27PMEHSACUTEHOSPITAL: Rate Year 2027 Acute Hospital Request for Applications

The Massachusetts Executive Office of Health and Human Services (EOHHS) is requesting applications from eligible in-state acute hospitals to participate as MassHealth providers under the Rate Year 2027 Acute Hospital RFA, with submissions due September 30, 2026, and written questions due September 23, 2026.

Eligible applicants must be Massachusetts hospitals licensed by the Department of Public Health, Medicare-certified, and maintain more than 50 percent of beds as medical/surgical, intensive care, coronary care, burn, pediatric, or maternal/neonatal beds. The scope covers inpatient and outpatient services, including emergency services, delivered to MassHealth members and Emergency Aid to the Elderly, Disabled and Children recipients at inpatient departments, outpatient departments, and satellite clinics.

Reimbursement methodologies are fixed and non-negotiable: hospitals must accept the rates outlined in the RFA as payment in full for all covered services. The Statewide Operating Standard per Discharge for RY27 is $11,423.66 and the Statewide Capital Standard per Discharge is $792.37, calculated using hospital-specific wage area indices and discharge-specific MassHealth DRG weights based on the Solventum APR-DRG Grouper Version 43. Additional methodologies include all-inclusive facility payments per discharge with outlier payments for qualifying cases, per diem payments for behavioral health services, and supplemental payments for specialized services including behavioral health crisis evaluations, recovery support navigator services, and medication-assisted treatment initiation. Outpatient services use the Adjudicated Payment per Episode of Care (APEC) system.

The contract term runs October 1, 2026, through September 30, 2027. All hospitals must comply with mandatory quality and performance reporting requirements, including the Clinical Quality Incentive Program and the Hospital Quality and Equity Incentive Program, and must participate in the Statewide Event Notification Service. EOHHS intends to contract with all eligible hospitals submitting satisfactory applications that agree to accept established rates and comply with program requirements. Failure to respond may result in termination of MassHealth provider status for non-emergency services.

Questions should be directed to Jin Pantano.