Common Contracts

COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES SCHOOL-BASED MEDICAID PROGRAM AMENDED AND RESTATED PROVIDER CONTRACT

Commonwealth of Massachusetts • January 29th, 2019 • Massachusetts

• Contract Type
  Commonwealth of Massachusetts
• 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 ______________________________________________________________________________________________________________________________________________________________ [Provider’s address].