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10.09.27.00.htm 10.09.27.00. Title 10 MARYLAND DEPARTMENT OF HEALTH Subtitle 09 MEDICAL CARE PROGRAMS Chapter 27 Home Care for Disabled Children Under a Model Waiver Authority: Health-General Article, §2-104(b) 15-103, and 15-105, Annotated Code of Maryland
10.09.27.01.htm 10.09.27.01. 01 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) "Certified nursing assistant" means an individual who:. a) Is certified by the Maryland Board of Nursing; and. b) Performs nursing tasks delegated by a registered nurse or licensed practical nurse pursuant to Health Occupations Article, Title 8, Annotated Code of Maryland.2) "Department" means the Maryland Department of Health as defined in COMAR 10.09.36..
10.09.27.02.htm 10.09.27.02. 02 Licensing Requirements.. Providers shall meet all licensing requirements specified in COMAR 10.09.36..
10.09.27.03.htm 10.09.27.03. 03 Conditions for Participation.. A. General requirements for participation in the Medical Assistance Program are that providers shall meet all conditions for participation specified in COMAR 10.09.36.B. Specific requirements for participation in the Program as a provider of home care services are as follows:1) The home care case management provider shall:. a) Have a written agreement with each participant which includes the following:. i) A description of the t
10.09.27.04.htm 10.09.27.04. 04 Covered Services.. A. The Program reimburses for home care services which include the following:. 1) Shift nursing services provided by a licensed registered nurse or a licensed practical nurse if:. a) The complexity of the service or the condition of a participant requires the judgment, knowledge, and skills of a licensed nurse for a shift of 4 or more continuous hours;b) The services are delivered to the participant in the participant's home or other setting when nor
10.09.27.05.htm 10.09.27.05. 05 Participant Eligibility.. A. Requirements. Model waiver participants shall meets the financial eligibility requirements under §B, C, or D of this regulation and the nonfinancial requirements of §E and F of this regulation.B. Categorically needy eligibility recipients of supplemental security income benefits under Title XVI of the Social Security Act are eligible for medical assistance benefits as categorically needy individuals as specified in COMAR 10.09.24.
10.09.27.06.htm 10.09.27.06. 06 Payment Procedures.. A. Request for Payment.. 1) Payment procedures as set forth in COMAR 10.09.36 apply.. 2) Requests for payment shall include all units of service, as specified in §C of this regulation.. 3) The nursing provider shall bill the Program the provider’s customary charge to the general public.4) Home care case management providers shall bill the Program as specified in §C(2) of this regulation.5) The principal physician provider shall bill the
10.09.27.07.htm 10.09.27.07. 07 Recovery and Reimbursement.. Recovery and reimbursement shall be as specified in COMAR 10.09.36..
10.09.27.08.htm 10.09.27.08. 08 Cause for Suspension or Removal and Imposition of Sanctions.. Cause for suspension or removal and imposition of sanctions shall be as specified in COMAR 10.09.36..
10.09.27.09.htm 10.09.27.09. 09 Appeal Procedures.. Appeal procedures shall be as specified in COMAR 10.09.36..
10.09.27.10.htm 10.09.27.10. 10 Interpretive Regulation.. State regulations shall be interpreted as specified in COMAR 10.09.36..
10.09.27.9999.htm 10.09.27.9999. Administrative History Effective date:. Regulations .01―10 adopted as an emergency provision effective May 10, 1985 (12:11 Md. R. 1041) emergency status extended at 12:19 Md. R. 1843 and 13:6 Md. R. 669; adopted permanently effective March 10, 1986 (13:5 Md. R. 543)Regulations .01―10 amended as an emergency provision effective March 11, 1991 (18:7 Md. R. 765) amended permanently effective July 1, 1991 (18:12 Md. Regulation .01B amended effective July 1, 1989 (16:12 Md. R. 1336).
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