Payment for the services described in 130 CMR 415.000 is made only to acute inpatient hospitals participating in MassHealth as of the date of service.

1. (A) In-State. To participate in MassHealth, an acute inpatient hospital located in Massachusetts must

   1. (1) be licensed as a hospital by the Massachusetts Department of Public Health;
   2. (2) have a signed provider agreement that specifies a payment methodology with the MassHealth agency; and
   3. (3) participate in the Medicare program.

2. (B) Out of State.

   1. (1) Out-of-state acute inpatient hospital services are covered only as provided in 130 CMR 450.109: Out-of-State Services.

   2. (2) To participate in MassHealth, an out-of-state acute inpatient hospital must obtain a MassHealth provider number and meet the following criteria:

      1. (a) be approved as an acute inpatient hospital by the governing or licensing agency in its state;
      2. (b) participate in the Medicare program; and
      3. (c) participate in that state's Medicaid Program (or equivalent).