals
Section 13g - Hospital Assets Not to Be Considered as Resources for Purpose of Establishing Rates
Section 13h - Recipients of Benefits Under Chapter 117a
Section 13i - Patients With Foreign Residency
Section 13j - Health Maintenance Organizations; Contracting Rights
Section 13k - Adjustment of Facility's Rate
Section 13l - Restriction of Hospital Access to Discounted Purchase of Prescription Drugs
Section 14 - Nursing Home Negotiated Rate Contracts
Section 15 - Medicaid Benefits; Rules and Regulations; Managed Care; Personal Expenses
Section 16a - Medical Care and Assistance Program for Disabled Children
Section 16c - Child Health Insurance Program; Medical Benefits; Costs; Eligibility
Section 16d - Aliens or Persons Residing in United States Under Color of Law; Benefits
Section 17 - Reimbursements for Non-Generic Drugs
Section 17a - Emergency Services Provided to Beneficiaries for Emergency Medical Conditions
Section 18 - Medical Insurance Purchases for Persons Eligible for Assistance
Section 20 - Application; Forms; Application by Institution
Section 21 - Inquiry by Department; Notification of Applicant; Agreement
Section 21a - Medical Assistance Eligibility of an Institutionalized Spouse
Section 22 - Third Party Payments; Repayment; Assignment; Subrogation
Section 23 - Subrogation Rights; Health Insurance Benefits; Garnishment of Wages
Section 23a - Financial Institutions; Request for Deposit and Withdrawal Records; Penalty
Section 25 - Exempt Income and Resources
Section 26 - Identification Card
Section 27 - Redetermination of Eligibility
Section 28 - Disposal of Resources at Less Than Fair Market Value; Period of Ineligibility
Section 29 - Transfer of Interest in Real Property; Notice
Section 31 - Adjustment or Recovery of Payments
Section 33 - Long Term Care Insurance Purchasers; Liability for Medical Assistance Paid
Section 34 - Liens and Encumbrances
Section 35 - Reimbursement for Covered Claims; Submission of Information
Section 36 - Eligible Providers; Responsibility for Overpayments
Section 37 - Distribution of Rules, Regulations to Providers; Administrative Sanctions
Section 38a - Retroactive Claims Denials for Behavioral Health Services
Section 39 - False Representations, Failure to Disclose; Penalty
Section 40 - False Statements or Representations by Providers; Penalty
Section 41 - Bribery or Rebates; Penalty
Section 42 - Excess Charges; Penalty
Section 44 - Civil Remedies; Limitations
Section 45 - Venue; Actions Relating to False Claims
Section 46 - Availability of Other Remedies
Section 47 - Persons Aggrieved; Right to Hearing; Investigation; Decision; Rehearing; Notice
Section 48 - Board of Hearings
Section 49 - Use and Disclosure of Information
Section 50 - Contract for Administrative Functions; Underwriting of Program
Section 52 - Maintenance of Standards for Providers; Development of New Programs
Section 54 - Wellness Program for Masshealth Enrollees
Section 56 - Controlled Substance Management Program for Masshealth Enrollees
Section 63 - Assessment per Non-Medicare Reimbursed Patient Day
Section 64 - Definitions for Secs. 64 Through 69
Section 65 - Health Safety Net Office
Section 66 - Health Safety Net Trust Fund
Section 67 - Liability of Acute Hospital to Fund
Section 67a - Nonpublic Ambulance Services; Liability; Uniform Assessment; Enforcement
Section 68 - Surcharge Assessed by Acute Hospitals and Ambulatory Surgical Centers
Section 70 - Definitions for Secs. 70 Through 75
Section 71 - Pca Quality Home Care Workforce Council
Section 74 - Pca Quality Home Care Workforce Council; Scope of Power and Authority
Section 75 - Performance Reviews
Section 77 - Office of Medicaid to Attribute Members to Primary Care Providers