Each PACT provider must have and observe written policies and procedures that include

1. (A) a statement of its philosophy and objectives and of the geographical area served;
2. (B) an intake policy;
3. (C) intake procedures, including criteria for client enrollment and procedures for multidisciplinary review of each individual referral;
4. (D) treatment procedures including, but not limited to, development of the treatment plan, case assignment, case review, discharge planning, and follow-up on members who leave the program voluntarily or involuntarily;
5. (E) a medication policy that includes prescription, administration, and monitoring data;
6. (F) a referral policy, including procedures for ensuring uninterrupted and coordinated member care upon transfer;
7. (G) recordkeeping policies, including what information must be included in each record, and procedures to ensure confidentiality;
8. (H) personnel and management policies, including policies for hiring, training, evaluation, supervision and termination protocol for all staff;
9. (I) a utilization review plan; and
10. (J) explicit fee policies with respect to billing third-party payers, cancellation procedures, and fee reductions.

Commonwealth of Massachusetts Subchapter Number and Title Page

MassHealth 4. Program Regulations

4-17

Provider Manual Series (130 CMR 464.000)

Transmittal Letter Date

Program of Assertive Community

Treatment Manual

PACT-1 11/1/2025