Mass Regulations

Massachusetts Regulations

The Alliance keeps members informed on state and federal regulations to ensure compliance in a changing environment. Our comprehensive resources cover licensure, patient care standards, worker protections, MassHealth guidelines, and reporting requirements like elder abuse. By understanding these regulations, agencies can avoid penalties, provide quality care, and meet accreditation standards for success.

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State Regulations Documents & Resources

What regulations apply to home care agencies in Massachusetts?

All businesses in Massachusetts are subject to regulation by the Secretary of State’s office. Additionally, all agencies that accept Medicare/Medicaid dollars are required to pass rigorous federal standards. However, Massachusetts does not have any specific regulations or standards for home care agencies that do not accept Medicare/Medicaid dollars. These agencies are also known as Private Care Agencies.

How are Private Care Agencies different from Medicare Certified Agencies?

They operate under completely different business models and offer different services.

Medicare Certified agencies can bill Medicare/Medicaid for their services, and some accept only Medicare patients. To qualify for Medicare reimbursement, patients must be 1) home-bound, 2) have skilled medical need requiring a nurse or other trained professional, and 3) have a doctor’s order verifying these first two.

Private Care agencies can not bill Medicare, but accept pay from a variety of other source, including private insurance programs, and out-of-pocket. Some Private Care agencies offer a combination of medically skilled and unskilled services, while others exclusively offer only non-medical. All of this gives private care agencies far greater flexibility than their certified cousins.

Important Websites

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Labor Laws

EOEA Regulations

EOEA Important Websites

EOEA Forms & Resources

Electronic Visit Verification

Electronic Visit Verification (EVV) is a tracking system that requires electronic verification of when a person receives Medicaid-funded personal care or home health services to continue receiving federal financial support toward the costs of those services.

Regulatory Help Desk

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Connect with statewide and regional bodies that are tasked with overseeing agencies and businesses in MA. Labor laws, Executive Office of Elder Affairs Regulations, Electronic Visit Verification, Department of Public Health, Mass Health Manuals and more.

Federal Regulations

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The Alliance, with our national partners, break down the complex federal regulatory systems and changes for members. Find resources like Medicare Manuals, tables and Payment Models, Quality Reporting, OASIS, HIPAA and more.

Regulations Documents & Resources

Home Care Worker Registry: Advanced Care Planning Important Websites MassHealth Manuals MassHealth Reform MassHealth Websites MassHealth Forms & Resources Labor Laws EOEA Regulations EOEA Important Websites EOEA Forms & Resources

Home Care Worker Registry:

In 2017, the Massachusetts State Legislature passed, and Governor Baker signed into law, legislation establishing a Home Care Worker Registry. The law requires that any home care agency contracting in the State Home Care Program maintain and upload their worker roster into the registry. The Alliance advocated successfully for an exemptions process, allowing workers to be exempt from the registry for various reasons.

Find more information at these links:

Home Care Worker Registry Website
Final Regulation
Exemption Form
Open PDF file, Home care worker registry
Implementation Notice to Agencies

Advanced Care Planning

MOLST is a standardized medical order form for use by clinicians caring for patients with serious advancing illnesses. The primary differences between the MOLST form and a DNR are: MOLST covers a variety of end-of-life treatments. A DNR only gives instructions about CPR. The MOLST form can also be used in a community setting where the DNR is intended to be used as a directive in a health care setting.