Code of Massachusetts Regulations › 130 CMR - DIVISION OF MEDICAL ASSISTANCE › Title 130 CMR 407.000 - Transportation Services › Section 407.405 - Provider Eligibility: In-state

Current through Register 1525, July 5, 2024
(A) In
			 order to be eligible to receive payment from MassHealth, a potential provider
			 must complete and submit an application to become an approved MassHealth
			 provider, own, lease, or otherwise control by means of a written agreement,
			 vehicles required for the transportation services it seeks to provide, be a
			 Medicare provider of any Medicare-covered services it seeks to provide, and be
			 assigned a MassHealth provider number by the MassHealth agency.
(B) The provider must ensure that applicants
			 and employees whose positions entail the potential for unsupervised contact
			 with MassHealth members including, but not limited to, drivers and attendants,
			 provide written references and undergo a Criminal Offender Record Information
			 (CORI) check before any contact with a MassHealth member. The provider must
			 ensure that all new employees whose positions entail the potential for
			 unsupervised contact with MassHealth members including, but not limited to,
			 drivers and attendants, undergo a CORI check prior to employment. The provider
			 must ensure that all existing employees whose positions entail the potential
			 for unsupervised contact with MassHealth members including, but not limited to,
			 drivers and attendants, undergo a CORI check annually to recertify their
			 eligibility for their position. The CORI must be in compliance with guidelines
			 that the Executive Office of Health and Human Services may issue. The CORI must
			 remain on file at the transportation provider's place of business.
(C) The provider must ensure that it and its
			 employees and contractors, as applicable, meet each of the requirements listed
			 in 130 CMR 407.405(C)(1) through (4). Providers must demonstrate compliance
			 with the following requirements through an attestation or other method
			 identified by EOHHS, in such form and at such frequency as designated by EOHHS
			 through provider bulletins or other written guidance.
(1) The provider and its employees and
			 contractors (including drivers and attendants) are not excluded from
			 participation in any federal health care program (as defined in section
			 1128B(f) of the Social Security Act) and is not listed on the exclusion list of
			 the Office of the Inspector General of the Department of Health and Human
			 Services (OIG). The provider must use the OIG's List of Excluded
			 Individuals/Entities to screen all employees and contractors to determine if
			 the OIG has excluded them from participation in federal health care programs,
			 both upon initial hiring or contracting and on an ongoing monthly
			 basis.
(2) Each individual driver
			 has a valid driver's license.
(3)
			 The provider has in place a process to address any violation of a state drug
			 law by its employees and contractors.
(4) The provider has in place a process to
			 disclose to MassHealth the driving history, including any traffic violations,
			 of each individual driver employed or contracted with by such
			 provider.