Lump Sum Payments for Workforce Investment Rates for Certain Health and Human Services Programs

May 22, 2023

As a result of the public health emergency related to COVID-19, MassHealth is working to provide fiscal recovery funds to support health and human services providers and their workforce.

In accordance with 101 CMR 452, enacted on September 2, 2022, MassHealth is issuing operational add-on rates for certain services whose basic rates are governed by other regulations.

Pursuant to 101 CMR 452.03(4), MassHealth will pay the operational add-on rate through two lump sum payments to eligible providers. MassHealth has already issued the first payments for the first six months of the covered time period, July 1, 2022 through December 31, 2022, with the exception payment for PT 05: Psychologists who received payment for the first three months of the covered time period. The second payment will pay for the second six months of the covered time period, January 1, 2023 through June 30, 2023. The second payment will also include payment for PT 05 for three months of the covered time period from October 1, 2022 to December 31, 2022.

For PT 65 and PT 28, the lump sum amount is calculated according to the following formula: Sum of {[(total fiscal year 2022 State spend on the services listed in 101 CMR 452.01(5)/12 (months)]}*(Add on rate of 10%)*(6 units). The factor of six reflects the number of months in the time period for the first payment. For PT 05, the lump sum amount is calculated according to the following formula: Sum of {[(total fiscal year 2022 State spend on the services listed in 101 CMR 452.01(5)/12 (months)]}*(Add on rate of 10%)*(3 units). The factor of three reflects the number of months in the time period.

The following are eligible provider types pursuant to 101 CMR 452:

PT 65: Psychiatric Day Treatment
PT 28: Substance Use Disorder Treatment
PT 05: Psychologist

As a condition of payment for the add-on rate, each provider must complete an attestation assuring EOHHS that they will use at least 90% of the funds for direct care workforce development, including hiring and retention bonuses and other categories of worker compensation. As a further condition of payment, a provider must submit a spending report to EOHHS for the use of the add-on rate, as directed by EOHHS. Where a provider delivers certain eligible services through separate businesses, that provider must submit one (1) attestation and one (1) spending report per Employer Identification Number (EIN) or Tax Identification Number (TIN). The provider spending report and attestation must be submitted to EOHHS by December 31, 2023. For additional information and requirements, please see https://tinyurl.com/4mvvc2ud.

If MassHealth did not make payments to a provider for services rendered in Fiscal Year 2022, that provider is ineligible to receive a lump sum payment from MassHealth for the add-on rate.

MassHealth anticipates the payment will be processed by May 24, 2023. Lump sum payments will be aggregated for organizations with multiple eligible providers, and those organizations will receive one lump sum payment for all the organization’s add-on rate eligible providers. Payments will be labeled “101 CMR 452.00 Workforce Investment” on VendorWeb/remittance advices.

On behalf of MassHealth, thank you for your dedication and partnership as we work together to care for the critical needs and supports of the individuals in our care.

If you have questions regarding this message, please contact MassHealth at provider@masshealthquestions.com or (800) 841-2900.

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Lump Sum Payments for Workforce Investment Rates for Certain Health and Human Services Programs