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10.09.13.00.htm 10.09.13.00. Title 10 MARYLAND DEPARTMENT OF HEALTH Subtitle 09 MEDICAL CARE PROGRAMS Chapter 13 Ambulance and Wheelchair Van Services Authority: Health-General Article, ยง2-104(b) 15-103, and 15-105, Annotated Code of Maryland
10.09.13.01.htm 10.09.13.01. 01 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) "Department" has the meaning stated in COMAR 10.09.36.. 2) "Medical Assistance Program" has the meaning stated in COMAR 10.09.36.. 3) "Medical Care Programs" has the meaning stated in COMAR 10.09.36.. 4) "Medicare" has the meaning stated in COMAR 10.09.36.. 5) "Program" has the meaning stated in COMAR 10.09.36.. 6) "Provider" has the meaning stated in COMAR 10.09.36..
10.09.13.02.htm 10.09.13.02. 02 Licensing Requirements.. Providers shall meet all licensing requirements as set forth in COMAR 10.09.36..
10.09.13.03.htm 10.09.13.03. 03 Conditions for Participation.. To participate in the Program, the provider shall:. A. Comply with the conditions for participation as set forth in COMAR 10.09.36;. B. Be approved as a provider of ambulance services by Medicare..
10.09.13.04.htm 10.09.13.04. 04 Covered Services.. The program covers copayment and deductible payments for Medicare-approved services to Maryland Medical Assistance recipients.
10.09.13.05.htm 10.09.13.05. 05 Limitations.. The Program does not cover any payment for service other than coinsurance and deductible as approved by Medicare.
10.09.13.06.htm 10.09.13.06. 06 Repealed..
10.09.13.07.htm 10.09.13.07. 07 Payment Procedures.. A. Payment procedures for this chapter are set forth in COMAR 10.09.36.. B. The Department will authorize payment on Medicare ambulance claims if:. 1) The provider accepts Medicare assignments;. 2) Medicare makes direct payment to the provider;. 3) The services are covered by the Program;. 4) Initial billing is made directly to Medicare according to Medicare guidelines;. 5) Medicare has determined that services were medically justified..
10.09.13.08.htm 10.09.13.08. 08 Recovery and Reimbursement.. Recovery and reimbursement for this chapter are set forth in COMAR 10.09.36..
10.09.13.09.htm 10.09.13.09. 09 Cause for Suspension or Removal and Imposition of Sanctions.. Cause for suspension or removal and imposition of sanctions for this chapter are set forth in COMAR 10.09.36.
10.09.13.10.htm 10.09.13.10. 10 Appeal Procedures.. Appeal procedures for this chapter are set forth in COMAR 10.09.36..
10.09.13.11.htm 10.09.13.11. 11 Interpretive Regulation.. The interpretive regulation for this chapter is set forth in COMAR 10.09.36..
10.09.13.9999.htm 10.09.13.9999. Administrative History Effective date: January 1, 1976 (2:29 Md. R. 1740). Chapter revised September 23, 1977 (4:20 Md. R. 1545). Regulation .01 amended effective January 23, 1989 (16:1 Md. R. 70). Regulation .01B and .05I amended, and .05J adoptedas an emergency provision effective July 17, 1990 (17:16 Md. R. 1984) adopted permanently effective November 1, 1990 (17:20 Md. R. 2427)Regulation .01C-1 adopted and D amended effective July 1, 1986 (13:13 Md. R. 1492).
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