Massachusetts COMMBUYS #26PMEHSACUTEHOSPITAL

Massachusetts EOHHS Rate Year 2026 Acute Hospital MassHealth Provider Applications

This opportunity from the Massachusetts Executive Office of Health and Human Services (EOHHS) invites in-state acute hospitals to apply as MassHealth Providers for Rate Year 2026. - Government Buyer: - Executive Office of Health and Human Services (EOHHS), Office of Medicaid, MassHealth - Contact: Ryan Schwarz - Products/Services Requested: - Comprehensive acute hospital inpatient and outpatient services for MassHealth members and Emergency Aid recipients - Inpatient Discharge Add-on Payments: - Payments from two pools ($225.6M and $41.36M) based on inpatient discharges - Includes interim and final true-up or recoupment adjustments - Outpatient Episode Add-on Payments: - Payments from two pools ($254.4M and $46.64M) based on outpatient episodes - Includes interim and final true-up or recoupment adjustments - Targeted Hospital Supplemental Payments: - Payments ranging from $2M to $12M for qualifying hospitals (cancer hospitals, critical access, high public payer mix, etc.) - Unique/Notable Requirements: - Hospitals must agree to specified reimbursement rates and methodologies - Compliance with Medicaid fraud investigations and MassHealth program rules - Participation in quality incentive programs and health information technology requirements - Reporting obligations and eligibility criteria updated in Amendment 3 - OEMs and Vendors: - No specific OEMs or commercial vendors are named; this is a provider participation solicitation for hospitals - Estimated Contract Value: - Payment pools and supplemental payments total hundreds of millions of dollars for Rate Year 2026 - Eligible for Small Business Purchasing Program (SBPP)

Description

The Executive Office of Health and Human Services (EOHHS) is issuing the Rate Year 2026 Acute Hospital Request for Applications (RFA) to solicit applications from eligible, in-state Acute Hospitals wishing to participate as MassHealth Providers. The contract covers Acute Hospital Inpatient and Outpatient Services provided to MassHealth Members and recipients of Emergency Aid to the Elderly, Disabled and Children. Hospitals must accept the reimbursement rates and methodologies outlined in the RFA to participate. The RFA includes detailed provisions on reimbursement systems, program participation requirements, and quality incentive programs.

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