Section 405.405 - Certification(A)Application. An application for certification as a CHC must be made on the form provided by the MassHealth agency and must be submitted to the MassHealth agency's program specialist for CHCs. Upon receipt of the completed application, the program specialist or his or her designee may arrange for a site visit with the applicant to determine compliance with 130 CMR 405.406 through 405.416, and if the applicant offers one or more of the services described in 130 CMR 405.431 through 405.471, compliance with the applicable portions of those sections. Based on the information revealed by the application and the site visit, the MassHealth agency will determine whether the applicant is certifiable, provisionally certifiable, or not certifiable. The program specialist will promptly notify the applicant of the determination in writing. If the applicant is not certifiable, the notice will contain a statement of the reasons for that determination.(B)Certification. A determination of certifiability indicates that the applicant has been found by the MassHealth agency to be in compliance with 130 CMR 405.406 through 405.416 and, to the extent applicable, with 130 CMR 405.431 through 405.471. Upon such determination of certifiability, the CHC may enter into a provider contract with the MassHealth agency in accordance with 130 CMR 450.000: Administrative and Billing Regulations.(C)Provisional Certification. Provisional certification means that the MassHealth agency has determined the applicant to be in compliance with 130 CMR 405.405(B), except for one or more of the following: 130 CMR 405.408(F): Nutrition Services, 405.408(C): Obstetrics/Gynecology, 405.414: Translation Services, or 405.415: Emergency Backup Services. If an applicant has been provisionally certified, the letter of notification will specify the certification requirements with which the applicant has failed to comply and the schedule for achieving compliance. When requirements for full certification have been met, the MassHealth agency will certify the CHC. Upon notice of provisional certification, the CHC may enter into a provider contract with the MassHealth agency in accordance with 130 CMR 450.000: Administrative and Billing Regulations, on the condition that such provider contract, by its own terms, will expire upon the date fixed in the letter of notification for full compliance.(D)Review of Certification.(1) The MassHealth agency's program specialist for CHCs has the right to review a certified or provisionally certified provider's continued compliance with the conditions for certification referred to in 130 CMR 405.405(A) through (C) upon reasonable notice and at any reasonable time during the hours of operation of the provider. The program specialist has the right to revoke the certification or provisional certification of a provider, subject to any applicable provisions of 130 CMR 450.000: Administrative and Billing Regulations, if such review reveals that the provider has failed or ceased to meet such conditions.(2) Any changes in the manager or professional services director or in the scope of services provided by a CHC must be reported in writing to the MassHealth agency's program specialist for CHCs. Any additions to the scope of services must be approved in writing by the program specialist before they are payable by the MassHealth agency. Elimination of services may result in review of the CHC by the MassHealth agency to determine whether the CHC still meets the requirements for certification set forth in 130 CMR 405.405.Amended by Mass Register Issue S1277, eff. 1/2/2015.Amended by Mass Register Issue 1387, eff. 3/22/2019.