The Executive Office of Health and Human Services shall amend the formula used to determine continuous skilled nursing care rates for singe and multi-patient home health service pursuant to chapter 118G of the General Laws by attributing no less than 30 percent of the rate to the indirect cost component used to determine payment to agencies; and no more than 10 percent of the rate to the indirect cost component used to determine payment to an individual practitioner.
The Division of Health Care Finance & Policy shall not establish rates to reimburse for continuous skilled nursing care provided by Licensed Practical Nurses relative to 114.3 CMR 50.04 (2)(2)(b) to three patients or more.
The Division of Medical Assistance shall authorize overtime hours for continuous skilled nursing services provided by a home health agency only in the case of a documented emergency and for a short-term basis, not to exceed thirty consecutive calendar days, and when all of the following conditions are met:
1) Prior authorization for overtime has been obtained from the Division of Medical Assistance or its designee;
2) Nursing services by a single nurse exceed 40 hours in a given calendar week for the MassHealth member.
The Division of Medical Assistance or its designee will not approve requests for overtime as part of a routine submission for authorization for nursing services.
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