Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 327.00 - Rates of Payment for Ambulance and Wheelchair Van Services › Section 327.02 - General Definitions

Current through Register 1525, July 5, 2024
Terms, as used in 101 CMR 327.00, have the meanings set forth
				in 101 CMR 327.02.
Ambulance
. An aircraft, boat, motor
				vehicle or other means of transportation, however named, whether privately or
				publicly owned, which is intended to be used for, and is maintained and
				operated for, the response to and the transportation of sick or injured
				individuals.
Center
. The Center for Health
				Information and Analysis, established under M.G.L. c. 12C.
Eligible Provider
. A person,
				partnership, corporation, governmental unit, or other entity that provides
				authorized emergency ambulance, nonemergency ambulance, and/or wheelchair van
				services and that also meets such conditions of participation as have been or
				may be adopted from time to time by a governmental unit purchasing ambulance
				services.
EOHHS
. The Executive Office of Health
				and Human Services, established under M.G.L. c. 6A.
Governmental Unit
. The Commonwealth of
				Massachusetts or any of its departments, agencies, boards, commissions, or
				political subdivisions.
Individual Consideration (I.C.)
. Rates
				of payment to eligible providers for services authorized, but not listed
				herein, or authorized services performed in exceptional circumstances will be
				determined on an individual consideration basis by the governmental unit upon
				receipt of a bill that describes the services rendered. Eligible providers must
				maintain adequate records to determine the appropriateness of their I.C. claims
				and must provide these documents to the governmental unit upon request.
Loaded Mileage
. The actual distance a
				person or persons is (are) transported in an ambulance or wheelchair
				van.
MassHealth
. The medical assistance and
				benefit programs administered by EOHHS pursuant to Title XIX of the Social
				Security Act (42 U.S.C.
				1396a
et seq
.), Title XXI of
				the Social Security Act (42
				U.S.C. 1397aa
et seq
.),
				M.G.L. c. 118E, and other applicable laws and waivers to provide and pay for
				medical services to eligible members.
Nonpublic Ambulance Service
. Ambulance
				services which are not provided by a city or town, county, district, or other
				governmental body and are licensed pursuant to M.G.L. c. 111C § 6.
Publicly Aided Individual
. A person
				for whose medical and other services a governmental unit is in whole or in part
				liable under a statutory program.
Trip
. The event of pick-up, transport,
				and delivery of a person or persons to or from a hospital or other health care
				facility by an ambulance or wheelchair van.
Trust Fund
. The Nonpublic Ambulance
				Service Reimbursement Trust Fund established under M.G.L. c. 29, § 2KKKKK,
				to provide money to be expended for Medicaid payments to nonpublic ambulance
				services, as specified in 101 CMR 324.00:
Nonpublic Ambulance Service
				Reimbursement Trust Fund Assessment and Funding
. The Secretary of
				Health and Human Services, as trustee, will administer the fund and will make
				expenditures from the fund consistent with M.G.L. c. 29, § 2KKKKK.
Wheelchair Van
. A motor vehicle that
				is specifically equipped to carry one or more persons who have a mobility
				disability or who are using a wheelchair.