Common Contracts

SCHOOL-BASED MEDICAID PROGRAM

Provider Contract • January 29th, 2019 • Massachusetts

• Contract Type
  Provider Contract
• Filed
  January 29th, 2019
• Jurisdiction
  Massachusetts

This Contract, effective is hereby amended and restated effective July 1, 2019, and is by and between the Commonwealth of Massachusetts Executive Office of Health and Human Services (hereinafter, “EOHHS”), with a business address of One Ashburton Place, Boston, Massachusetts 02108 and , (the legal name of the School- Based Medicaid Provider, hereinafter, the “Provider”) with a principal place of business located at