26PMEHSACUTEHOSPITAL: Rate Year 2026 Acute Hospital Request for Applications

The Executive Office of Health and Human Services is soliciting applications from eligible in-state acute hospitals to participate as MassHealth providers for Rate Year 2026 through Request for Applications BD-26-1039-EHS01-ASHWA-120635. Applications must be submitted no later than September 30, 2025, at 5:00 p.m., either electronically via email to AcuteHospitalRFA@mass.gov or by hard copy to the specified Quincy address, with all required documentation including the signed contract in Appendix A, the Application for Participation in Appendix B, and supporting forms from Appendix E. Hospitals must be licensed, in good standing, and capable of meeting compliance obligations under state and federal regulations including HIPAA, 45 CFR, and M.G.L. c. 66A. The contract term runs from October 1, 2025, to September 30, 2026, with performance evaluated exclusively through a weighted Clinical Quality Incentive Program that assesses six domains: Care Coordination/Integration (25%), Patient Safety (25%), Patient Experience (20%), Care for Acute and Chronic Conditions (15%), Perinatal Care (15%), and Behavioral Health Care (15%), with scores calculated based on attainment, improvement, or reporting-only status for specific clinical measures such as CLABSI, CAUTI, MRSA, HCAHPS, and stroke care protocols. Incentive payments are tied directly to the hospital's overall quality score, with no consideration given to cost or price, and a trade-off model rewards hospitals demonstrating high performance across multiple metrics, including bonus points for outcomes that statistically exceed the state average. Hospitals must adhere to strict reporting and data submission requirements via the MassQEX Portal and CDC’s NHSN or CMS’s HCAHPS systems, and comply with EOHHS Technical Specifications for data formats and timelines. They are obligated to report Serious Reportable Events as defined in 105 CMR 130.332 and maintain documentation for audit review, while also implementing safeguards against data breaches under state and federal privacy laws. Special requirements include disclosure of any change in ownership or control within 35 days, mandatory reporting of suspected fraud within 10 days, and ensuring staffing meets clinical standards such as having trained psychiatrists and multidisciplinary teams for specialty services like eating disorder care. The contract incorporates binding