Skip to Main Content
<< Back | Return to Main COMAR Search Page

14 records match your request.

FileAbstract
10.09.06.00.htm 10.09.06.00. Title 10 MARYLAND DEPARTMENT OF HEALTH Subtitle 09 MEDICAL CARE PROGRAMS Chapter 06 Adult Residential Substance Use Disorder Services Authority: Health-General Article, §2-104(b) 7.5-204(c) 7.5-205(d) and 15-105(b) Annotated Code of Maryland
10.09.06.01.htm 10.09.06.01. 01 Scope.. This chapter governs residential substance use disorder services for adults, effective July 1, 2017..
10.09.06.02.htm 10.09.06.02. 02 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) “30-day span of care” means a continuous stay of up to 30 days in an institution for mental disease.2) “Accrediting body” means an entity approved by the Secretary or the Secretary’s designee, under Health-General Article, §19-2302, Annotated Code of Maryland.3) “Administrative day” means a day of services rendered to a participant who no longer requires the
10.09.06.03.htm 10.09.06.03. 03 Licensure Requirements.. To participate in the Program, a provider shall:. A. Meet the license requirements stated in COMAR 10.09.36.02 and, after April 1, 2018, COMAR 10.63.01.05;B. Be accredited by a Maryland-approved accrediting body; and. C. Be licensed by the Office of Health Care Quality for each level of care..
10.09.06.04.htm 10.09.06.04. 04 Conditions for Participation.. A. A provider shall meet all conditions for participation as set forth in COMAR 10.09.36.03.. B. To participate in the Program as a residential substance use disorder provider, the provider shall:1) Be in compliance with COMAR 10.63.03 as applicable to each ASAM level of care;. 2) Be in compliance with all ASAM requirements for each applicable level of care;. 3) Demonstrate competence in the ability to deliver a minimum of three evid
10.09.06.05.htm 10.09.06.05. 05 Participant Eligibility and Referral.. A participant is eligible for substance use disorder services under this chapter if the participant:. A. Is enrolled in the Program and is not enrolled in Medicare on the day a service is rendered;. B. Meets the Department’s medical necessity criteria based on the ASAM placement criteria for each level of care; andC. Is 18 years old or older and is not receiving care from a provider under COMAR 10.09.23.04..
10.09.06.06.htm 10.09.06.06. 06 Covered Services.. A. A residential-medium intensity level 3.3 provider shall:. 1) Provide clinically managed substance use disorder treatment 20 to 35 hours per week based on a comprehensive assessment; and2) Provide services in a structured environment in combination with medium-intensity treatment and ancillary services to support and promote recovery.B. A residential, high intensity level 3.5 provider shall:. 1) Provide clinically managed substance use disord
10.09.06.07.htm 10.09.06.07. 07 Limitations.. The Program does not cover the following in a residential substance use disorder treatment facility for adults:A. Services not medically necessary;. B. ASAM Level 1 or 2 services by any provider;. C. Services not specified in Regulation .06 of this chapter;. D. Services beyond the provider’s scope of practice;. E. Investigational and experimental drugs and procedures;. F. More than two 30-day spans of care in a 12-month period;.
10.09.06.08.htm 10.09.06.08. 08 Authorization Requirements.. A. The provider shall obtain authorization from the ASO to provide residential substance use disorder services outlined in Regulation .06 of this chapter.B. The ASO agent shall authorize services that are:. 1) Medically necessary for the applicable level of service as outlined by ASAM criteria for admission; and2) Of a type, frequency, and duration that are consistent with expected results and cost-effectiveness.C. No payment shall be re
10.09.06.09.htm 10.09.06.09. 09 Payment Procedures.. A. General policies governing payment procedures that are applicable to all providers are set forth in COMAR 10.09.36.04.B. Billing time limitations for claims submitted under this chapter are set forth in COMAR 10.09.36.06.C. Effective July 1, 2017, rates for the services outlined in this chapter shall be as follows.. 1) For ASAM Level 3.3, the provider shall receive $189.44 per diem;. 2) For ASAM Level 3.5, the provider shall receive $189.44 per diem;.
10.09.06.10.htm 10.09.06.10. 10 Recovery and Reimbursement.. Recovery and reimbursement shall be as set forth in COMAR 10.09.36.07..
10.09.06.11.htm 10.09.06.11. 11 Cause for Suspension or Removal and Imposition of Sanctions.. Causes for suspension or removal and imposition of sanctions shall be as set forth in COMAR 10.09.36.08.
10.09.06.12.htm 10.09.06.12. 12 Appeals Procedures.. Appeals procedures shall be as set forth in accordance with COMAR 10.09.36.09..
10.09.06.9999.htm 10.09.06.9999. Administrative History Effective date: September 11, 2017 (44:18 Md. R. 865).
<< Back | Return to Main COMAR Search Page