101 CMR, § 327.02

Current through Register 1527, August 2, 2024
Section 327.02 - General Definitions

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. 1396aet seq.), Title XXI of the Social Security Act (42 U.S.C. 1397aaet 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.

101 CMR, § 327.02

Adopted by Mass Register Issue 1412, eff. 3/6/2020.
Amended by Mass Register Issue 1451, eff. 8/20/2021.
Amended by Mass Register Issue 1456, eff. 8/20/2021.
Amended by Mass Register Issue 1461, eff. 1/21/2022.
Amended by Mass Register Issue 1482, eff. 11/1/2022 (EMERGENCY).
Amended by Mass Register Issue 1486, eff. 1/6/2023.
Amended by Mass Register Issue 1506, eff. 9/29/2023 (EMERGENCY).
Amended by Mass Register Issue 1512, eff. 9/29/2023 (EMERGENCY).
Amended by Mass Register Issue 1518, eff. 9/29/2023 (EMERGENCY).
Amended by Mass Register Issue 1522, eff. 5/24/2024.