Capitol Building

Maryland Register


Issue Date: December 9, 2016

Volume 43 • Issue 25 • Pages 1375-1430

IN THIS ISSUE

Judiciary

Regulations

Special Documents

General Notices

 

Pursuant to State Government Article, §7-206, Annotated Code of Maryland, this issue contains all previously unpublished documents required to be published, and filed on or before November 18, 2016 5 p.m.
 
Pursuant to State Government Article, §7-206, Annotated Code of Maryland, I hereby certify that this issue contains all documents required to be codified as of November 18, 2016.
 
Brian Morris
Administrator, Division of State Documents
Office of the Secretary of State

Seal

Information About the Maryland Register and COMAR

MARYLAND REGISTER

   The Maryland Register is an official State publication published every other week throughout the year. A cumulative index is published quarterly.

   The Maryland Register is the temporary supplement to the Code of Maryland Regulations. Any change to the text of regulations published  in COMAR, whether by adoption, amendment, repeal, or emergency action, must first be published in the Register.

   The following information is also published regularly in the Register:

   • Governor’s Executive Orders

   • Attorney General’s Opinions in full text

   • Open Meetings Compliance Board Opinions in full text

   • State Ethics Commission Opinions in full text

   • Court Rules

   • District Court Administrative Memoranda

   • Courts of Appeal Hearing Calendars

   • Agency Hearing and Meeting Notices

   • Synopses of Bills Introduced and Enacted by the General Assembly

   • Other documents considered to be in the public interest

CITATION TO THE MARYLAND REGISTER

   The Maryland Register is cited by volume, issue, page number, and date. Example:

• 19:8 Md. R. 815—817 (April 17, 1992) refers to Volume 19, Issue 8, pages 815—817 of the Maryland Register issued on April 17, 1992.

CODE OF MARYLAND REGULATIONS (COMAR)

   COMAR is the official compilation of all regulations issued by agencies of the State of Maryland. The Maryland Register is COMAR’s temporary supplement, printing all changes to regulations as soon as they occur. At least once annually, the changes to regulations printed in the Maryland Register are incorporated into COMAR by means of permanent supplements.

CITATION TO COMAR REGULATIONS

   COMAR regulations are cited by title number, subtitle number, chapter number, and regulation number. Example: COMAR 10.08.01.03 refers to Title 10, Subtitle 08, Chapter 01, Regulation 03.

DOCUMENTS INCORPORATED BY REFERENCE

   Incorporation by reference is a legal device by which a document is made part of COMAR simply by referring to it. While the text of an incorporated document does not appear in COMAR, the provisions of the incorporated document are as fully enforceable as any other COMAR regulation. Each regulation that proposes to incorporate a document is identified in the Maryland Register by an Editor’s Note. The Cumulative Table of COMAR Regulations Adopted, Amended or Repealed, found online, also identifies each regulation incorporating a document. Documents incorporated by reference are available for inspection in various depository libraries located throughout the State and at the Division of State Documents. These depositories are listed in the first issue of the Maryland Register published each year. For further information, call 410-974-2486.

HOW TO RESEARCH REGULATIONS

An Administrative History at the end of every COMAR chapter gives information about past changes to regulations. To determine if there have been any subsequent changes, check the ‘‘Cumulative Table of COMAR Regulations Adopted, Amended, or Repealed’’ which is found online at http://www.dsd.state.md.us/PDF/CumulativeTable.pdf. This table lists the regulations in numerical order, by their COMAR number, followed by the citation to the Maryland Register in which the change occurred. The Maryland Register serves as a temporary supplement to COMAR, and the two publications must always be used together. A Research Guide for Maryland Regulations is available. For further information, call 410-260-3876.

SUBSCRIPTION INFORMATION

   For subscription forms for the Maryland Register and COMAR, see the back pages of the Maryland Register. Single issues of the Maryland Register are $15.00 per issue.

CITIZEN PARTICIPATION IN
THE REGULATION-MAKING PROCESS

   Maryland citizens and other interested persons may participate in the process by which administrative regulations are adopted, amended, or repealed, and may also initiate the process by which the validity and applicability of regulations is determined. Listed below are some of the ways in which citizens may participate (references are to State Government Article (SG),

Annotated Code of Maryland):

   • By submitting data or views on proposed regulations either orally or in writing, to the proposing agency (see ‘‘Opportunity for Public Comment’’ at the beginning of all regulations appearing in the Proposed Action on Regulations section of the Maryland Register). (See SG, §10-112)

   • By petitioning an agency to adopt, amend, or repeal regulations. The agency must respond to the petition. (See SG §10-123)

   • By petitioning an agency to issue a declaratory ruling with respect to how any regulation, order, or statute enforced by the agency applies. (SG, Title 10, Subtitle 3)

   • By petitioning the circuit court for a declaratory judgment

on the validity of a regulation when it appears that the regulation interferes with or impairs the legal rights or privileges of the petitioner. (SG, §10-125)

   • By inspecting a certified copy of any document filed with the Division of State Documents for publication in the Maryland Register. (See SG, §7-213)

 

Maryland Register (ISSN 0360-2834). Postmaster: Send address changes and other mail to: Maryland Register, State House, Annapolis, Maryland 21401. Tel. 410-260-3876; Fax 410-280-5647. Published biweekly, with cumulative indexes published quarterly, by the State of Maryland, Division of State Documents, State House, Annapolis, Maryland 21401. The subscription rate for the Maryland Register is $225 per year (first class mail). All subscriptions post-paid to points in the U.S. periodicals postage paid at Annapolis, Maryland and additional mailing offices.

Lawrence J. Hogan, Jr., Governor; John C. Wobensmith, Secretary of State; Brian Morris, Administrator; Gail S. Klakring, Senior Editor; Mary D. MacDonald, Editor, Maryland Register and COMAR; Elizabeth Ramsey, Editor, COMAR Online, and Subscription Manager; Tami Cathell, Help Desk, COMAR and Maryland Register Online.

Front cover: State House, Annapolis, MD, built 1772—79.

Illustrations by Carolyn Anderson, Dept. of General Services

 

     Note: All products purchased are for individual use only. Resale or other compensated transfer of the information in printed or electronic form is a prohibited commercial purpose (see State Government Article, §7-206.2, Annotated Code of Maryland). By purchasing a product, the buyer agrees that the purchase is for individual use only and will not sell or give the product to another individual or entity.

 


Closing Dates for the Maryland Register

Schedule of Closing Dates and Issue Dates for the
Maryland Register ....................................................................  1379

 

COMAR Research Aids

Table of Pending Proposals .........................................................  1380

 

Index of COMAR Titles Affected in This Issue

COMAR Title Number and Name                                                  Page

08        Department of Natural Resources ....................................  1388

09        Department of Labor, Licensing, and Regulation .............  1384

10        Department of Health and Mental
               Hygiene .....................................................  1384, 1387, 1392

13B     Maryland Higher Education Commission ........................  1385

22        State Retirement and Pension System ..............................  1386

26        Department of the Environment .............................  1378, 1424

30        Maryland Institute for Emergency Medical Services
Systems (MIEMSS) ....................................................  1386

31        Maryland Insurance Administration .............  1386, 1387, 1425

 

PERSONS WITH DISABILITIES

Individuals with disabilities who desire assistance in using the publications and services of the Division of State Documents are encouraged to call (410) 974-2486, or (800) 633-9657, or FAX to (410) 974-2546, or through Maryland Relay.

 

The Judiciary

COURT OF APPEALS OF MARYLAND

DISCIPLINARY PROCEEDINGS ........................................  1383

 

Final Action on Regulations

09  DEPARTMENT OF LABOR, LICENSING, AND
   REGULATION

RACING COMMISSION

Prohibited Acts .........................................................................  1384

Satellite Simulcast Betting .  1384

10  DEPARTMENT OF HEALTH AND MENTAL HYGIENE

HOSPITALS

Limited Private Inpatient Facilities .  1384

MEDICAL CARE PROGRAMS

Nursing Facility Services .  1384

BOARD OF PODIATRIC MEDICAL EXAMINERS

Licensing and Continuing Education Requirements .  1385

BOARD OF NURSING — LICENSED DIRECT-ENTRY
   MIDWIVES

Practice of Licensed Direct-Entry Midwives .  1385

13B MARYLAND HIGHER EDUCATION COMMISSION

COMMUNITY COLLEGES

Construction Procedures .  1385

Space Allocation Guidelines .  1385

22  STATE RETIREMENT AND PENSION SYSTEM

BOARD OF TRUSTEES

Investment Division — Brokerage Commissions .....................  1386

30  MARYLAND INSTITUTE FOR EMERGENCY
   MEDICAL SERVICES SYSTEMS (MIEMSS)

GENERAL

Documents Incorporated by Reference .  1386

31  MARYLAND INSURANCE ADMINISTRATION

LIFE INSURANCE AND ANNUITIES

Charitable Gift Annuities .  1386

 

Withdrawal of Regulations

10  DEPARTMENT OF HEALTH AND MENTAL HYGIENE

BOARD OF NURSING

Practice of Nurse Anesthetist ....................................................  1387

13B  MARYLAND HIGHER EDUCATION COMMISSION

GENERAL EDUCATION AND TRANSFER

Public Institutions of Higher Education ....................................  1387

31  MARYLAND INSURANCE ADMINISTRATION

PROPERTY AND CASUALTY INSURANCE

Liability of Insurer — Failure to Act in Good Faith .................  1387

 

Proposed Action on Regulations

08  DEPARTMENT OF NATURAL RESOURCES

FISHERIES SERVICE

General .....................................................................................  1388

Fishing in Nontidal Waters .......................................................  1389

10  DEPARTMENT OF HEALTH AND MENTAL HYGIENE

DISEASES

Communicable Diseases — Rabies ..........................................  1392

MEDICAL CARE PROGRAMS

Vision Care Services ................................................................  1393

Physical Therapy Services .  1393

Early and Periodic Screening, Diagnosis and Treatment
   (EPSDT) Services .................................................................  1393

Early and Periodic Screening, Diagnosis, and Treatment
   (EPSDT) Audiology Services .  1393

Maryland Medicaid Managed Care Program: Managed Care
   Organizations .  1394

Maryland Medicaid Managed Care Program: Non-Capitated
   Covered Services .  1398

Community-Based Substance Use Disorder Services ..............  1402

CANCER CONTROL

Cancer Registry .  1404

Cigarette Restitution Fund Program ..........................................  1406

FOOD

Manufacture and Sale of Frozen Dairy Foods and Ices
   Manufactured for Sale in Maryland .......................................  1407

Production, Processing, Transportation, Storage, and
   Distribution of Grade “A” Milk .............................................  1407

Farmstead Cheese Program ..  1407

HOUSING

Health and Medication Requirements for Youth
   Camps ....................................................................................  1415

MARYLAND HEALTH CARE COMMISSION

State Health Plan for Facilities and Services: Specialized
   Health Care Services —Organ Transplant Services .  1417

BOARD OF NURSING

Registered Nurse — Forensic Nurse Examiner  1418

BOARD OF EXAMINERS OF NURSING HOME
   ADMINISTRATORS

Nursing Home Administrators .................................................  1419

BOARD OF EXAMINERS FOR AUDIOLOGISTS, HEARING
   AID DISPENSERS, AND SPEECH-LANGUAGE
   PATHOLOGISTS

Licensure and Continuing Education ........................................  1420

Hearing Aid Dispensers .  1420

Speech-Language Pathology Assistants ...................................  1420

13B MARYLAND HIGHER EDUCATION COMMISSION

NONPUBLIC SCHOOLS

Minimum Requirements for Private Career Schools .................  1421

ACADEMIC REGULATIONS

Minimum Requirements for In-State Degree-Granting
   Institutions .............................................................................  1422

FULLY ONLINE PROGRAMS

Registration ...............................................................................  1423

Registration .  1424

26  DEPARTMENT OF THE ENVIRONMENT

REGULATION OF WATER SUPPLY, SEWAGE DISPOSAL,
   AND SOLID WASTE

Sewage Disposal and Certain Water Systems for Homes and
   Other Establishments in the Counties of Maryland Where a
   Public Sewage System Is Not Available .  1424

31  MARYLAND INSURANCE ADMINISTRATION

INSURERS

Antifraud Plans .  1425

ASSETS, LIABILITIES, RESERVES, AND INVESTMENTS
   OF INSURERS

Annual Financial Reporting .  1425

Property and Casualty Actuarial Opinion .................................  1425

 

Special Documents

MARYLAND HEALTH CARE COMMISSION

NUMBER OF CHRONIC HOSPITAL BEDS, PATIENT DAYS, AND AVERAGE ANNUAL BED OCCUPANCY: MARYLAND, FY 2015  1427

 

General Notices

DEPARTMENT OF AGING

Public Meeting ..........................................................................  1428

ATHLETIC COMMISSION

Public Meeting .  1428

CRIMINAL JUSTICE INFORMATION ADVISORY BOARD

Public Meeting .  1428

DEPARTMENT OF INFORMATION TECHNOLOGY

Public Meeting .  1428

Public Meeting .  1428

MARYLAND INSURANCE ADMINISTRATION

Public Hearing ..........................................................................  1428

Public Meeting .  1428

MARYLAND HEALTH CARE COMMISSION

Public Meeting ..........................................................................  1428

Public Meeting .  1428

Formal Start of Review .............................................................  1428

Notice of Receipt of a Letter of Intent and Review for Organ
   Transplant Services — Liver .................................................  1429

Notice of Receipt of a Letter of Intent and Review for Organ
   Transplant Services — Kidney ..............................................  1429

GOVERNOR'S COMMISSION ON MARYLAND MILITARY
   MONUMENTS

Public Meeting .  1429

RURAL HEALTHCARE DELIVERY WORKGROUP

Public Meeting ..........................................................................  1429

DEPARTMENT OF NATURAL RESOURCES/FISHING AND
   BOATING SERVICES

Public Notice — 2016 Commercial Striped Bass Individual
   Transferable Quota Season Modification ...............................  1429

DEPARTMENT OF VETERANS AFFAIRS/MARYLAND
   VETERANS COMMISSION

Public Meeting ..........................................................................  1429

NORTHEAST MARYLAND WASTE DISPOSAL
   AUTHORITY

Public Meetings Notice Procedure .  1429

WORKERS' COMPENSATION COMMISSION

Public Meeting .  1429

 

 

COMAR Online

        The Code of Maryland Regulations is available at www.dsd.state.md.us as a free service of the Office of the Secretary of State, Division of State Documents. The full text of regulations is available and searchable. Note, however, that the printed COMAR continues to be the only official and enforceable version of COMAR.

        The Maryland Register is also available at www.dsd.state.md.us.

        For additional information, visit www.dsd.state.md.us, Division of State Documents, or call us at (410) 974-2486 or 1 (800) 633-9657.

 

Availability of Monthly List of
Maryland Documents

        The Maryland Department of Legislative Services receives copies of all publications issued by State officers and agencies. The Department prepares and distributes, for a fee, a list of these publications under the title ‘‘Maryland Documents’’. This list is published monthly, and contains bibliographic information concerning regular and special reports, bulletins, serials, periodicals, catalogues, and a variety of other State publications. ‘‘Maryland Documents’’ also includes local publications.

        Anyone wishing to receive ‘‘Maryland Documents’’ should write to: Legislative Sales, Maryland Department of Legislative Services, 90 State Circle, Annapolis, MD 21401.

 

CLOSING DATES AND ISSUE DATES through JULY 21, 2017

Issue
Date

Emergency

and Proposed

Regulations

5 p.m.*

Final

Regulations

10:30 a.m.

Notices, etc.

10:30 a.m.

December 23

December 5

December 14

December 12

January 6**

December 19

December 28

December 23

January 20**

December 30

January 11

January 9

February 3**

January 13

January 25

January 23

February 17

January 30

February 8

February 6

March 3**

February 13

February 22

February 17

March 17

February 27

March 8

March 6

March 31

March 13

March 22

March 20

April 14

March 27

April 5

April 3

April 28

April 10

April 19

April 17

May 12

April 24

May 3

May 1

May 26

May 8

May 17

May 15

June 9**

May 22

May 31

May 26

June 23

June 5

June 14

June 12

July 7

June 19

June 28

June 26

July 21

July 3

July 12

July 10

 

*   Due date for documents containing 8 to 18 pages — 48 hours before date shown; due date for documents exceeding 18 pages — 1 week before date shown

NOTE:  ALL DOCUMENTS MUST BE SUBMITTED IN TIMES NEW ROMAN, 9-POINT, SINGLE-SPACED FORMAT. THE REVISED PAGE COUNT REFLECTS THIS FORMATTING.

** Note closing date changes

***   Note issue date and closing date changes

The regular closing date for Proposals and Emergencies is Monday.

 

 


 
Cumulative Table of COMAR Regulations
Adopted, Amended, or Repealed

   This table, previously printed in the Maryland Register lists the regulations, by COMAR title, that have been adopted, amended, or repealed in the Maryland Register since the regulations were originally published or last supplemented in the Code of Maryland Regulations (COMAR). The table is no longer printed here but may be found on the Division of State Documents website at www.dsd.state.md.us.

Table of Pending Proposals

   The table below lists proposed changes to COMAR regulations. The proposed changes are listed by their COMAR number, followed by a citation to that issue of the Maryland Register in which the proposal appeared. Errata pertaining to proposed regulations are listed, followed by “(err)”. Regulations referencing a document incorporated by reference are followed by “(ibr)”. None of the proposals listed in this table have been adopted. A list of adopted proposals appears in the Cumulative Table of COMAR Regulations Adopted, Amended, or Repealed.

 


02 OFFICE OF THE ATTORNEY GENERAL

 

02.06.03.01—.10 • 42:13 Md. R. 798 (6-26-15)

 

03 COMPTROLLER OF THE TREASURY

 

03.11.01.01—.14 • 43:17 Md. R. 960 (8-19-16)

 

07 DEPARTMENT OF HUMAN RESOURCES

 

07.02.10.08,.18 • 43:24 Md. R. 1352 (11-28-16)

07.02.11.03,.05,.16 • 43:24 Md. R. 1353 (11-28-16)

07.02.14.01—.14 • 43:2 Md. R. 143 (1-22-16)

07.02.15.01—.11 • 43:17 Md. R. 964 (8-19-16)

07.02.17.03,.04,.06—.08 • 43:17 Md. R. 968 (8-19-16)

07.02.18.02,.04,.06—.14 • 43:17 Md. R. 969 (8-19-16)

07.02.19.01—.08,.10,.12—.14,.16 • 43:17 Md. R. 971 (8-19-16)

 

08 DEPARTMENT OF NATURAL RESOURCES

 

08.02.01.05 • 43:23 Md. R. 1282 (11-14-16)

08.02.01.09 • 43:25 Md. R. 1388 (12-9-16)

08.02.01.13 • 43:16 Md. R. 903 (8-5-16)

08.02.05.22 • 43:23 Md. R. 1283 (11-14-16)

08.02.10.01 • 43:23 Md. R. 1283 (11-14-16)

08.02.11.01,.04 • 43:25 Md. R. 1389 (12-9-16)

08.03.01.01 • 43:16 Md. R. 904 (8-5-16)

08.03.10.11 • 43:22 Md. R. 1225 (10-28-16)

08.03.16.01—.05 • 43:22 Md. R. 1225 (10-28-16) (ibr)

08.04.16.01—.03 • 43:2 Md. R. 162 (1-22-16)

 

09 DEPARTMENT OF LABOR, LICENSING, AND REGULATION

 

09.11.09.02 • 43:13 Md. R. 721 (6-24-16)

09.12.21.02 • 43:22 Md. R. 1227 (10-28-16)

09.12.31 • 43:2 Md. R. 176 (1-22-16)

09.12.35.01—.05 • 43:22 Md. R. 1228 (10-28-16)

09.20.01.01—.05 • 43:16 Md. R. 904 (8-5-16) (ibr)

09.35.02.02,.03 • 43:21 Md. R. 1170 (10-14-16)

09.38.01.01 • 43:18 Md. R. 1022 (9-2-16)

 

10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE

 

     Subtitles 01—08 (1st volume)

 

10.03.01.08 • 43:23 Md. R. 1284 (11-14-16)

10.06.02.02,.04,.13 • 43:25 Md. R. 1392 (12-9-16)

 

     Subtitle 09 (2nd volume)

 

10.09.14.07 • 43:25 Md. R. 1393 (12-9-16)

10.09.17.06 • 43:25 Md. R. 1393 (12-9-16)

10.09.20.09—.11,.14 • 43:23 Md. R. 1284 (11-14-16)

10.09.23.01-1,.07 • 43:25 Md. R. 1393 (12-9-16) (ibr)

10.09.23.03 • 43:24 Md. R. 1354 (11-28-16)

10.09.51.07 • 43:25 Md. R. 1393 (12-9-16)

10.09.54.13—.19,.22 • 43:23 Md. R. 1285 (11-14-16)

10.09.60.01—.08 • 43:24 Md. R. 1355 (11-28-16)

10.09.65.19 • 43:25 Md. R. 1394 (12-9-16)

10.09.65.19-3 • 43:24 Md. R. 1354 (11-28-16)

10.09.67.01,.07,.12 • 43:24 Md. R. 1354 (11-28-16)

10.09.70.02 • 43:25 Md. R. 1398 (12-9-16)

10.09.80.01,.05,.06,.08 • 43:25 Md. R. 1402 (12-9-16)

10.09.84.14—.20,.23,.24 • 43:23 Md. R. 1286 (11-14-16)

 

     Subtitles 10 — 22 (3rd Volume)

 

10.14.01.01,.02,.02-1,.07 • 43:25 Md. R. 1404 (12-9-16) (ibr)

10.14.06.02—.06 • 43:25 Md. R. 1406 (12-9-16)

10.15.05.01,.01-1,.13,.14,.20-1,.21,
     .24—.26-2
• 43:25 Md. R. 1407 (12-9-16) (ibr)

10.15.06.01-.07,.10,.12—.20 • 43:25 Md. R. 1407 (12-9-16)

10.15.07.01 • 43:22 Md. R. 1229 (10-28-16) (ibr)

10.15.08.02,.03 • 43:25 Md. R. 1407 (12-9-16)

10.16.07.03,.14 • 43:25 Md. R. 1415 (12-9-16)

10.21.01.02,.04,.08,.09 • 43:19 Md. R. 1076 (9-16-16)

10.21.25.03,.08 • 43:22 Md. R. 1229 (10-28-16)

10.21.25.03-2,.05—.13 • 43:19 Md. R. 1077 (9-16-16)

10.22.10.05 • 43:23 Md. R. 1287 (11-14-16)

10.22.17.06—.08 • 43:22 Md. R. 1231 (10-28-16)

 

     Subtitles 23 — 36 (4th Volume)

 

10.24.15.01 • 43:25 Md. R. 1417 (12-9-16) (ibr)

10.24.19.01 • 43:18 Md. R. 1027 (9-2-16) (ibr)

10.27.01.04—.18 • 43:24 Md. R. 1357 (11-28-16)

10.27.21.02—.05,.07 • 43:25 Md. R. 1418 (12-9-16)

10.32.01.08,.10,.11 • 43:22 Md. R. 1239 (10-28-16)

10.32.03.09 • 43:22 Md. R. 1239 (10-28-16)

10.32.06.07,.08 • 43:22 Md. R. 1239 (10-28-16)

10.32.08.07 • 43:22 Md. R. 1239 (10-28-16)

10.32.10.13 • 43:22 Md. R. 1239 (10-28-16)

10.32.11.09,.11 • 43:22 Md. R. 1239 (10-28-16)

10.33.01.14 • 43:25 Md. R. 1419 (12-9-16)

 

     Subtitles 37—65 (5th Volume)

 

10.37.10.03 • 43:20 Md. R. 1115 (9-30-16)

10.37.10.07-2 • 43:22 Md. R. 1244 (10-28-16)

10.38.12.01—.04 • 43:23 Md. R. 1287 (11-14-16)

10.39.01.03—.09 • 43:24 Md. R. 1357 (11-28-16)

10.39.04.04 • 43:24 Md. R. 1357 (11-28-16)

10.41.03.08 • 43:25 Md. R. 1420 (12-9-16)

10.41.08.02 • 43:25 Md. R. 1420 (12-9-16)

10.41.11.02 • 43:25 Md. R. 1420 (12-9-16)

10.43.01.01—.06 • 43:20 Md. R. 1117 (9-30-16)

10.43.03.01—.03 • 43:20 Md. R. 1117 (9-30-16)

10.43.04.01 • 43:20 Md. R. 1117 (9-30-16)

10.43.05.02,.03 • 43:20 Md. R. 1117 (9-30-16)

10.43.06.02—.05 • 43:20 Md. R. 1117 (9-30-16)

10.43.07.01,.09 • 43:20 Md. R. 1117 (9-30-16)

10.43.08.01,.02 • 43:20 Md. R. 1117 (9-30-16)

10.43.09.02 • 43:20 Md. R. 1117 (9-30-16)

10.43.10.02 • 43:20 Md. R. 1117 (9-30-16)

10.43.11.02 • 43:20 Md. R. 1117 (9-30-16)

10.43.12.01—.07 • 43:20 Md. R. 1117 (9-30-16)

10.43.13.01—.10 • 43:20 Md. R. 1117 (9-30-16)

10.43.14.02 • 43:20 Md. R. 1117 (9-30-16)

10.43.15.02 • 43:20 Md. R. 1117 (9-30-16)

10.44.20.02 • 43:22 Md. R. 1245 (10-28-16)

10.53.02.01—.10 • 43:24 Md. R. 1357 (11-28-16)

10.62.01.01 • 43:22 Md. R. 1245 (10-28-16)

10.62.08.03,.05—.07 • 43:22 Md. R. 1245 (10-28-16)

10.62.09.03 • 43:22 Md. R. 1245 (10-28-16)

10.62.12.02 • 43:22 Md. R. 1245 (10-28-16)

10.62.15.04—.07 • 43:22 Md. R. 1245 (10-28-16)

10.62.19.02,.04—.06 • 43:22 Md. R. 1245 (10-28-16)

10.62.20.03 • 43:22 Md. R. 1245 (10-28-16)

10.62.22.02 • 43:22 Md. R. 1245 (10-28-16)

10.62.25.03,.05—.07 • 43:22 Md. R. 1245 (10-28-16)

10.62.26.03 • 43:22 Md. R. 1245 (10-28-16)

10.62.28.02 • 43:22 Md. R. 1245 (10-28-16)

10.63.01.02,.04,.05 • 43:23 Md. R. 1289 (11-14-16)

10.63.03.14,.18,.19 • 43:23 Md. R. 1289 (11-14-16)

10.63.04.03 • 43:23 Md. R. 1289 (11-14-16)

10.63.06.10 • 43:23 Md. R. 1289 (11-14-16)

10.65.01.01—.14 • 43:20 Md. R. 1117 (9-30-16)

10.65.02.01—.09 • 43:20 Md. R. 1117 (9-30-16)

10.65.03.03,.09 • 43:20 Md. R. 1117 (9-30-16)

10.65.04.01—.03,.06 • 43:20 Md. R. 1117 (9-30-16)

10.65.05.01—.04 • 43:20 Md. R. 1117 (9-30-16)

10.65.06.01,.02 • 43:20 Md. R. 1117 (9-30-16)

10.65.07.01—.04 • 43:20 Md. R. 1117 (9-30-16)

10.65.08.01,.02 • 43:20 Md. R. 1117 (9-30-16)

10.65.09.01—.06 • 43:20 Md. R. 1117 (9-30-16)

 

11 DEPARTMENT OF TRANSPORTATION

 

     Subtitles 01—10

 

11.01.18.01,.02 • 43:22 Md. R. 1251 (10-28-16)

 

12 DEPARTMENT OF PUBLIC SAFETY AND CORRECTIONAL SERVICES

 

12.14.03.02,.03,.06,.09 • 43:20 Md. R. 1136 (9-30-16)

12.14.04.01,.02,.05,.08 • 43:20 Md. R. 1136 (9-30-16)

12.14.05.01,.02,.05,.08 • 43:20 Md. R. 1136 (9-30-16)

 

13A STATE BOARD OF EDUCATION

 

13A.02.08.01—.03 • 43:22 Md. R. 1252 (10-28-16)

13A.03.07.01—.05 • 43:22 Md. R. 1252 (10-28-16)

13A.04.03.01—.11 • 43:22 Md. R. 1253 (10-28-16)

13A.04.10.01,.02 • 43:19 Md. R. 1085 (9-16-16) (ibr)

13A.05.01 • 43:21 Md. R. 1182 (10-14-16) (err)

13A.05.01.03,.05—.08 • 43:20 Md. R. 1138 (9-30-16)

13A.05.03.01—.03 • 43:19 Md. R. 1086 (9-16-16)

13A.05.08.01—.06 • 43:19 Md. R. 1086 (9-16-16)

13A.05.12.01—.03 • 43:19 Md. R. 1087 (9-16-16)

13A.07.11.01—.05 • 43:10 Md. R. 595 (5-13-16) (ibr)

 

 

13B MARYLAND HIGHER EDUCATION COMMISSION

 

13B.01.01.03,.15 • 43:25 Md. R. 1421 (12-9-16)

13B.02.02.08 • 43:25 Md. R. 1422 (12-9-16)

13B.05.01.05 • 43:25 Md. R. 1423 (12-9-16)

13B.05.01.06 • 43:25 Md. R. 1424 (12-9-16)

13B.07.02.07 • 43:23 Md. R. 1290 (11-14-16)

13B.08.09.01—.11 • 42:22 Md. R. 1398 (10-30-15)

13B.08.13.01—.10 • 43:8 Md. R. 506 (4-15-16)

13B.08.14.01—.15 • 43:6 Md. R. 421 (3-18-16)

13B.08.15.01—.16 • 43:9 Md. R. 546 (4-29-16)

 

14 INDEPENDENT AGENCIES

 

14.06.03.05,.06 • 42:26 Md. R. 1638 (12-28-15)

14.35.01.01,.02 • 43:18 Md. R. 1039 (9-2-16)

14.35.07 • 43:19 Md. R. 1092 (9-16-16) (err)

14.35.07.01—.21 • 43:18 Md. R. 1039 (9-2-16)

14.36.04.01,.03—.08 • 43:4 Md. R. 342 (2-19-16)

 

15 DEPARTMENT OF AGRICULTURE

 

15.05.01.02 • 43:19 Md. R. 1088 (9-16-16)

15.06.04.06 • 43:21 Md. R. 1171 (10-14-16)

15.20.07.02 • 43:22 Md. R. 1254 (10-28-16) (ibr)

 

18 DEPARTMENT OF ASSESSMENTS AND TAXATION

 

18.04.11.01 • 43:22 Md. R. 1255 (10-28-16)

 

19A STATE ETHICS COMMISSION

 

19A.01.01.02,.04 • 43:20 Md. R. 1140 (9-30-16)

19A.01.02.02,.04 • 43:20 Md. R. 1140 (9-30-16)

19A.01.03.02,.04 • 43:20 Md. R. 1140 (9-30-16)

19A.04.Appendices A and B • 43:20 Md. R. 1140 (9-30-16)

19A.04.01.03 • 43:20 Md. R. 1140 (9-30-16)

19A.04.02.04,.05 • 43:20 Md. R. 1140 (9-30-16)

19A.04.03.01 • 43:20 Md. R. 1140 (9-30-16)

19A.05.Appendices A and B • 43:20 Md. R. 1140 (9-30-16)

19A.05.02.04,.06 • 43:20 Md. R. 1140 (9-30-16)

19A.06.01.03 • 43:20 Md. R. 1140 (9-30-16)

19A.06.02.04,.05 • 43:20 Md. R. 1140 (9-30-16)

19A.06.02.04,.05 • 43:20 Md. R. 1140 (9-30-16)

19A.06.03.05,.07 • 43:20 Md. R. 1140 (9-30-16)

19A.07.01.04,.06—.08 • 43:20 Md. R. 1140 (9-30-16)

 

20 PUBLIC SERVICE COMMISSION

 

20.31.01.02 • 43:23 Md. R. 1291 (11-14-16)

20.31.03.01 • 43:23 Md. R. 1291 (11-14-16)

 

21 STATE PROCUREMENT REGULATIONS

 

21.01.02.01 • 43:21 Md. R. 1172 (10-14-16)

21.02.01.04 • 43:21 Md. R. 1172 (10-14-16)

21.02.03.02,.03 • 43:21 Md. R. 1172 (10-14-16)

21.04.01.03 • 43:21 Md. R. 1172 (10-14-16)

21.05.01.01 • 43:21 Md. R. 1172 (10-14-16)

21.05.05.04 • 43:21 Md. R. 1172 (10-14-16)

21.05.08.04,.07,.08 • 43:21 Md. R. 1172 (10-14-16)

21.05.12.01—.07 • 43:21 Md. R. 1172 (10-14-16)

21.06.07.09,.10 • 43:21 Md. R. 1172 (10-14-16)

21.06.09.01—.06 • 43:21 Md. R. 1172 (10-14-16)

21.07.01.08,.18,.20,.25,.26 • 43:21 Md. R. 1172 (10-14-16)

21.07.02.04 • 43:21 Md. R. 1172 (10-14-16)

21.11.03.09 • 43:21 Md. R. 1172 (10-14-16)

21.11.09.01,.02 • 43:21 Md. R. 1172 (10-14-16)

21.11.13.02,.04 • 43:21 Md. R. 1172 (10-14-16)

21.12.04.10,.10-1 • 43:21 Md. R. 1172 (10-14-16)

21.12.05.01 • 43:21 Md. R. 1172 (10-14-16)

21.14.01.01—.07 • 43:21 Md. R. 1172 (10-14-16)

 

 

26 DEPARTMENT OF THE ENVIRONMENT

 

     Subtitles 01—07 (Part 1)

 

26.04.02.09 • 43:25 Md. R. 1424 (12-9-16)

 

     Subtitles 08—12 (Part 2)

 

26.08.07.04 • 43:24 Md. R. 1361 (11-28-16)

 

     Subtitles 19—27 (Part 4)

 

26.19.01.01—.61 • 43:23 Md. R. 1293 (11-14-16) (ibr)

 

29 DEPARTMENT OF STATE POLICE

 

29.01.02.01,.02,.11,.16 • 43:10 Md. R. 609 (5-13-16)

29.05.02.01—.08 • 43:12 Md. R. 693 (6-10-16)

 

30 MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS)

 

30.08.15.03 • 43:23 Md. R. 1316 (11-14-16)

 

31 MARYLAND INSURANCE ADMINISTRATION

 

31.04.15.03 • 43:25 Md. R. 1425 (12-9-16)

31.05.11.02 • 43:25 Md. R. 1425 (12-9-16)

31.05.12.01 • 43:25 Md. R. 1425 (12-9-16)

31.08.01.02 • 43:24 Md. R. 1362 (11-28-16)

31.08.02.02 • 43:24 Md. R. 1362 (11-28-16)

31.08.03 • 43:24 Md. R. 1362 (11-28-16)

31.08.08.07 • 43:24 Md. R. 1362 (11-28-16)

31.08.09.06—.08,.13,.14 • 43:24 Md. R. 1362 (11-28-16)

31.08.10.02 • 43:24 Md. R. 1362 (11-28-16)

31.08.13.03,.04,.06 • 43:20 Md. R. 1146 (9-30-16)

31.10.11.14 • 43:24 Md. R. 1365 (11-28-16)

31.13.01.22 • 43:23 Md. R. 1318 (11-14-16)

31.14.03.06 • 43:24 Md. R. 1365 (11-28-16)

31.15 • 43:2 Md. R. 128 (1-22-16) (err)

31.15.04.01—.07 • 43:1 Md. R. 76 (1-8-16)

                               43:14 Md. R. 789 (7-8-16)

31.15.15.01—.09 • 43:1 Md. R. 76 (1-8-16)

                               43:14 Md. R. 789 (7-8-16)

31.16.08.06 • 43:24 Md. R. 1366 (11-28-16)

 

33 STATE BOARD OF ELECTIONS

 

33.01.01.01 • 43:4 Md. R. 345 (2-19-16)

33.05.04.05 • 43:4 Md. R. 346 (2-19-16)

33.13.07.06 • 43:24 Md. R. 1367 (11-28-16)

33.13.08.06,.07 • 43:24 Md. R. 1367 (11-28-16)

33.13.10.02—.04 • 43:24 Md. R. 1367 (11-28-16)

33.13.13.08 • 43:24 Md. R. 1367 (11-28-16)

33.14.02.03 • 43:24 Md. R. 1369 (11-28-16)

33.16.01.01 • 43:4 Md. R. 346 (2-19-16)

33.16.02.05 • 43:4 Md. R. 346 (2-19-16)

33.16.03.01,.02 • 43:4 Md. R. 346 (2-19-16)

33.16.04.01 • 43:4 Md. R. 346 (2-19-16)

33.16.05.03,.04 • 43:4 Md. R. 346 (2-19-16)

33.16.06.01 • 43:4 Md. R. 346 (2-19-16)

33.20.06.01 • 43:24 Md. R. 1369 (11-28-16)

 

36 MARYLAND STATE LOTTERY AND GAMING CONTROL AGENCY

 

36.03.10.11 • 43:22 Md. R. 1255 (10-28-16)

36.07.01.03 • 43:21 Md. R. 1180 (10-14-16)

 


The Judiciary  COURT OF APPEALS OF MARYLAND

DISCIPLINARY PROCEEDINGS

     This is to certify that by an Order of the Court of Appeals dated November 14, 2016, KEITH ERIC TIMMONS, 326 St. Paul Place, #300, Baltimore, Maryland 21202, has been replaced upon the register of attorneys in this Court as of November 14, 2016. Notice of this action is certified in accordance with Maryland Rule 19-761.

*   *   *   *   *   *   *   *   *   *

     This is to certify that by an Order of the Court of Appeals dated November 15, 2016, DAVID MICHAEL LUX, 9909 Autumnwood Way, Potomac, Maryland 20854, has been placed on inactive status by consent, effective immediately, from the further practice of law in this State, and his name as an attorney at law has been stricken from the register of attorneys in this Court (Maryland Rule 19-761).

*   *   *   *   *   *   *   *   *   *

     This is to certify that by an Order of the Court of Appeals dated November 21, 2016, SANDRA LYNN RENO, 152 Cypress Street, Centreville, Maryland 21617-2112, has been replaced upon the register of attorneys in this Court as of November 21, 2016. Notice of this action is certified in accordance with Maryland Rule 19-761.

*   *   *   *   *   *   *   *   *   *

     This is to certify that by an Order of the Court of Appeals dated November 21, 2016, DAVID N. HONICK, 6813 Seneca Drive, Snow Hill, Maryland 21863, has been replaced upon the register of attorneys in this Court as of November 21, 2016. Notice of this action is certified in accordance with Maryland Rule 19-761.

*   *   *   *   *   *   *   *   *   *

     This is to certify that by an Opinion & Order of the Court of Appeals dated November 21, 2016, SUSAN MYRA GELLER KIRWAN, 200 East Lexington Street, Suite 407, Baltimore, Maryland 21202, has been indefinitely suspended, effective immediately, from the further practice of law in the State, and her name as an attorney at law has been stricken from the register of attorneys in this Court (Maryland Rule 19-761).

*   *   *   *   *   *   *   *   *   *

     This is to certify that by an Opinion & Order of the Court of Appeals dated November 22, 2016

SANDY F. THOMAS-BELLAMY, 3503 Highwood Drive, SE, Washington, DC 20020, has been indefinitely suspended, effective immediately, from the further practice of law in the State, and her name as an attorney at law has been stricken from the register of attorneys in this Court (Maryland Rule 19-761).

[16-25-18]

 

 


Final Action on Regulations

 

Symbol Key

•   Roman type indicates text already existing at the time of the proposed action.

•   Italic type indicates new text added at the time of proposed action.

•   Single underline, italic indicates new text added at the time of final action.

•   Single underline, roman indicates existing text added at the time of final action.

•   [[Double brackets]] indicate text deleted at the time of final action.

 

 


Title 09
DEPARTMENT OF LABOR, LICENSING, AND REGULATION

Subtitle 10 RACING COMMISSION

09.10.03 Prohibited Acts

Authority: Business Regulation Article, §11-210, Annotated Code of Maryland

Notice of Final Action

[16-254-F]

On November 15, 2016, the Maryland Racing Commission adopted amendments to Regulation .01 under COMAR 09.10.03 Prohibited Acts. This action, which was proposed for adoption in 43:20 Md. R. 1113 (September 30, 2016), has been adopted as proposed.

Effective Date: December 19, 2016.

J. MICHAEL HOPKINS
Executive Director

 

Subtitle 10 RACING COMMISSION

09.10.05 Satellite Simulcast Betting

Authority: Business Regulation Article, §11-210, Annotated Code of Maryland

Notice of Final Action

[16-255-F]

On November 15, 2016, the Maryland Racing Commission adopted amendments to Regulation .05 under COMAR 09.10.05 Satellite Simulcast Betting. This action, which was proposed for adoption in 43:20 Md. R. 1114 (September 30, 2016), has been adopted as proposed.

Effective Date: December 19, 2016.

J. MICHAEL HOPKINS
Executive Director

 

Title 10
DEPARTMENT OF HEALTH AND MENTAL HYGIENE

Subtitle 07 HOSPITALS

10.07.16 Limited Private Inpatient Facilities

Authority: Health-General Article, §10-502, Annotated Code of Maryland

Notice of Final Action

[16-258-F]

On November 18, 2016, the Secretary of Health and Mental Hygiene adopted new Regulation .23 under COMAR 10.07.16 Limited Private Inpatient Facilities. This action, which was proposed for adoption in 43:20 Md. R. 1114—1115 (September 30, 2016), has been adopted as proposed.

Effective Date: December 19, 2016.

VAN T. MITCHELL
Secretary of Health and Mental Hygiene

 

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.10 Nursing Facility Services

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

Notice of Final Action

[16-219-F]

On November 22, 2016, the Secretary of Health and Mental Hygiene adopted amendments to Regulations .07-1, .07-2, .10-1, .11-2, .11-7, .11-8, .15-1, and .25 under COMAR 10.09.10 Nursing Facility Services. This action, which was proposed for adoption in 43:18 Md. R. 1023-1025 (September 2, 2016), has been adopted with the nonsubstantive changes shown below.

Effective Date: December 19, 2016.

Attorney General's Certification

In accordance with State Government Article, §10-113, Annotated Code of Maryland, the Attorney General certifies that the following changes do not differ substantively from the proposed text. The nature of the changes and the basis for this conclusion are as follows:

Regulation .15-1D(2)(a)(iii): In response to comments received, the Department reviewed its criteria and agreed that a reduced percentage of annual billings would be sufficient to protect the Program regarding potential financial liabilities of a provider anticipating a change of ownership. The percentage is within the scope of the proposed text.

Regulation .15-1D(2)(b): In response to comments received, language has been added to clarify the duration of a provider’s obligation to maintain an indemnity bond or standby letter of credit. This does not represent a change in existing policy.

Regulation .15-D(2)(c): A typographical error is corrected in this text.

.15-1 New Nursing Facilities, Replacement Facilities, and Change of Ownership for Rates Effective January 1, 2015.

A.—C. (text unchanged)

D. Change of Ownership.

(1) (text unchanged)

(2) Indemnity Bond or Standby Letter of Credit.

(a) The indemnity bond or standby letter of credit required by §D(1)(a)(ii) or (b)(iii) of this regulation shall be in the amount of:

(i)―(ii) (proposed text unchanged)

(iii) [[10]] 5 percent of the Program billings for the most recent annual fiscal period; and

(iv) (text unchanged)

(b) The indemnity bond or standby letter of credit obligation under §D(2)(a) of this regulation shall remain in effect until all financial liabilities are resolved.

[[(b)]] (c) If a court of competent jurisdiction discharges the debt of a bankrupt provider, the Program shall release to the purchaser the difference between the indemnity bond [[of]] or standby letter of credit required under §D(1)(b)(iii) of this regulation and the amount of the financial obligation discharged by the court.

(3)—(5) (text unchanged)

VAN T. MITCHELL
Secretary of Health and Mental Hygiene

 

Subtitle 40 BOARD OF PODIATRIC MEDICAL EXAMINERS

10.40.02 Licensing and Continuing Education Requirements

Authority: Health Occupations Article, §§16–205(a), 16–301, 16–302(h),
16–302.1, 16–303(a),
16–307, 16–308, and 16–311(28), Annotated Code of Maryland

Notice of Final Action

[16-257-F]

On November 22, 2016, the Secretary of Health and Mental Hygiene adopted amendments to Regulation .03 under COMAR 10.40.02 Licensing and Continuing Education Requirements. This action, which was proposed for adoption in 43:20 Md. R. 1116 (September 30, 2016), has been adopted as proposed.

Effective Date: December 19, 2016.

VAN T. MITCHELL
Secretary of Health and Mental Hygiene

 

Subtitle 64 BOARD OF NURSING — LICENSED DIRECT-ENTRY MIDWIVES

10.64.01 Practice of Licensed Direct-Entry Midwives

Authority: Health Occupations Article, §§8-205 and Title 8, Subtitle 6C, Annotated Code of Maryland; Ch. 383, Acts of 2015

Notice of Final Action

[16-249-F]

On November 17, 2016, the Secretary of Health and Mental Hygiene adopted new Regulations .01—.19 under a new chapter, COMAR 10.64.01 Practice of Licensed Direct-Entry Midwives under a new subtitle, Subtitle 64 Board of Nursing — Licensed Direct-Entry Midwives. This action, which was proposed for adoption in 43:20 Md. R. 1128—1136 (September 30, 2016), has been adopted as proposed.

Effective Date: December 19, 2016.

VAN T. MITCHELL
Secretary of Health and Mental Hygiene

 

Title 13B
MARYLAND HIGHER EDUCATION COMMISSION

Subtitle 07 COMMUNITY COLLEGES

Notice of Final Action

[16-227-F]

On November 16, 2016, the Maryland Higher Education Commission adopted amendments to:

(1) Regulations .01—.04 under COMAR 13B.07.04 Construction Procedures; and

(2) Regulations .01 and .02 under COMAR 13B.07.05 Space Allocation Guidelines.

This action, which was proposed for adoption in 43:18 Md. R. 1038—1039 (September 2, 2016), has been adopted as proposed.

Effective Date: December 19, 2016.

JAMES D. FIELDER, JR., Ph.D.
Secretary of Higher Education

 

Title 22
STATE RETIREMENT AND PENSION SYSTEM

Subtitle 03 BOARD OF TRUSTEES

22.03.05 Investment Division — Brokerage Commissions

Authority: State Personnel and Pensions Article, §§21-110 and 21-122(d), Annotated Code of Maryland

Notice of Final Action

[16-247-F]

On November 17, 2016, the Board of Trustees for the State Retirement and Pension System adopted the repeal of Regulations .01 — .03 under COMAR 22.03.05 Investment Division — Brokerage Commission. This action, which was proposed for adoption in 43:20 Md. R. 1097—1154 (September 30, 2016), has been adopted as proposed.

Effective Date: December 19, 2016.

R DEAN KENDERDINE
Executive Director

 

Title 30
MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS)

Subtitle 01 GENERAL

30.01.02 Documents Incorporated by Reference

Authority: Education Article, §13-516, Annotated Code of Maryland

Notice of Final Action

[16-199-F-I]

On November 15, 2016, the Maryland State Emergency Medical Services Board adopted amendments to Regulation .01 under COMAR 30.01.02 Documents Incorporated by Reference. This action was taken at a public meeting, notice of which was given by publication on the Maryland Institute for Emergency Medical Services Systems website, www.miemss.org, from September 1, 2015 through November 15, 2015, pursuant to General Provisions Article, §3-302(c), Annotated Code of Maryland. This action, which was proposed for adoption in 43:16 Md. R. 930—931 (August 5, 2016), has been adopted as proposed.

Effective Date: December 19, 2016.

JEANNIE ABRAMSON
Chief Administrative Officer

 

Title 31
MARYLAND INSURANCE ADMINISTRATION

Subtitle 09 LIFE INSURANCE AND ANNUITIES

31.09.07 Charitable Gift Annuities

Authority: Insurance Article, §§2-109 and 16-114, Annotated Code of Maryland

Notice of Final Action

[16-251-F]

On November 21, 2016, the Insurance Commissioner adopted amendments to Regulation .04 under COMAR 31.09.07 Charitable Gift Annuities. This action, which was proposed for adoption in 43:20 Md. R. 1147 (September 30, 2016), has been adopted as proposed.

Effective Date: December 19, 2016.

ALFRED W. REDMER, JR.
Insurance Commissioner

 


Withdrawal of Regulations

Title 10
DEPARTMENT OF HEALTH AND MENTAL HYGIENE

Subtitle 27 BOARD OF NURSING

10.27.06 Practice of Nurse Anesthetist 

Authority: Health Occupations Article, §§8-205(a)(1)(2)(4) and (5) and 8-302(b)(2)(ii), Annotated Code of Maryland

Notice of Withdrawal

[15-354-W]

Pursuant to State Government Article, §10-116(b), Annotated Code of Maryland, notice is given that the proposal to amend Regulations  .01—.04 and .06 and recodify existing Regulations .07 and .08 to be Regulations .08 and .07 under COMAR 10.27.05 Practice of Nurse Anesthetist, which was published in 42:23 Md. R. 1451—1452 (November 13, 2015), has been withdrawn by operation of law.

BRIAN MORRIS
Administrator
Division of State Documents

 

Title 13B
MARYLAND HIGHER EDUCATION COMMISSION

Subtitle 06 GENERAL EDUCATION AND TRANSFER

13B.06.01 Public Institutions of Higher Education

Authority: Education Article, §§11-105(u) and 11-207, Annotated Code of Maryland

Notice of Withdrawal

[16-195-W]

The Maryland Higher Education Commission withdraws its proposal to amend Regulations .02, .02-1, and .04 — .08 in COMAR 13B.06.01 Public Institutions of Higher Education, as published in 43:16 Md. R. 927—930 (August 5, 2016). At its November 16, 2016 meeting, the Maryland Higher Education Commission adopted a new proposed action to amend Regulations .02, .02-1, and .04 — .10 under the same chapter.

JAMES D. FIELDER, JR., Ph.D.
Secretary of Higher Education

 

Title 31
MARYLAND INSURANCE ADMINISTRATION

Subtitle 08 PROPERTY AND CASUALTY INSURANCE

31.08.11 Liability of Insurer — Failure to Act in Good Faith

Authority: Courts and Judicial Proceedings Article, §3-1701; Insurance Article, §§2-109(a)(1) and 27-1001; Annotated Code of Maryland

Notice of Withdrawal

[16-256-W]

The Insurance Commissioner withdraws the proposal to amend Regulations .01, .02, .04, .05, and .07 under COMAR 31.08.11 Liability of Insurer—Failure to Act in Good Faith, as published in 43:20 Md. R. 1145—1146 (September 30, 2016). Substantively similar text will be proposed as new chapter, COMAR 31.15.16 Liability of Insurer—Failure to Act in Good Faith.

ALFRED W. REDMER, JR.
Insurance Commissioner

 


Proposed Action on Regulations

 


 



Title 08
DEPARTMENT OF NATURAL RESOURCES

Subtitle 02 FISHERIES SERVICE

08.02.01 General

Authority: Natural Resources Article, §4-205, Annotated Code of Maryland

Notice of Proposed Action

[16-328-P]

The Secretary of Natural Resources proposes to amend Regulation .09 under COMAR 08.02.01 General.

Statement of Purpose

The purpose of this action is to establish a dividing line on Barren Creek for tidal and nontidal waters. Barren Creek is a large tributary to the Nanticoke River. Each water body in Maryland is assigned a use class by the Maryland Department of the Environment. The use class is a grouping or set of designated uses that apply to a water body which individually may or may not be supported now, but should be attainable. Barren Creek is designated as Use Class I (nontidal) upstream of the U.S. Route 50 Bridge and Use Class II (tidal) downstream of the bridge. Use Class I designated uses include: water contact recreation and protection of nontidal warm water aquatic life. Use Class II designated uses include: support of estuarine and marine aquatic life and shellfish harvesting. The proposed action establishes a dividing line on Barren Creek at the U.S. Route 50 Bridge located in Mardela Springs to maintain consistency with the state use classifications. Dividing lines are established for the purpose of delineating those areas in which nontidal fishing licenses or Chesapeake Bay and coastal sport fishing licenses are required and tidal or nontidal fishing regulations apply.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

Estimate of Economic Impact

I. Summary of Economic Impact. The proposed action may have an impact on anglers and the Department.

 

 

Revenue (R+/R-)

 

II. Types of Economic Impact.

Expenditure (E+/E-)

Magnitude

 


A. On issuing agency:

(1) Nontidal Angler’s Licenses

(R+)

Indeterminable

(2) Chesapeake Bay & Coastal Fishing License

(R-)

Indeterminable

B. On other State agencies:

NONE

C. On local governments:

NONE

 

 

Benefit (+)
Cost (-)

Magnitude

 


D. On regulated industries or trade groups:

License Requirements

(+)

Indeterminable

E. On other industries or trade groups:

NONE

F. Direct and indirect effects on public:

NONE

III. Assumptions. (Identified by Impact Letter and Number from Section II.)

A(1). There could be an increase in nontidal angler’s license sales since an individual will now need a nontidal license to fish above the dividing line. However, this action also provides additional fishing areas for individuals that already have a nontidal license. The actual magnitude is indeterminable.

 

A(2). There could be a decrease in Chesapeake Bay & Coastal fishing license sales since an individual will now need a nontidal license to fish above the dividing line instead of the tidal license. The actual magnitude is indeterminable because it is unknown how many individuals will be affected by this action.

D. This action could benefit some anglers and could be a cost for others. There are several different scenarios that could happen with the license type needed for fishing in this area. The impact would be different for each situation and the magnitude cannot be determined since the Department cannot predict the actions of anglers. There are anglers who currently purchase a Nontidal Sport Fishing License that will not be affected economically, but will have another area to fish. There are anglers that traditionally had to purchase a Chesapeake Bay and Coastal Sport Fishing license to fish in the area that will now have to purchase a Nontidal Sport Fishing License if they want to fish upstream of the dividing line. The cost of a Nontidal Sport Fishing License is $20.50 per year. The cost of a Chesapeake Bay and Coastal Sport Fishing License is $15 per year. Some individuals will only need one license type and others will need both license types. The magnitude of the impact is indeterminable because the Department does not know the numbers of individuals that fish in those areas and which license type they currently purchase.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Dividing Lines, Regulatory Staff, Department of Natural Resources Fishing and Boating Services, 580 Taylor Ave., B-2, Annapolis, MD 21401, or call 410-260-8300, or email to fisheriespubliccomment.dnr@maryland.gov, or fax to 410-260-8310. Comments will be accepted through January 9, 2016. A public hearing has not been scheduled.

.09 Dividing Lines; Tidal and Nontidal Waters.

The following boundaries are designated as official dividing lines for tidal and nontidal waters. These boundary lines are for the purpose of delineating those areas in which nontidal fishing licenses or Chesapeake Bay and coastal sport fishing licenses are required and tidal or nontidal fishing regulations apply, and have no other legal significance.

A.—G. (text unchanged)

H. Wicomico and Worcester Counties.

(1)—(4) text unchanged)

(5) Barren Creek: U.S. Route 50 Bridge

I.—M. (text unchanged)

MARK J. BELTON
Secretary of Natural Resources

 

Subtitle 02 FISHERIES SERVICE

08.02.11 Fishing in Nontidal Waters

Authority: Natural Resources Article, §§4-215, 4-602 and 4-614, Annotated Code of Maryland

Notice of Proposed Action

[16-315-P]

The Secretary of Natural Resources proposes to amend Regulations .01 and .04 under COMAR 08.02.11 Fishing in Nontidal Waters.

Statement of Purpose

The purpose of this action is to amend and clarify existing regulations for fishing in nontidal waters. Specifically, the proposed action increases the possession limits for trout, changes the closures for four put-and-take areas (Accident Pond, Georges Creek, Muddy Creek, and Little Youghiogheny River), extends the boundary on the North Branch Potomac River upper catch-and-return trout fishing area; makes possession limits for game fish consistent, defines when an individual needs a trout stamp, and clarifies the regulation by removing duplicate text.

The proposed action increases the trout possession limit. Increasing the possession to twice the daily creel will allow someone who may be on a multi-day fishing trip the ability to keep more than one daily limit without having to consume the fish they catch each day.

The proposed action changes the closure period from a “1” to a “0” on four streams (Georges Creek, Accident Pond, Muddy Creek and Little Youghiogheny River) managed under put–and–take trout fishing areas. The areas where the closure period is being changed to “0” are currently closed to fishing for up to three weeks after the initial stocking. The Department has received calls during the past several years that catch rates were low or non-existent by opening day. Georges Creek still has acid mine drainage (AMD) issues and is a very “flashy” stream during rain events. The Little Youghiogheny River within the Town of Oakland becomes quite turbid during rain events. Muddy Creek has experienced fish kills due to acidification; however, fish kills have been avoided since limestone was deposited in the stream (1999 - present), but during heavy snowmelt events the pH can still dip below 6.0. Removing the closure provides increased angler opportunity and a better return (catch) on the stocked trout. A change from a “1” closure to a “0” closure will allow fishing immediately after the initial stocking. All four locations combined will provide for an additional 84 days of recreational fishing opportunities. Water quality issues that may occur during the three week closure period may be less of an issue if anglers can fish for the trout immediately after stocking. All areas have the approval from local jurisdictions.

The proposed action extends the upper boundary on the North Branch Potomac River’s upper catch–and–return trout fishing area. The purpose of this action is to increase angler access and fishing opportunities in the North Branch Potomac River. The United States Army Corps of Engineers (USACE) approached the Department regarding increasing public access to the upper catch-and-return trout fishing area in May 2016. Currently the public has access along the river via the Senator Sarbanes Trail; however, one must walk downstream approximately 165 yards before legally being able to fish. The USACE would like to provide fishing opportunities in this stretch of the river. The boundary is being moved upstream to the point where the Senator Sarbanes Trail meets the river, at a location agreed upon by the USACE. This may also provide additional stocking locations since it will be open to public fishing.

The proposed action increases the possession limit to twice the daily creel limit for certain fish species and changes the areas where size limits apply for yellow perch. The proposed action creates consistency with having the possession limit be double the daily creel on all species except American eel and baitfish. Increasing the possession to twice the daily creel will allow someone who may be on a multi–day fishing trip the ability to keep more than one daily limit without having to consume the fish they catch each day. Even though the possession is increased, the daily creel limit will remain the same. Daily creel is the number of fish that an angler can keep after a single day of fishing and possession limit is the maximum number of fish that an angler may have in their possession after two or more days of fishing. The proposed action establishes a creel limit, possession limit and size limit for yellow perch caught in reservoirs, lakes, ponds, impoundments, and waters upstream of them. Establishing creel and possession limits for yellow perch in nontidal lakes and ponds provides resource protection from excessive harvest and wanton waste. The proposed action specifies where the size limits for yellow perch occur and makes them consistent throughout the state, rather than by area.

The proposed action requires an individual to have a trout stamp to catch, attempt to catch or possess trout. Prior to the 2016 legislative session, it was unclear where an individual needed a trout stamp. Legislation became effective in 2016 that allows the Department to clarify the trout stamp requirements and remove any confusion about the management areas covered by the trout stamp. A trout stamp is required when you are fishing for or possessing trout anywhere in the state. Areas are not specified because a person may be fishing for species other than trout in the same area. Catch is defined in Natural Resources Article, §4-101, Annotated Code of Maryland and means to take, kill, trap, gather, harvest or in any manner reduce any fish to personal possession.

The proposed action removes the section that applies to Fishery Management Areas because those areas and their rules are located elsewhere in the Code of Maryland Regulations (COMAR 08.02.01.13) and do not need to be duplicated in this regulation.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

Estimate of Economic Impact

I. Summary of Economic Impact. The proposed action may have an impact on the Department, anglers, and fishing supply stores.

 

 

Revenue (R+/R-)

 

II. Types of Economic Impact.

Expenditure (E+/E-)

Magnitude

 


A. On issuing agency:

Trout Stamp

(R+)

Indeterminable

B. On other State agencies:

NONE

C. On local governments:

NONE

 

 

Benefit (+)
Cost (-)

Magnitude

 


D. On regulated industries or trade groups:

Trout Stamp

(-)

$5 per year

 

E. On other industries or trade groups:

(1) Removal of Trout Closure Period

(+)

Indeterminable

(2) Extending the Boundary on the North Branch

(+)

Indeterminable

F. Direct and indirect effects on public:

NONE

III. Assumptions. (Identified by Impact Letter and Number from Section II.)

A. Prior to the 2016 legislative session only certain individuals were required to obtain a trout stamp. The proposed action requires a trout stamp for anyone who catches or attempts to catch a trout. This could result in an increased number of trout stamps being sold. The amount is indeterminable because it is unknown how many anglers will fish for trout and need a trout stamp each year. Most anglers fishing for trout likely already purchase the stamp each year so the magnitude of additional revenue is likely to be minimal.

D. Prior to the 2016 legislative session only certain individuals were required to obtain a trout stamp. The proposed action requires a trout stamp for anyone who catches or attempts to catch a trout. This could result in an angler needing to spend an additional $5 per year for the stamp.

E(1). Removing the closure period for four locations may increase fishing pressure in those areas which may increase business at local bait and tackle stores. The actual amount is indeterminable.

E(2). Increasing the public access on the North Branch of the Potomac River may increase fishing pressure in that area which may increase business at local bait and tackle stores. The actual amount is indeterminable.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to 2017 Nontidal Regulations, Regulatory Staff, Department of Natural Resources Fishing and Boating Services, 580 Taylor Ave., B-2, Annapolis, MD 21401, or call 410-260-8300, or email to fisheriespubliccomment.dnr@maryland.gov, or fax to 410-260-8310. Comments will be accepted through January 9, 2017. A public hearing has not been scheduled.

.01 Trout Fishing and Management Areas.

A. Basic Statewide Trout Fishing. Except as listed in §§B—H of this regulation, the following shall be in effect for trout fishing in all nontidal waters of the State:

(1)—(2) (text unchanged)

(3) Creel and possession limits (all species of trout) in aggregate — daily: 2, possession: [2] 4;

(4)—(5) (text unchanged)

B. Put-and-Take Trout Fishing Areas.

(1)—(2) (text unchanged)

(3) Creel and Possession Limits (all species of trout) in aggregate — Daily: 5, Possession: [5] 10;

(4)—(5) (text unchanged)

(6) Except as provided in §C(1) of this regulation the following areas are subject to the provisions in §B(1)—(4) of this regulation:

 

Closure Periods

   (a) Allegany County:

     (i)—(xi) (text unchanged)

     (xii) Georges Creek mainstem from the upper extent of Town Park in Westernport upstream to Neff Run

[1] 0

     (xiii)—(xvi) (text unchanged)

   (b)—(h) (text unchanged)

   (i) Garrett County:

      (i)—(iv) (text unchanged)

      (v) Muddy Creek mainstem

[1] 0

      (vi)—(xi) (text unchanged)

      (xii) Accident Pond

[1] 0

      (xiii) Little Youghiogheny River mainstem, from Maryland Route 219 downstream to the Youghiogheny River

[1] 0

      (xiv)—(xvii) (text unchanged)

   (j)—(n) (text unchanged)

 

C. Catch-and-Return Trout Fishing Areas.

(1)—(2) (text unchanged)

(3) Areas Limited to Use of Artificial Lures Only.

(a) (text unchanged)

(b) Areas subject to the provisions of this section are:

(i)—(iv) (text unchanged)

(v) North Branch Potomac River from an overhead cable and red bank post located approximately [510] 345 yards below the Jennings Randolph Reservoir spillway downstream approximately 1 mile to a red post, located approximately 100 yards above the upstream concrete abutments at Barnum, West Virginia, and from a red post located below a pool known as Blue Hole approximately 1/3 mile upstream of Bench Mark 1110 on the Westernport U.S.G.S. Quadrangle, downstream approximately 4 miles to the confluence of Piney Swamp Run.

(vi)—(vii) (text unchanged)

(4) (text unchanged)

D.—H. (text unchanged)

.04 Statewide General Regulations.

A. Open Seasons, Creel, Possession, and Size Limits on Game and Fresh Water Fish in Nontidal Waters. Except as otherwise provided in this chapter for specific areas, the following apply Statewide:

(1) (text unchanged)

(2) Creel and Possession Limits.

 

Daily Creel

Possession

   (a) Trout (all species) in aggregate

     (i) Put-and-take areas

  5

  [5] 10

      (ii) Other areas not described in Regulation .03 of this chapter

  2

  [2] 4

   (b) (text unchanged)

   (c) Walleye

  5

  10

   (d) Pickerel

  5

  10

   (e) Northern pike

  2

  4

   (f) Muskellunge and hybrids including tiger musky

  1

  2

   (g)—(r) (text unchanged)

 

 

   (s) Yellow Perch

  10

  20

      [(i) Nontidal waters

  10, except no limit in reservoirs, lakes, ponds, impoundments, and waters upstream of them.

      (ii) Deep Creek Lake

  10

  20]

   (t) (text unchanged)

 

(3) Minimum Size from Tip of Nose to End of Caudal Fin or Tail.

 

(a)—(q) (text unchanged)

(r) Yellow Perch

(i) Nontidal [waters] streams and rivers

9 inches[, except no minimum size in reservoirs, lakes, ponds, impoundments, and upstream of them.]

(ii) [Deep Creek Lake] Nontidal lakes and ponds

No minimum size.

 

B.—L. (text unchanged)

M. [License to Fish] Licenses and Stamps.

(a) A person may not catch or attempt to catch game or freshwater fish without first [procuring] obtaining an angler’s license in accordance with Natural Resources Article, §4-604, Annotated Code of Maryland.

(b) A person may not catch, attempt to catch or possess trout without first obtaining a trout stamp.

N.—O. (text unchanged)

[P. Feeding Wildlife on Fisheries Management Areas.

(1) In this section, “wildlife” has the meaning stated in Natural Resources Article, §10-101(cc), Annotated Code of Maryland.

(2) Except for lawful fishing and hunting activities, a person may not feed wildlife in the following Fisheries Management Areas owned and controlled by the Department of Natural Resources:

(a) Albert Powell Hatchery — Washington County;

(b) Bear Creek Rearing Station — Garrett County;

(c) Big Mill Pond — Kent County;

(d) Brownsville Pond — Washington County;

(e) Brunswick Pond — Frederick County;

(f) Bynum Run Pond — Harford County;

(g) Evitts Creek Pond — Allegany County;

(h) Forest Hill Pond — Harford County;

(i) Frank Bentz Pond — Frederick County;

(j) Hughesville Pond — Charles County;

(k) Lewistown Work Center — Frederick County;

(l) Manning Hatchery — Charles County;

(m) North Branch Potomac River — Gary A. Yoder Landing — Allegany County;

(n) North Branch Potomac River — McCoole — Allegany County;

(o) North Branch Potomac River — Folly and Laurel Runs — Garrett County;

(p) Piney Point Aquaculture Center — St. Mary’s County;

(q) Rising Sun Pond — Cecil County;

(r) Smithville Lake — Caroline County;

(s) Unicorn Lake — Queen Anne’s County;

(t) Urbana Lake — Frederick County; or

(u) Urieville Lake — Kent County.]

[Q.] P. (text unchanged)

MARK J. BELTON
Secretary of Natural Resources

 

Title 10
DEPARTMENT OF HEALTH AND MENTAL HYGIENE

Subtitle 06 DISEASES

10.06.02 Communicable Diseases — Rabies

Authority: Health-General Article, §§18-102, 18-312—18-313, 18-316, 18-318—18-320, Annotated Code of Maryland

Notice of Proposed Action

[16-320-P]

The Secretary of Health and Mental Hygiene proposes to amend Regulations .02, .04, and .13 under COMAR 10.06.02 Communicable Diseases — Rabies.

Statement of Purpose

The purpose of this action is to amend this chapter to implement selected aspects of the updated version of the Compendium of Animal Rabies Prevention and Control, 2016 published by the National Association of State Public Health Veterinarians. These changes include reducing the minimum time for strict quarantine of a domestic animal that has been exposed to a rabid animal from 6 to 4 months according to the updated Compendium of Animal Rabies Prevention and Control, and replacing the term “isolation” with “quarantine” to refer to the action taken when animals have been exposed to rabies, but have not developed clinical illness.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Michele Phinney, Director, Office of Regulation and Policy Coordination, Department of Health and Mental Hygiene, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to dhmh.regs@maryland.gov, or fax to 410-767-6483. Comments will be accepted through January 9, 2017. A public hearing has not been scheduled.

.02 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(20) (text unchanged)

(21) “Provoked [bite]” means [a] that bite or non-bite contact from an animal [that] resulted from human activity, such as an individual attempting to play with, pet, feed, handle, hold, harm, or redirect an animal’s actions.

(22)—(26) (text unchanged)

(27) “Serologic monitoring” means monitoring of a dog or cat that was previously vaccinated against rabies to see if the animal demonstrates sufficient evidence of an immune response within seven days of being vaccinated against rabies.

[(27)] (28) (text unchanged)

[(28)] (29) “Strict [isolation] quarantine” means that:

(a)—(d) (text unchanged)

[(29)] (30)—[(30)] (31) (text unchanged)

.04 Animal Rabies.

A. (text unchanged)

B. Disposition of a Suspected Rabid Animal —— No Bite or Non-Bite Human Contact.

(1) Dogs, Cats, and Ferrets.

(a) Except as provided in §B(3) of this regulation, the director of a Department-approved facility shall hold in strict [isolation] quarantine, in a manner and place as established by the local health officer or the Public Health Veterinarian, any dog, cat, or ferret suspected of having rabies that has not had bite or non-bite contact with an individual in the preceding 10 days.

(b) Except as provided in §B(3) of this regulation, unless otherwise specified by the Public Health Veterinarian, the director of a Department-approved facility shall continue the strict [isolation] quarantine of the suspected rabid animal for at least 10 days and maintain proper, humane care of the animal during the period of [isolation] strict quarantine, after which the animal may be humanely killed or released to its owner or custodian or for adoption.

(c) At any time during the [isolation] strict quarantine period, the local health officer, the Public Health Veterinarian, the owner, or the custodian of the animal may direct that the animal suspected of having rabies be humanely killed for the purpose of rabies testing.

(d) At any time during the [isolation] strict quarantine period, the owner or custodian of the animal may direct that the animal be humanely killed.

(e) (text unchanged)

(2) Livestock.

(a) Except as provided in §B(3) of this regulation, the Public Health Veterinarian shall direct the owner or custodian of livestock that has not had bite or non-bite contact with an individual and is suspected of having rabies to hold the livestock in strict [isolation] quarantine for at least 10 days and shall designate the place and manner in which the strict [isolation] quarantine is to be carried out, after which the livestock may be humanely killed or released to the owner or custodian.

(b) At any time during the strict [isolation] quarantine period, the local health officer, the Public Health Veterinarian, the owner, or the custodian of the animal may direct that the animal be humanely killed for the purpose of rabies testing.

(c) At any time during the [isolation] strict quarantine period, the owner or custodian of the animal may direct that the animal be humanely killed.

(d) (text unchanged)

(3) Wild Animals.

(a)—(b) (text unchanged)

(c) If an owner or custodian of the wild animal claims the animal within 24 hours, the Public Health Veterinarian may order the owner to hold the animal in strict [isolation] quarantine in a place and manner determined by the Public Health Veterinarian for at least 30 days, after which it may be released to the owner or custodian if the animal has not developed rabies.

(d) At any time during the [isolation] strict quarantine period, the local health officer, the Public Health Veterinarian, or the owner or custodian of the animal may direct that the animal be humanely killed for the purpose of rabies testing.

C. (text unchanged)

D. Disposition of an Animal Exposed to a Rabid Animal or to an Animal Suspected of Having Rabies.

(1) If the owner or custodian of a domestic animal that has been exposed to a rabid animal, or to an animal suspected of having rabies, is able to provide a current or expired rabies vaccination certificate for the animal, the owner or custodian shall:

(a) (text unchanged)

(b) [Hold the animal in quarantine] Keep the animal under the owner or custodian’s control and observed for 45 calendar days or for such time as specified by the Public Health Veterinarian.

(2) If the owner or custodian of a domestic animal that has been exposed to a rabid animal, or to an animal suspected of having rabies, is unable to provide a current or expired rabies vaccination certificate [but has an expired rabies vaccination certificate, the local health officer or animal control authority shall consult with the Public Health Veterinarian to determine the disposition of the animal considering the:

(a) Animal’s:

(i) Age;

(ii) Health status; and

(iii) Number of prior vaccinations;

(b) Severity of the exposure; and

(c) Time elapsed since last rabies vaccination.

(3) If the owner or custodian of a domestic animal that has been exposed to a rabid animal, or to an animal suspected of having rabies, is unable to provide any rabies vaccination certificate, the]:

(a) The owner or custodian shall:

[(a)] (i) (text unchanged)

[(b)] (ii) Have the animal vaccinated against rabies immediately, and hold [the animal] dogs and cats in strict [isolation] quarantine for a minimum of [6] 4 months and other animals in strict quarantine for a minimum of 6 months in a facility and a manner approved by the Public Health Veterinarian; or

(b) The local health officer or animal control authority may consult with the Public Health Veterinarian to determine if serologic monitoring can be used to keep a dog or cat under the owner or custodian’s control and observed for 45 calendar days rather than under strict quarantine for 4 months if the owner or custodian of a dog or cat states that the dog or cat was previously vaccinated.

[(4)] (3) The owner or custodian of a domestic animal that is being held in strict [isolation or] quarantine is responsible for all costs related to [isolation or] strict quarantine of the animal.

[(5)] (4) The local health officer [or], the Public Health Veterinarian, or the local animal control authority may make inspections of the site where an animal is being held in strict [isolation] quarantine to assure that the animal is being held in [isolation] strict quarantine under the terms specified in this chapter.

[(6)] (5) The local health officer or the Public Health Veterinarian may order the humane killing for rabies testing of an animal exposed to a rabid animal or to an animal suspected of having rabies if:

(a) The [isolation] strict quarantine agreement defined in Regulation .02B(28) of this chapter is violated;

(b)—(f) (text unchanged)

.13 Disposition of Animals by Animal Shelters, Pounds, or Veterinarians.

A. (text unchanged)

B. Except as provided in §C of this regulation, if the animal has had bite or non-bite contact with an individual within the time periods specified in §A of this regulation, the animal shelter, pound, or veterinarian shall:

(1) (text unchanged)

(2) If the animal is a wild animal, immediately humanely kill the animal and submit its [brain] head for rabies testing.

C. (text unchanged)

VAN T. MITCHELL
Secretary of Health and Mental Hygiene

 

Subtitle 09 MEDICAL CARE PROGRAMS

Notice of Proposed Action

[16-325-P-I]

The Secretary of Health and Mental Hygiene proposes to:

(1) Amend Regulation .07 under COMAR 10.09.14 Vision Care Services;

(2) Amend Regulation .06 under COMAR 10.09.17 Physical Therapy Services;

(3) Adopt new Regulation .01-1 and amend Regulation .07 under COMAR 10.09.23 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services; and

(4) Amend Regulation .07 under COMAR 10.09.51 Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Audiology Services.

Statement of Purpose

The purpose of this action is to incorporate by reference the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Provider Manual. This proposal also updates references to this document in other chapters.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Michele Phinney, Director, Office of Regulation and Policy Coordination, Department of Health and Mental Hygiene, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to dhmh.regs@maryland.gov, or fax to 410-767-6483. Comments will be accepted through January 9, 2016. A public hearing has not been scheduled.

 

 Editor’s Note on Incorporation by Reference

     Pursuant to State Government Article, §7-207, Annotated Code of Maryland, the Early Periodic, Screening, Diagnosis, and Treatment (EPSDT) Provider Manual (Maryland Medical Assistance Program, Effective January 1, 2017) has been declared a document generally available to the public and appropriate for incorporation by reference. For this reason, it will not be printed in the Maryland Register or the Code of Maryland Regulations (COMAR). Copies of this document are filed in special public depositories located throughout the State. A list of these depositories was published in 43:1 Md. R. 10 (January 8, 2016), and is available online at www.dsd.state.md.us. The document may also be inspected at the office of the Division of State Documents, 16 Francis Street, Annapolis, Maryland 21401.

 

10.09.14 Vision Care Services

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

.07 Payment Procedures.

A.—D. (text unchanged)

E. [The Maryland Medicaid Vision Services—Provider Type 12, Procedure Code and Fee Schedule—2008 is contained in the Medical Assistance Provider Fee Manual, dated October 1, 1986, all the provisions of which are incorporated by reference] Vision care services are reimbursed according to COMAR 10.09.23.01-1.

F.—N. (text unchanged)

 

10.09.17 Physical Therapy Services

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

.06 Payment Procedures.

A.—D. (text unchanged)

E. The [fee schedule for] services covered in this chapter [is contained in the Maryland Medical Assistance Program Physicians’ Services Provider Fee Manual, Revision July—December 2011, contained in the Medical Assistance Provider Fee Manual, dated October 1986. All the provisions of this document, unless specifically excepted, are incorporated by reference] are reimbursed according to COMAR 10.09.23.01-1.

F.—K. (text unchanged)

 

10.09.23 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

.01-1 Incorporation by Reference.

The Early Periodic, Screening, Diagnosis, and Treatment (EPSDT) Provider Manual (Maryland Medical Assistance Program, Effective January 1, 2017) is incorporated by reference.

.07 Payment Procedures.

A.—B. (text unchanged)

C. Rates for services provided by chiropractors, speech therapists, occupational therapists, [professional counselors, psychologists, social workers,] and nutritionists [, and nurse psychotherapists] covered under this chapter are included in the [current Program Physicians’ Provider Fee Manual, which is contained in the Medical Assistance Provider Fee Manual, dated October 1986, all the provisions of which, unless specifically excepted, are incorporated by reference in COMAR 10.09.02.07] Early Periodic, Screening, Diagnosis, and Treatment (EPSDT) Provider Manual.

D.—F. (text unchanged)

 

10.09.51 Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Audiology Services

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

.07 Payment Procedures.

A. (text unchanged)

B. [The Audiology Procedure Code and Fee Schedule, Revision 2010 is incorporated by reference and is contained in the Medical Assistance Audiology Provider Manual dated November, 2010.] Audiology services are reimbursed according to COMAR 10.09.23.01-1.

C.—O. (text unchanged)

VAN T. MITCHELL
Secretary of Health and Mental Hygiene

 

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.65 Maryland Medicaid Managed Care Program: Managed Care Organizations

Authority: Health-General Article, §§2-104, 15-102.3, and 15-103; Insurance Article, §§15-112, 15-605, and 15-1008; Annotated Code of Maryland

Notice of Proposed Action

[16-327-P]

The Secretary of Health and Mental Hygiene proposes to amend Regulation .19 under COMAR 10.09.65 Maryland Medicaid Managed Care Program: Managed Care Organizations.

Statement of Purpose

The purpose of this action is to repeal the calendar year 2015 HealthChoice MCO’s rates, to implement the calendar year 2017 HealthChoice MCO’s rates and to clarify the interim rate adjustment methodology.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

Estimate of Economic Impact

I. Summary of Economic Impact. The HealthChoice CY 2016, MCO interim rate adjustment is an overall increase of $23,393,246. This was primarily the result of increasing physician fees to 94 percent of Medicare rates, adjusting for HSCRC hospital rate changes and the redetermination impact.

The HealthChoice CY 2017 MCO rate adjustment is an increase of $109,202,607 above the appropriation or a 1.0 percent rate increase. This increase includes an observed medical trend increase of 2.8 percent overall.

The combined total related to the MCO CY 2016 Interim rate adjustment of $23,393,246 and the CY 2017 rate increase of $109,202,607 is $132,595,853.

 

 

Revenue (R+/R-)

 

II. Types of Economic Impact.

Expenditure (E+/E-)

Magnitude

 


A. On issuing agency:

(E+)

$132,595,853

B. On other State agencies:

NONE

C. On local governments:

NONE

 

 

Benefit (+)
Cost (-)

Magnitude

 


D. On regulated industries or trade groups:

(+)

$132,595,853

E. On other industries or trade groups:

NONE

F. Direct and indirect effects on public:

NONE

III. Assumptions. (Identified by Impact Letter and Number from Section II.)

A. For CY 2016 the interim rate adjustment is an overall increase of $23,393,246 in general funds.

For CY 2017, there is a 1.0 percent rate increase or $109,202,607 increase to the Department’s expenses.

D. For CY 2016 the interim rate adjustment is an overall increase of $23,393,246 in general funds.

For CY 2017, there is a 1.0 percent rate increase or $109,202,607 increase to the MCOs revenue.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Michele Phinney, Director, Office of Regulation and Policy Coordination, Department of Health and Mental Hygiene, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to dhmh.regs@maryland.gov, or fax to 410-767-6483. Comments will be accepted through January 9, 2017. A public hearing has not been scheduled.

.19 MCO Reimbursement.

A. (text unchanged)

B. Capitation Rate-Setting Methodology.

(1)—(3) (text unchanged)

(4) Except to the extent of adjustments required by §D of this regulation or by Regulations .19-1—.19-4 of this chapter, the Department shall make payments monthly at the rates specified in the following tables:

[(a)—(h)] (proposed for repeal)

(a) Rate Table for Families and Children Effective January 1, 2017 — December 31, 2017.

 

Age/RAC

Gender

PMPM Baltimore City

PMPM Montgomery County

PMPM Rest of State

 

Under age 1 Birth Weight 1500 grams or less

Both

$9,079.56

$8,246.40

$8,469.74

 

Under age 1 Birth Weight over 1500 grams

Both

$516.80

$469.38

$482.09

 

1-5

Male

$199.52

$181.21

$186.12

 

 

Female

$169.36

$153.82

$157.98

 

6-14

Male

$108.93

$98.93

$101.61

 

 

Female

$99.99

$90.82

$93.28

 

15-20

Male

$116.34

$105.67

$108.53

 

 

Female

$160.01

$145.32

$149.26

 

21-44

Male

$237.39

$182.28

$200.17

 

 

Female

$364.91

$280.20

$307.70

 

45-64

Male

$494.42

$379.64

$416.90

 

 

Female

$562.02

$431.54

$473.90

ACG-adjusted cells

 

 

  

 

 

ACG 100, 200, 300, 400, 500, 600, 700, 900, 1000, 1100, 1200, 1300, 1600, 1710, 1711, 1712, 1720, 1721, 1722, 1730, 1731, 1732, 1800, 1900, 2000, 2100, 2200, 2300, 2400, 2500, 2800, 2900, 3000, 3100, 3200, 3300, 3400, 3500, 3800, 4210, 5100, 5110, 5200 5230, 5310, 5339  

RAC 1F

Both

$234.90

$180.37

$198.07

ACG 800, 1740, 1741, 1742, 1750, 2700, 3600, 1750, 1751, 1752, 2700, 3600, 3700, 3900, 4000, 4100, 4220, 4310, 4410, 4510, 4610, 4710, 4720, 4810, 5340  

RAC 2F

Both

$376.44

$289.05

$317.42

ACG 1400, 1500, 1750, 1761, 1762, 1770, 1771, 1772, 2600, 4320, 4520, 4620, 4820  

RAC 3F

Both

$523.51

$401.98

$441.43

ACG 4330, 4420, 4830, 4910, 4920, 5010, 5020, 5040  

RAC 4F

Both

$722.68

$554.91

$609.38

 

ACG 4430, 4730, 4930, 5030, 5050

RAC 5F

Both

$957.37

$735.12

$807.28

ACG 4940, 5060  

RAC 6F

Both

$1,263.62

$970.27

$1,065.51

ACG 5070  

RAC 7F

Both

$1,962.90

$1,507.21

$1,655.16

ACG 100, 200, 300, 500, 600, 1100, 1600, 2000, 2400, 3400, 5100, 5110, 5200  

RAC 1G

Both

$86.50

$78.56

$80.69

ACG 400, 700, 900, 1000, 1200, 1300, 1710, 1711, 1712, 1800, 1900, 2100, 2200, 2300, 2800, 2900, 3000, 3100, 5310  

RAC 2G

Both

$111.43

$101.21

$103.95

ACG 1720, 1721, 1722, 1731, 1732, 1730, 2500, 3200, 3300, 3500, 3800, 4210, 5230, 5339  

RAC 3G

Both

$144.82

$131.53

$135.09

ACG 800, 1740, 1741, 1742, 1750, 2700, 3600, 1750, 1751, 1752, 2700, 3600, 3700, 3900, 4000, 4100, 4220, 4310, 4410, 4510, 4610, 4710, 4720, 4810, 5340  

RAC 4G

Both

$198.35

$180.14

$185.02

ACG 1400, 1500, 1750, 1761, 1762, 1770, 1771, 1772, 2600, 4320, 4520, 4620, 4820  

RAC 5G

Both

$306.82

$278.67

$286.21

ACG 4330, 4420, 4830, 4910, 4920, 5010, 5020, 5040  

RAC 6G

Both

$349.10

$317.07

$325.65

ACG 4430, 4730, 4930,4940, 5030, 5050, 5060, 5070  

RAC 7G

Both

$885.12

$803.90

$825.67

SOBRA Mothers  

 

 

$850.46

$653.02

$717.12  

Persons with HIV

ALL

Both

$648.67

$648.67

$648.67

 

(b) Rate Table for Disabled Individuals Effective January 1, 2017—December 31, 2017.

 

 

Age/RAC

Gender

PMPM   Baltimore   City

PMPM Montgomery County

PMPM Rest   of State

 

Under Age 1

Both

$6,465.12

$6,465.12

$6,465.12

 

1-5

Male

$1,664.34

$1,664.34

$1,664.34

 

 

Female

$1,444.43

$1,444.43

$1,444.43

 

6-14

Male

$311.82

$311.82

$311.82

 

 

Female

$546.20

$546.20

$456.20

 

15-20

Male

$225.06

$225.06

$225.06

 

 

Female

$326.94

$326.94

$326.94

 

21-44

Male

$856.35

$726.80

$793.46

 

 

Female

$1,160.01

$984.52

$1,074.82

 

45-64

Male

$1,942.90

$1,648.96

$1,800.21

 

 

Female

$1,808.14

$1,534.59

$1,675.35

ACG-adjusted cells

 

 

 

 

 

ACG 100, 200, 300, 1100, 1300, 1400, 1500, 1600, 1710, 1711, 1712, 1720, 1721, 1722, 1730, 1731, 1732, 1900, 2400, 2600, 2900, 3400, 5100, 5110, 5200, 5310  

RAC 10

Both

$281.02

$238.50

$260.38

ACG 400, 500, 700, 900, 1000, 1200, 1740, 1741, 1742, 1750, 1751, 1752 1800, 2000, 2100, 2200, 2300, 2500, 2700, 2800, 3000, 3100, 3200, 3300, 3500, 3900, 4000, 4310, 5330  

RAC 11

Both

$339.48

$288.12

$314.55

ACG 600, 1760, 1761, 1762, 3600, 3700, 4100, 4320, 4410, 4710, 4810, 4820  

RAC 12

Both

$658.09

$558.53

$609.76

ACG 3800, 4210, 4220, 4330, 4420, 4720, 4910, 5320  

RAC13

Both

$748.80

$635.51

$693.80

ACG 800, 4430, 4510, 4610, 5040, 5340  

RAC14

Both

$931.42

$790.51

$863.02

ACG 1770, 1771, 1772, 4520, 4620, 4830, 4920, 5050  

RAC15

Both

$1,265.48

$1,074.03

$1,172.54

ACG 4730, 4930, 5010  

RAC16

Both

$1,344.28

$1,140.90

$1,245.55

ACG 4940, 5020, 5060  

RAC17

Both

$1,967.45

$1,669.79

$1,822.95

ACG 5030, 5070  

RAC 18

Both

$3,491.82

$2,963.55

$3,235.37

Persons with AIDS  

All

Both

$2,229.83

$1,259.72

$1,259.72

Persons with HIV

All

Both

$1,860.15

$1,860.15

$1,860.15

 

(c) Rate Table for Supplemental Payments for Delivery/Newborn and Hepatitis C Therapy Effective January 1, 2017—December 31, 2017.

 

 

Age

Gender

Baltimore City

Montgomery County

Rest of State

Supplemental Payment Cells

 

 

 

 

 

Delivery/Newborn-all births except live birth weight 1,500 grams or less  

All

Both

$13,946.08

$10,543.25

$11,299.98

Delivery/Newborn-live birth weight 1,500 grams or less

All

Both

$69,697.48

$69,697.48

$69,697.48

Delivery/Newborn by same enrollee-subsequent live birth weight 1,500 grams or less

All

Both

$13,946.08

$10,543.25

$11,299.98

Hepatitis C Therapy (per member per month)

All

Both

$30,527.57

$30,527.57

$30,527.57

 

(d) Rate Table for Childless Adult Population Effective January 1, 2017—December 31, 2017.

 

 

Age/RAC

Gender

PMPM Baltimore City

Montgomery County

PMPM Rest of State

 

19-44

Male

$504.81

$349.55

$472.77

 

19-44

Female

$627.27

$434.35

$587.45

 

45-64

Male

$989.05

$684.86

$926.27

 

45-64

Female

$996.05

$689.71

$932.88

ACG-adjusted cells

 

 

 

 

 

ACG 100, 200, 300, 400, 500, 600, 700, 900, 1000, 1100, 1200, 1300, 1600, 1710, 1711, 1712, 1720, 1721, 1722, 1730, 1731, 1732, 1800, 1900, 2000, 2100, 2200, 2300, 2400, 2500, 2800, 2900, 3000, 3100, 3200, 3300, 3400, 3500, 3800, 4210, 5100, 5110, 5200 5230, 5310, 5339

RAC 1H

Both

$230.96

$159.93

$216.31

ACG 800, 1740, 1741, 1742, 1750, 2700, 3600, 1750, 1751, 1752, 2700, 3600, 3700, 3900, 4000, 4100, 4220, 4310, 4410, 4510, 4610, 4710, 4720, 4810, 5340

RAC 2H

Both

$426.45

$295.30

$399.39

ACG 1400, 1500, 1750, 1761, 1762, 1770, 1771, 1772, 2600, 4320, 4520, 4620, 4820

RAC 3H

Both

$674.07

$466.76

$631.29

ACG 4330, 4420, 4830, 4910, 4920, 5010, 5020, 5040

RAC 4H

Both

$717.46

$496.80

$671.93

ACG 4430, 4730, 4930, 5030, 5050

RAC 5H

Both

$920.66

$637.50

$862.23

ACG 4940, 5060

RAC 6H

Both

$1,177.86

$815.60

$1,103.10

ACG 5070

RAC 7H

Both

$1,690.20

$1,170.37

$1,582.93

HIV

19-64

Both

$835.92

$835.92

$835.92

 

 

 


[(i)] (e)—[l] (h) (text unchanged)

(5) (text unchanged)

C. (text unchanged)

D. Interim Rates Adjustments.

(1) (text unchanged)

(2) The Department shall adjust the payment rates specified in §B(4)(a)—(d) of this regulation to reflect service cost changes that qualify under §D(3) of this regulation and result from:

(a)—(b) (text unchanged)

(c) Effective January 1, [2015] 2017, an increase or decrease in the [preliminary current year Statewide Medicaid MCO] inpatient hospital per capita as calculated [using data provided annually by the Health Services Cost Review Commission (HSCRC) during the agreed on rate setting timeline as compared to the data originally available relative to the Statewide HSCRC derived inpatient all-payer per capita and updated information for the prior period years; or] by the multiplication of:

(i) The change in the restated unit cost provided annually by the Health Service Cost Review Commission (HSCRC) as compared to the data originally provided; and

(ii) The change in the restated recommended utilization, adjusted for case mix, position of the Department’s rate certifying actuary as compared to the originally provided utilization position; or

(d) An increase or decrease in the [preliminary current year Statewide Medicaid MCO] outpatient hospital per capita as calculated [using data provided annually by the Health Services Cost Review Commission during the agreed on rate setting timeline as compared to the data originally available relative to the Statewide HSCRC derived outpatient all-payer per capita and updated information for prior period years] by the multiplication of:

(i) The change in the restated unit cost provided annually by the HSCRC as compared to the data originally provided; and

(ii) The change in the restated recommended utilization, adjusted for case mix, position of the Department’s rate certifying actuary as compared to the originally provided utilization position; or

(e) Other changes or circumstances the Department determines are necessary to ensure the rates are actuarially sound.

(3)—(6) (text unchanged)

VAN T. MITCHELL
Secretary of Health and Mental Hygiene

 

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.70 Maryland Medicaid Managed Care Program: Non-Capitated Covered Services

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

Notice of Proposed Action

[16-326-P]

The Secretary of Health and Mental Hygiene proposes to amend Regulation .02 under COMAR 10.09.70 Maryland Medicaid Managed Care Program: Non-Capitated Covered Services.

Statement of Purpose

The purpose of this action is to update the ICD-10 diagnosis codes included in the behavioral health carve out. The amendment delineates which claims the Administrative Service Organization is responsible for paying and which claims the Managed Care Organizations are responsible for paying. This will bring the regulations up to date with the latest CMS mandated updates.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Michele Phinney, Director, Office of Regulation and Policy Coordination, Department of Health and Mental Hygiene, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to dhmh.regs@maryland.gov, or fax to 410-767-6483. Comments will be accepted through January 9, 2017. A public hearing has not been scheduled.

.02 Behavioral Health Non-Capitated Covered Services.

A.—C. (text unchanged)

D. An MCO is not responsible for reimbursing for the following substance use disorder services if the MCO is billed with a primary diagnosis listed in [§J] §K of this regulation:

E.—F. (text unchanged)

G. An MCO is not responsible for reimbursing the behavioral poisoning diagnoses listed in §N of this regulation in an emergency department setting.

[G.] H. An MCO is not responsible for services billed by specialty mental health providers listed in COMAR 10.09.59 when the bill includes the specialty behavioral health diagnoses listed in [§J or K] §K or L in the primary diagnosis field.

[H.] I. — [J.] K. (text unchanged)

[K.] L. Table of mental health diagnoses:

(1) (text unchanged)

 


 (2) For dates of service on or after October 1, 2015:

 

F200—F325

(text unchanged)

[F328

Other depressive episodes]

F3281

Premenstrual dysphoric disorder

F3289

Other specified depressive episodes

F329—F341

(text unchanged)

[F348

Other persistent mood (affective) disorders]

F3481

Disruptive mood dysregulation disorder

F3489

Other specified persistent mood disorders

F349—F419

(text unchanged)

[F42

Obsessive-compulsive disorder]

F422

Mixed obsessional thoughts and acts

F423

Hoarding disorder

F424

Excoriation (skin-picking) disorder

F428

Other obsessive compulsive disorder

F429

Obsessive-compulsive disorder, unspecified

F430—F502

(text unchanged)

[F508

Other eating disorders]

F5081

Binge eating disorder

F5089

Other specified eating disorder

F509—F639

(text unchanged)

F640

Transsexualism

F641—Z046

(text unchanged)

 

[L.] M. (text unchanged)

N. Table of poisoning diagnoses, for dates of service on or after July 1, 2016:

 

T360X2A

Poisoning by penicillins, intentional self-harm

T361X2A

Poisoning by cephalosporins and other beta-lactam antibiotics, intentional self-harm

T362X2A

Poisoning by chloramphenicol group, intentional self-harm

T363X2A

Poisoning by macrolides, intentional self-harm

T364X2A

Poisoning by tetracyclines, intentional self-harm

T365X2A

Poisoning by aminoglycosides, intentional self-harm

T366X2A

Poisoning by rifampicins, intentional self-harm

T367X2A

Poisoning by antifungal antibiotics, systemically used, intentional self-harm

T368X2A

Poisoning by other systemic antibiotics, intentional self-harm

T369X2A

Poisoning by unspecified systemic antibiotic, intentional self-harm

T370X2A

Poisoning by sulfonamides, intentional self-harm

T371X2A

Poisoning by antimycobacterial drugs, intentional self-harm

T372X2A

Poisoning by antimalarials and drugs acting on other blood protozoa, intentional self-harm

T373X2A

Poisoning by other antiprotozoal drugs, intentional self-harm

T374X2A

Poisoning by anthelminthics, intentional self-harm

T375X2A

Poisoning by antiviral drugs, intentional self-harm

T378X2A

Poisoning by other specified systemic anti-infectives and antiparasitics, intentional self-harm

T3792XA

Poisoning by unspecified systemic anti-infective and antiparasitics, intentional self-harm

T380X2A

Poisoning by glucocorticoids and synthetic analogues, intentional self-harm

T381X2A

Poisoning by thyroid hormones and substitutes, intentional self-harm

T382X2A

Poisoning by antithyroid drugs, intentional self-harm

T383X2A

Poisoning by insulin and oral hypoglycemic [antidiabetic] drugs, intentional self-harm

T384X2A

Poisoning by oral contraceptives, intentional self-harm

T385X2A

Poisoning by other estrogens and progestogens, intentional self-harm

T386X2A

Poisoning by antigonadotrophins, antiestrogens, antiandrogens, not elsewhere classified, intentional self-harm

T387X2A

Poisoning by androgens and anabolic congeners, intentional self-harm

T38802A

Poisoning by unspecified hormones and synthetic substitutes, intentional self-harm

T38812A

Poisoning by anterior pituitary [adenohypophyseal] hormones, intentional self-harm

T38892A

Poisoning by other hormones and synthetic substitutes, intentional self-harm

T38902A

Poisoning by unspecified hormone antagonists, intentional self-harm

T38992A

Poisoning by other hormone antagonists, intentional self-harm

T39012A

Poisoning by aspirin, intentional self-harm

T39092A

Poisoning by salicylates, intentional self-harm

T391X2A

Poisoning by 4-Aminophenol derivatives, intentional self-harm

T392X2A

Poisoning by pyrazolone derivatives, intentional self-harm

T39312A

Poisoning by propionic acid derivatives, intentional self-harm

T39392A

Poisoning by other nonsteroidal anti-inflammatory drugs [NSAID], intentional self-harm

T394X2A

Poisoning by antirheumatics, not elsewhere classified, intentional self-harm

T398X2A

Poisoning by other nonopioid analgesics and antipyretics, not elsewhere classified, intentional self-harm

T3992XA

Poisoning by unspecified nonopioid analgesic, antipyretic and antirheumatic, intentional self-harm

T400X2A

Poisoning by opium, intentional self-harm

T401X2A

Poisoning by heroin, intentional self-harm

T402X2A

Poisoning by other opioids, intentional self-harm

T403X2A

Poisoning by methadone, intentional self-harm

T404X2A

Poisoning by other synthetic narcotics, intentional self-harm

T405X2A

Poisoning by cocaine, intentional self-harm

T40602A

Poisoning by unspecified narcotics, intentional self-harm

T40692A

Poisoning by other narcotics, intentional self-harm

T407X2A

Poisoning by cannabis (derivatives), intentional self-harm

T408X2A

Poisoning by lysergide [LSD], intentional self-harm

T40902A

Poisoning by unspecified psychodysleptics [hallucinogens], intentional self-harm

T40992A

Poisoning by other psychodysleptics [hallucinogens], intentional self-harm

T410X2A

Poisoning by inhaled anesthetics, intentional self-harm

T411X2A

Poisoning by intravenous anesthetics, intentional self-harm

T41202A

Poisoning by unspecified general anesthetics, intentional self-harm

T41292A

Poisoning by other general anesthetics, intentional self-harm

T413X2A

Poisoning by local anesthetics, intentional self-harm

T4142XA

Poisoning by unspecified anesthetic, intentional self-harm

T415X2A

Poisoning by therapeutic gases, intentional self-harm

T420X2A

Poisoning by hydantoin derivatives, intentional self-harm

T421X2A

Poisoning by iminostilbenes, intentional self-harm

T422X2A

Poisoning by succinimides and oxazolidinediones, intentional self-harm

T423X2A

Poisoning by barbiturates, intentional self-harm

T424X2A

Poisoning by benzodiazepines, intentional self-harm

T425X2A

Poisoning by mixed antiepileptics, intentional self-harm

T426X2A

Poisoning by other antiepileptic and sedative-hypnotic drugs, intentional self-harm

T4272XA

Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, intentional self-harm

T428X2A

Poisoning by antiparkinsonism drugs and other central muscle-tone depressants, intentional self-harm

T43012A

Poisoning by tricyclic antidepressants, intentional self-harm

T43022A

Poisoning by tetracyclic antidepressants, intentional self-harm

T431X2A

Poisoning by monoamine-oxidase-inhibitor antidepressants, intentional self-harm

T43202A

Poisoning by unspecified antidepressants, intentional self-harm

T43212A

Poisoning by selective serotonin and norepinephrine reuptake inhibitors, intentional self-harm

T43222A

Poisoning by selective serotonin reuptake inhibitors, intentional self-harm

T43292A

Poisoning by other antidepressants, intentional self-harm

T433X2A

Poisoning by phenothiazine antipsychotics and neuroleptics, intentional self-harm

T434X2A

Poisoning by butyrophenone and thiothixene neuroleptics, intentional self-harm

T43502A

Poisoning by unspecified antipsychotics and neuroleptics, intentional self-harm

T43592A

Poisoning by other antipsychotics and neuroleptics, intentional self-harm

T43602A

Poisoning by unspecified psychostimulants, intentional self-harm

T43612A

Poisoning by caffeine, intentional self-harm

T43622A

Poisoning by amphetamines, intentional self-harm

T43632A

Poisoning by methylphenidate, intentional self-harm

T43692A

Poisoning by other psychostimulants, intentional self-harm

T438X2A

Poisoning by other psychotropic drugs, intentional self-harm

T4392XA

Poisoning by unspecified psychotropic drug, intentional self-harm

T440X2A

Poisoning by anticholinesterase agents, intentional self-harm

T441X2A

Poisoning by other parasympathomimetics [cholinergics], intentional self-harm

T442X2A

Poisoning by ganglionic blocking drugs, intentional self-harm

T443X2A

Poisoning by other parasympatholytics [anticholinergics and antimuscarinics] and spasmolytics, intentional self-harm

T444X2A

Poisoning by predominantly alpha-adrenoreceptor agonists, intentional self-harm

T445X2A

Poisoning by predominantly beta-adrenoreceptor agonists, intentional self-harm

T446X2A

Poisoning by alpha-adrenoreceptor antagonists, intentional self-harm

T447X2A

Poisoning by beta-adrenoreceptor antagonists, intentional self-harm

T448X2A

Poisoning by centrally-acting and adrenergic-neuron-blocking agents, intentional self-harm

T44902A

Poisoning by unspecified drugs primarily affecting the autonomic nervous system, intentional self-harm

T44992A

Poisoning by other drug primarily affecting the autonomic nervous system, intentional self-harm

T450X2A

Poisoning by antiallergic and antiemetic drugs, intentional self-harm

T451X2A

Poisoning by antineoplastic and immunosuppressive drugs, intentional self-harm

T452X2A

Poisoning by vitamins, intentional self-harm

T453X2A

Poisoning by enzymes, intentional self-harm

T454X2A

Poisoning by iron and its compounds, intentional self-harm

T45512A

Poisoning by anticoagulants, intentional self-harm

T45522A

Poisoning by antithrombotic drugs, intentional self-harm

T45602A

Poisoning by unspecified fibrinolysis-affecting drugs, intentional self-harm

T45612A

Poisoning by thrombolytic drug, intentional self-harm

T45622A

Poisoning by hemostatic drug, intentional self-harm

T45692A

Poisoning by other fibrinolysis-affecting drugs, intentional self-harm

T457X2A

Poisoning by anticoagulant antagonists, vitamin K and other coagulants, intentional self-harm

T458X2A

Poisoning by other primarily systemic and hematological agents, intentional self-harm

T4592XA

Poisoning by unspecified primarily systemic and hematological agent, intentional self-harm

T460X2A

Poisoning by cardiac-stimulant glycosides and drugs of similar action, intentional self-harm

T461X2A

Poisoning by calcium-channel blockers, intentional self-harm

T462X2A

Poisoning by other antidysrhythmic drugs, intentional self-harm

T463X2A

Poisoning by coronary vasodilators, intentional self-harm

T464X2A

Poisoning by angiotensin-converting-enzyme inhibitors, intentional self-harm

T465X2A

Poisoning by other antihypertensive drugs, intentional self-harm

T466X2A

Poisoning by antihyperlipidemic and antiarteriosclerotic drugs, intentional self-harm

T467X2A

Poisoning by peripheral vasodilators, intentional self-harm

T468X2A

Poisoning by antivaricose drugs, including sclerosing agents, intentional self-harm

T46902A

Poisoning by unspecified agents primarily affecting the cardiovascular system, intentional self-harm

T46992A

Poisoning by other agents primarily affecting the cardiovascular system, intentional self-harm

T470X2A

Poisoning by histamine H2-receptor blockers, intentional self-harm

T471X2A

Poisoning by other antacids and anti-gastric-secretion drugs, intentional self-harm

T472X2A

Poisoning by stimulant laxatives, intentional self-harm

T473X2A

Poisoning by saline and osmotic laxatives, intentional self-harm

T474X2A

Poisoning by other laxatives, intentional self-harm

T475X2A

Poisoning by digestants, intentional self-harm

T476X2A

Poisoning by antidiarrheal drugs, intentional self-harm

T477X2A

Poisoning by emetics, intentional self-harm

T478X2A

Poisoning by other agents primarily affecting gastrointestinal system, intentional self-harm

T4792XA

Poisoning by unspecified agents primarily affecting the gastrointestinal system, intentional self-harm

T480X2A

Poisoning by oxytocic drugs, intentional self-harm

T481X2A

Poisoning by skeletal muscle relaxants [neuromuscular blocking agents], intentional self-harm

T48202A

Poisoning by unspecified drugs acting on muscles, intentional self-harm

T48292A

Poisoning by other drugs acting on muscles, intentional self-harm

T483X2A

Poisoning by antitussives, intentional self-harm

T484X2A

Poisoning by expectorants, intentional self-harm

T485X2A

Poisoning by other anti-common-cold drugs, intentional self-harm

T486X2A

Poisoning by antiasthmatics, intentional self-harm

T48902A

Poisoning by unspecified agents primarily acting on the respiratory system, intentional self-harm

T48992A

Poisoning by other agents primarily acting on the respiratory system, intentional self-harm

T490X2A

Poisoning by local antifungal, anti-infective and anti-inflammatory drugs, intentional self-harm

T491X2A

Poisoning by antipruritics, intentional self-harm

T492X2A

Poisoning by local astringents and local detergents, intentional self-harm

T493X2A

Poisoning by emollients, demulcents and protectants, intentional self-harm

T494X2A

Poisoning by keratolytics, keratoplastics, and other hair treatment drugs and preparations, intentional self-harm

T495X2A

Poisoning by ophthalmological drugs and preparations, intentional self-harm

T496X2A

Poisoning by otorhinolaryngological drugs and preparations, intentional self-harm

T497X2A

Poisoning by dental drugs, topically applied, intentional self-harm

T498X2A

Poisoning by other topical agents, intentional self-harm

T4992XA

Poisoning by unspecified topical agent, intentional self-harm

T500X2A

Poisoning by mineralocorticoids and their antagonists, intentional self-harm

T501X2A

Poisoning by loop [high-ceiling] diuretics, intentional self-harm

T502X2A

Poisoning by carbonic-anhydrase inhibitors, benzothiadiazides and other diuretics, intentional self-harm

T503X2A

Poisoning by electrolytic, caloric and water-balance agents, intentional self-harm

T504X2A

Poisoning by drugs affecting uric acid metabolism, intentional self-harm

T505X2A

Poisoning by appetite depressants, intentional self-harm

T506X2A

Poisoning by antidotes and chelating agents, intentional self-harm

T507X2A

Poisoning by analeptics and opioid receptor antagonists, intentional self-harm

T508X2A

Poisoning by diagnostic agents, intentional self-harm

T50902A

Poisoning by unspecified drugs, medicaments and biological substances, intentional self-harm

T50992A

Poisoning by other drugs, medicaments and biological substances, intentional self-harm

VAN T. MITCHELL
Secretary of Health and Mental Hygiene

 

 

 


Subtitle 09 MEDICAL CARE PROGRAMS

10.09.80 Community-Based Substance Use Disorder Services

Authority: Health-General Article, §§2-104(b), 7.5-204, 7.5-402, 15-103(a)(1), and 15-105(b), Annotated Code of Maryland

Notice of Proposed Action

[16-330-P]

The Secretary of Health and Mental Hygiene proposes to amend Regulations .01, .05, .06, and .08 under COMAR 10.09.80 Community-Based Substance Use Disorder Services.

Statement of Purpose

The purpose of this action is to change methadone reimbursement to better align service delivery with payment. The proposal includes a new bundled rate specifically for medication assisted treatment services and a separate reimbursement for Level 1 counseling services when delivered by appropriately licensed professionals. This proposal adds the ability for opioid treatment programs to be reimbursed separately for services, including an induction service of the selected medication (methadone or buprenorphine), periodic medication management visits, and guest dosing services.

An additional purpose of this proposal is to update regulations to allow certified or licensed addictions programs (provider type 50s) who employ a DATA 2000 waiver physician to be reimbursed for periodic medication management visits and the cost of buprenorphine itself through their certified addictions program.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Michele Phinney, Director, Office of Regulation and Policy Coordination, Department of Health and Mental Hygiene, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to dhmh.regs@maryland.gov, or fax to 410-767-6483. Comments will be accepted through January 9, 2017. A public hearing has not been scheduled.

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(4) (text unchanged)

(5) “DATA 2000 waived provider” means a physician who has received a waiver under the Drug Addiction and Treatment Act of 2000 which expands the clinical context of medication assisted opioid dependency treatment and permits qualified physicians to dispense or prescribe certain narcotic medications that have a lower risk of abuse, like buprenorphine, in settings other than an opioid treatment program.

[(5)] (6)—[(10)] (11) (text unchanged)

[(11)] (12) “Office of Health Care Quality (OHCQ)” means the office within the Department responsible for certification and inspection of programs for the Behavioral Health Administration.

[(12)] (13)—[(18)] (19) (text unchanged)

.05 Covered Services.

A. Comprehensive substance use disorder assessment at a minimum shall:

(1) Be delivered through an:

(a) OHCQ certified or licensed substance use disorder treatment provider; or

(b) Opioid treatment program;

(2) Be completed before providing the community based behavioral health services listed in §§B—I of this regulation;

[(1)] (3)—[(2)] (4) (text unchanged)

B. Level 1 group and individual substance use disorder counseling shall [include]:

(1) Be delivered through an:

(a) OHCQ certified or licensed substance use disorder treatment provider; or

(b) Opioid treatment program;

[(1)] (2) [Services] Include services for participants who require less than 9 hours weekly for adults and 6 hours weekly for adolescents; and

[(2)] (3) [A] Include a written individualized treatment plan, with the participation of the participant based on the comprehensive assessment that shall:

(a)—(b) (text unchanged)

[(3)] (4) [Family] Include family members, if necessary, as long as the participant is also present in a Level 1 group counseling session.

C. Level 2.1 Intensive Outpatient services shall [include]:

(1) Be delivered through an OHCQ certified or licensed substance use disorder treatment provider only;

[(1)] (2) [Services] Include services for participants who require outpatient treatment for 9 or more hours weekly for an adult and 6 or more hours weekly for an adolescent;

[(2)] (3) [A] Include a written individualized treatment plan, with the participation of the participant based on the comprehensive assessment that shall:

(a)—(b) (text unchanged)

[(3)] (4) [A] Include a discharge plan, which includes written recommendations to assist the participant with continued recovery efforts, as well as appropriate referral services.

D. Level 2.5 partial hospitalization services shall [include]:

(1) Be delivered through an OHCQ certified or licensed substance use disorder treatment provider;

[(1)] (2) [Services] Include services for participants who require a minimum of 20 hours weekly of structured outpatient treatment delivered in the following ways:

(a)—(b) (text unchanged)

[(2)] (3) [A] Include a written individualized treatment plan, with the participation of the participant based on the comprehensive assessment that shall:

(a)—(b) (text unchanged)

[(3)] (4) [A] Include a discharge plan, which includes written recommendations to assist the participant with continued recovery efforts, as well as appropriate referral services.

E. Ambulatory withdrawal management service shall:

(1) Be delivered through an OHCQ certified or licensed substance use disorder treatment provider;

(2) Include the following services as medically necessary:

(a) Administration and monitoring of medication, including administration and monitoring of psychotropic medication by qualified staff, as necessary; and

(b) Managing withdrawal symptoms;

(3) Include a participant progress note added to the participant’s record after each session.

F. Buprenorphine and other medication assisted treatment delivered by an OHCQ certified or licensed substance use disorder treatment provider that employs a DATA 2000 waived provider shall:

(1) Be delivered by a DATA 2000 waived provider;

(2) Include pharmacological interventions, including the use of FDA-approved opiate agonist and partial agonist treatment medications to provide treatment, support, and recovery to opioid-addicted participants;

(3) Include, at a minimum, medical services required to be provided by the Program that:

(a) Ensure that participants receive a dose adequate to alleviate withdrawal symptoms;

(b) Employ dose increases and behavior therapy before mandatory detoxification for participants continuing to use drugs;

(c) Establish participant dosing based on an individual need;

(d) Provide flexible dosage tapering and withdrawal management with dosage reductions at the participant’s request;

(4) Include ordering and administering non-narcotic drugs; and

(5) Include point of care presumptive drug testing that shall be:

(a) Presumptive in nature and performed at the point of care; and

(b) Capable of being read by direct optical observation only.

[E.] G. Opioid maintenance therapy service delivered through the use of methadone or buprenorphine by opioid treatment programs shall include:

[(1) A comprehensive substance use disorder assessment as described in §A of this regulation;]

[(2)] (1) (text unchanged)

[(3)] (2) The following services:

(a) (text unchanged)

(b) Point of care presumptive drug testing;

(c) Definitive drug testing when completed by a laboratory;

[(b)] (d) Substance use disorder and related counseling as recommended in the individualized treatment plan; [and]

(e) Periodic medication management; and

[(c)] (f) Ordering and administering non-narcotic drugs; [and]

(4) A discharge plan, which includes written recommendations to assist the participant with continued recovery efforts, as well as appropriate referral services[.]; and

(5) Guest dosing arrangements with other opioid treatment programs, as medically necessary.

[F.] H. [Buprenorphine] Medication assisted treatment induction service delivered by opioid treatment programs shall include the following services, as medically necessary:

[(1) A comprehensive substance use disorder assessment as described in §A of this regulation; and

(2) The following services as clinically indicated:]

[(a)] (1) Pharmacological interventions, including the use of one of the following FDA-approved opiate agonist and partial agonist treatment medications to provide treatment, support, and recovery to opioid-addicted participants[;]:

(a) Buprenorphine; or

(b) Methadone;

[(b)] (2[(c)] (3) (text unchanged)

[G. Buprenorphine maintenance therapy delivered by an opioid treatment program shall include:

(1) An individualized treatment plan that shall be reviewed and approved by a licensed physician or licensed practitioner of the healing arts, within the scope of his or her practice under State law;

(2) The following services as clinically indicated:

(a) Pharmacological interventions, including the use of FDA-approved opiate agonist and partial agonist treatment medications to provide treatment, support, and recovery to opioid-addicted participants;

(b) Substance use disorder and related counseling as recommended in the individualized treatment plan;

(c) Medical services, including, but not limited to, those required to be provided by the Program that:

(i) Ensure that participants receive a dose adequate to alleviate withdrawal symptoms;

(ii) Employ dose increases and behavior therapy before mandatory detoxification for participants continuing to use drugs;

(iii) Establish participant dosing on an individual need;

(iv) Provide flexible dosage tapering at the participant’s request; and

(v) Include a withdrawal management plan with dosage reductions; and

(d) Ordering and administering non-narcotic drugs; and

(3) A discharge plan, which includes written recommendations to assist the participant with continued recovery efforts, as well as appropriate referral services.

H. Ambulatory withdrawal management service shall include:

(1) A comprehensive substance use disorder assessment as described in §A of this regulation;

(2) The following services as clinically indicated:

(a) Administration and monitoring of medication, including administration and monitoring of psychotropic medication by qualified staff, as necessary; and

(b) Managing withdrawal symptoms; and

(3) A participant progress note added to the participant’s record after each session.]

.06 Limitations.

A. (text unchanged)

B. Providers may not be reimbursed by the Program for:

(1)—(4) (text unchanged)

(5) Level 1 group or individual counseling during the same week as a Level 2.1 Intensive Outpatient treatment[,] or Level 2.5 Partial Hospitalization[, Buprenorphine Induction, or Buprenorphine Maintenance Therapy] service unless the participant has been discharged from or admitted to a new level of care[:];

(6) (text unchanged)

[(7) Opioid maintenance therapy delivered by an opioid treatment program during the same week as a Level 1 group or individual counseling session, Level 2.1 Intensive Outpatient treatment or Level 2.5 Partial Hospitalization;]

(7) Level 1 group or individual counseling during the same week as Level 1 group or individual counseling offered by another provider;

(8) (text unchanged)

[(9) Buprenorphine induction delivered by an opioid treatment program during the same week as a Level 1 group or individual counseling session, Level 2.1 Intensive Outpatient treatment, Level 2.5 Partial Hospitalization or Opioid Maintenance Therapy;]

[(10)] (9) Buprenorphine maintenance therapy delivered by an opioid treatment program, an OHCQ certified, or a licensed substance use disorder treatment provider during the same week as [a Level 1 group or individual counseling session, Level 2.1 Intensive Outpatient treatment, Level 2.5 Partial Hospitalization or Opioid] Methadone Maintenance Therapy;

[(11)] (10) Ambulatory withdrawal management during the same week as [an opioid maintenance therapy, buprenorphine induction, or buprenorphine maintenance] services delivered by an opioid treatment program;

[(12)] (11) (text unchanged)

[(13)] (12) Services delivered by federally qualified health centers other than those billed using T-codes that may include the following delivered by two separate appropriately licensed providers:

(a) One T-code for mental health services per day with associated mental health procedure code; and

(b) One T-code for substance use disorder services with associated H-code per day;

[(14)] (13) Services rendered but not appropriately documented to the level of service;

[(15)] (14)—[(18)] (17) (text unchanged)

C.—E. (text unchanged)

F. The Department shall pay participating opioid treatment programs, per participant, per week provided the participant received ongoing opioid treatment medications and at least one face-to-face documented treatment service in the [week] month for which the Program is billed.

G. In order for an opioid treatment program to bill for [buprenorphine] medication assisted treatment induction, the provider shall bill this service only in the first week of treatment per participant or in the first week of treatment after a break from treatment of at least 6 months.

H.—I. (text unchanged)

J. All drug screening lab claims submitted to the ASO by providers other than opioid treatment programs shall list the applicable substance use disorder diagnosis.

.08 Payment Procedures.

A.—C. (text unchanged)

D. [Rates] Effective July 1, 2016, rates for the services outlined in this regulation shall be as follows:

(1) For services outlined in this regulation, as delivered through an OHCQ certified or licensed substance use disorder treatment provider:

[(1)] (a) Comprehensive substance use disorder assessment — [$142] $144.82;

[(2)] (b) Level 1 group substance use disorder counseling — [$39] $39.78 per session;

[(3)] (c) Level 1 individual substance use disorder counseling — [$20] $20.40 per 15-minute increment with a maximum of six 15-minute increments per day;

[(4)] (d) Level [2.5] 2.1 Intensive Outpatient treatment — [$125] $127.50 per diem;

[(5)] (e) Level 2.5 Partial Hospitalization half day session — [$130] $132.60 per diem;

[(6)] (f) Level 2.5 Partial Hospitalization full day session — [$210] $214.20 per diem;

[(7) Opioid Maintenance Therapy — $80 per participant per week;

(8) Buprenorphine Induction — $200 per participant per week;

(9) Buprenorphine Maintenance Therapy — $75 per participant per week; and]

[(10)] (g) Ambulatory Withdrawal Management — [$70] $71.40 per diem[.];

(h) Point of care presumptive drug test — $11.81 per test; and

(i) Buprenorphine and other medication assisted treatment through office based evaluation and management visits, according to COMAR 10.09.02.07D.

(2) For services outlined in this regulation as delivered through an opioid treatment program