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10.09.07.00.htm 10.09.07.00. Title 10 MARYLAND DEPARTMENT OF HEALTH Subtitle 09 MEDICAL CARE PROGRAMS Chapter 07 Medical Day Care Services Authority: Health-General Article, §2-104(b) 15-103, 15-105, and 15-111, Annotated Code of Maryland
10.09.07.01.htm 10.09.07.01. 01 Definitions.. A. The following terms have the meanings indicated.. B. Terms Defined.. 1) “Adult Day Care Assessment and Planning System (ADCAPS) means a system that is comprised of a comprehensive assessment completed by a registered nurse, which is designed to evaluate the participant’s strengths and needs, and to facilitate the development of a problem list, service plan, and plan of care.2) "Adult Evaluation and Review Services (AERS) means an entity within the
10.09.07.02.htm 10.09.07.02. 02 Licensing Requirements.. The provider shall be licensed under COMAR 10.12.04..
10.09.07.03.htm 10.09.07.03. 03 Conditions for Participation.. Requirements for providing medical day care services are that the providers shall:. A. Meet the licensure requirements as provided in Regulation .02 of this chapter;. B. Meet the requirements of COMAR 10.09.36;. C. Be open to participants at least 6 hours a day, 5 days a week, and post hours of operation;. D. Verify the licenses and credentials for all professionals employed by or contracting with the medical day care center;
10.09.07.04.htm 10.09.07.04. 04 Staffing Requirements.. A. The medical day care center shall have adequate staffing capability to monitor the participants at all times. The composition of the staff depends in part on the needs of the participants and on the number of participants the medical day care center serves. At a minimum, the medical day care center shall meet the requirements of COMAR 10.12.04.14.B. The medical day care center shall also have:. 1) A full-time or part-time licensed social worker
10.09.07.05.htm 10.09.07.05. 05 Covered Services.. A. The Program reimburses for a day of care which includes the following services:. 1) Health care services supervised by the director, medical director, or health director, which emphasize primary prevention, early diagnosis and treatment, rehabilitation and continuity of care, including the following:a) Participation in the development of the individual participant's plan of care;. b) Participation in the determination of the participant's medical, psychos
10.09.07.06.htm 10.09.07.06. 06 Limitations.. A. Medical day care services are not covered for:. 1) Individuals who do not meet the definition of "participant" in Regulation .01B of this chapter; and2) Individuals younger than 16 years old.. B. Covered services do not include:. 1) Days of service in excess of the frequency specified in the participant’s home and community based services waiver service plan;2) Services which are not part of those services listed in Regulation .05 of this chapter;.
10.09.07.07.htm 10.09.07.07. 07 Authorization Requirements.. The provider is entitled to reimbursement from the Program when:. A. The participant is enrolled in a home and community based services waiver; and. B. The service is specified in the participant’s home and community based services waiver service plan.
10.09.07.08.htm 10.09.07.08. 08 Payment Procedures.. A. Requests for Payment.. 1) All requests for payment of services rendered shall be submitted in accordance with COMAR 10.09.36.2) Billing time limitations for claims submitted pursuant to this chapter are set forth in COMAR 10.09.36.B. Payment to a provider shall be limited to the number of days each participant attends the medical day care center, as authorized by a participant’s home and community based services waiver service C. Payment shall be made
10.09.07.09.htm 10.09.07.09. 09 Recovery and Reimbursement.. Recovery and reimbursement shall be in accordance with COMAR 10.09.36..
10.09.07.10.htm 10.09.07.10. 10 Cause for Suspension or Removal and Imposition of Sanctions.. Cause for suspension or removal and imposition of sanctions shall be in accordance with COMAR 10.09.36.
10.09.07.11.htm 10.09.07.11. 11 Appeal Procedures.. Appeal procedures shall be in accordance with COMAR 10.09.36..
10.09.07.12.htm 10.09.07.12. 12 Interpretive Regulation.. State regulations shall be interpreted in accordance with COMAR 10.09.36..
10.09.07.9999.htm 10.09.07.9999. Administrative History Effective date: January 1, 1980 (6:26 Md. R. 2073). Regulations .03B, C and .07D amended effective March 10, 1986 (13:5 Md. R. 543). Regulation .03D adopted effective January 6, 1983 (9:26 Md. R. 2572). Regulation .03E adopted and .07A amended effective January 30, 1984 (11:2 Md. R. 113). Regulation .07A amended effective June 3, 1985 (12:11 Md. R. 1049). Regulation .07F amended as an emergency provision effective July 1, 1983 (10:12 Md. R. 1070) adopted
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