Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 444.00 - Rates for Certain Substance Use Disorder Services › Section 444.02 - Definitions

Current through Register 1525, July 5, 2024
As used in
				101 CMR
				444.00, terms shall have the following meanings,
				unless the context requires otherwise.
Approved Program Rate
. The rate per
				service unit approved by EOHHS and filed with the Secretary of the
				Commonwealth.
Center
. The Center for Health
				Information and Analysis established under M.G.L. c. 12C.
Eligible Provider
. Any individual,
				group, partnership, trust, corporation, or other legal entity that offers
				services for purchase by a governmental unit and that meets the conditions of
				purchase or licensure that have been or may be adopted by a purchasing
				governmental unit.
EOHHS
. The Executive Office of Health
				and Human Services established under M.G.L. c. 6A.
Established Charge
. The lowest fee
				that is charged or accepted as payment by the eligible provider to the general
				public or any third-party payer, other than a governmental unit, for the
				provision of services. Fees based upon the client's ability to pay, as in the
				case of a sliding fee scale, and fees subject to EOHHS review and approval are
				not deemed to be established charges.
Governmental Unit
. The Commonwealth,
				any board, commission, department, division, or agency of the Commonwealth and
				any political subdivision of the Commonwealth.
Individualized Treatment and Stabilization
				Services
. Acute Treatment Services (ASAM Level 3.7) and Clinical
				Stabilization Services (ASAM Level 3.5) provided in an appropriately licensed
				facility and in accordance with all applicable specifications.
Medical Evaluation
. An initial and
				annual one hour drug assessment conducted by a physician, advanced nurse
				practitioner, or other licensed medical practitioner.
Opioid Treatment Program (OTP)
. A
				program that provides opioid treatment services. An opioid treatment programs
				must be federally certified by the Substance Abuse Mental Health Services
				Administration and must be licensed as an Opioid Treatment Programs by the
				Department of Public Health under
				105 CMR
				164.000:
Licensure of Substance Use Disorder
				Treatment Programs.
Opioid Treatment Programs must conform to the
				federal opioid treatment standards set forth in
				42 CFR
				8.12.
Opioid Treatment Services
. Supervised
				assessment and treatment of an individual, using FDA approved medications
				(including methadone, buprenorphine, buprenorphine/naloxone, and naltrexone),
				along with a comprehensive range of medical and rehabilitative services, when
				clinically necessary, to alleviate the adverse medical, psychological, or
				physical effects incident to opiate use disorders. This term encompasses
				withdrawal management and maintenance treatment.
Publicly Assisted Client
. A person who
				receives program services for which a governmental unit is liable, in whole or
				in part, under a statutory program of financial assistance.
Purchasing Governmental Unit
. A
				governmental unit that has purchased or is purchasing service units from an
				eligible provider.
Recovery Support Navigator
. A
				paraprofessional or peer specialist who receives specialized training in the
				essentials of substance use disorder and evidence-based techniques such as
				motivational interviewing, and who supports members in accessing and navigating
				the substance use disorder treatment system through activities that can include
				care coordination, case management, and motivational support.