26MMEHSPSYCHHOSPITALRFA: Rate Year 2026 Psychiatric Hospital Request for Applications

The Massachusetts Executive Office of Health and Human Services (EOHHS) has issued a Request for Applications (RFA) for the Rate Year 2026 seeking eligible in-state psychiatric hospitals to become MassHealth providers of Psychiatric Hospital Services. The solicitation, posted September 2, 2025, and with applications due by September 16, 2026, outlines the contracting process, payment structures, clinical quality requirements, and administrative obligations. Participating hospitals are expected to comply with Massachusetts regulations (130 CMR 425.000, 434.000, 450.000) and federal requirements such as HIPAA and CMS inpatient psychiatric facility quality reporting. The contract incorporates a detailed Psychiatric Hospital Contract, payment rates for various psychiatric service categories including specialty services for eating disorders and neurodevelopmental disorders, and participation in a Clinical Quality Incentive Program that evaluates performance across multiple quality measures like timely claims receipt, medication continuity, readmissions, and follow-up visits post-hospitalization. The RFA sets forth mandatory program participation criteria that applicants must satisfy to be eligible for contract award, including submission of required documentation, acceptance of contract terms, and certification of compliance. Once eligibility is confirmed, contractors participate in performance measurement through a scoring system that can influence incentive payments, although initial contract awards appear to be compliance-based rather than cost-competitive. The contract term begins as early as October 1, 2025, and ends September 30, 2026, covering service delivery at the providers’ Massachusetts psychiatric facilities. Payment mechanisms include per diem and per admission rates along with supplemental pools tied to admissions and clinical quality outcomes. The contract specifies key contract clauses addressing breach, amendments, privacy and HIPAA compliance, and advance directives. Applicants must follow strict submission protocols using provided templates and electronic signatures, submitting their complete applications electronically. Overall, the contract emphasizes quality performance accountability, regulatory compliance, data privacy, and clinical operational standards, supported by extensive appendices detailing rates, clinical competencies, reporting requirements, and specialty treatment standards.