Furnish Inpatient Services to MassHealth Members that conform to the requirements for such Inpatient Services as set forth in the MassHealth Program regulations; furnish only those Inpatient Services that qualify as medically necessary under the MassHealth Program regulations; furnish Inpatient Services that conform to the professionally recognized standards of health care within the Commonwealth for the applicable provider type and/or specialty type, or, if appropriate, that conform to the generally accepted standards within the Commonwealth for the trade. If furnishing Outpatient Services to MassHealth Members, furnish Outpatient Services that conform to the requirements for such Outpatient Services as set forth in the MassHealth Program regulations; furnish only those Outpatient Services that qualify as medically necessary under the MassHealth Program regulations; furnish Outpatient Services that conform to the professionally recognized standards of health care within the Commonwealth for the applicable provider type and/or specialty type, or, if appropriate, that conform to the generally accepted standards within the Commonwealth for the trade. Comply with, and is subject to, all federal and state statutes, rules and regulations governing the MassHealth Program, including, but not limited to, Psychiatric Inpatient Hospital regulations at 130 CMR 425.000 et seq.; Psychiatric Hospital Outpatient Services regulations at 130 CMR 434.000 et seq., as applicable; and Administrative and Billing regulations at 130 CMR 450.000 et seq.; provided, however, that in the event of any conflict between the documents which are part of the Hospital’s Contract with EOHHS and any regulation now existing or hereinafter adopted, the terms of the Contract shall prevail. All references to statutes and regulations refer to such statutes and regulations as they may be amended from time to time. In addition, the Contractor must comply with all billing instructions and provider bulletins applicable to the Contractor’s participation in the MassHealth Program, now existing or adopted during the term of this Contract.
