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10.09.32.00.htm 10.09.32.00. Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE Subtitle 09 MEDICAL CARE PROGRAMS Chapter 32 Targeted Case Management for HIV-Infected Individuals Authority: Health-General Article, §2-104(b) 15-103, and 15-105, Annotated Code of Maryland
10.09.32.01.htm 10.09.32.01. 01 Definitions.. A. The following terms have the meanings indicated.. B. Terms Defined.. 1) "Case management" means services which will assist participants in gaining access to the full range of Medical Assistance services, as well as to any additional needed medical, social, housing, financial, counseling, and other support services.2) “Case manager” means a physician, nurse, or social worker (refer to Regulation .02 of this chapter) employed by the HIV ongoing case management pro
10.09.32.02.htm 10.09.32.02. 02 Licensing Requirements.. A. Registered nurses participating in targeted case management for HIV-infected individuals shall be licensed pursuant to Health Occupations Article, Title 7, Annotated Code of Maryland, or pursuant to comparable licensing requirements of the jurisdiction in which services are rendered.B. Social workers participating in targeted case management for HIV-infected individuals shall be licensed pursuant to Health Occupations Article, Tit
10.09.32.03.htm 10.09.32.03. 03 Conditions for Participation.. A. General requirements for participation in the Medical Assistance Program are that providers shall meet all the conditions for participation as set forth in COMAR 10.09.36.03.B. Specific requirements for participation in the Program as a provider of services covered under this chapter are that the provider shall maintain a record on each participant which meets the Program’s requirements and which includes:
10.09.32.04.htm 10.09.32.04. 04 Covered Services.. The Program covers the following services when they have been documented as medically necessary:. A. HIV Diagnostic Evaluation Services.. 1) These services shall include, as a unit of service, performance of a bio-psychosocial assessment and development or revision of a recommended plan of care, as well as all other necessary covered services described in §A(2) of this regulation.2) A bio-psychosocial assessment shall be completed within 6 weeks of the p
10.09.32.05.htm 10.09.32.05. 05 Limitations.. A. HIV-targeted case management shall be advisory in nature.. B. A restriction may not be placed on qualified recipients' option to receive HIV case management services.C. HIV-targeted case management does not restrict or otherwise affect:. 1) Eligibility for Title XIX benefits or other available benefits or programs;. 2) The freedom of a recipient to select from all available services for which the individual is found to be eligible; or
10.09.32.06.htm 10.09.32.06. 06 Payment Procedures.. A. Request for Payment.. 1) Requests for payment of HIV-targeted case management services rendered shall be submitted by an approved provider according to procedures as set forth in COMAR 10.09.36.04.2) Requests for payment shall be submitted on the invoice form specified by the Department. The completed form shall indicate the:a) Date or dates of service;. b) Participant's name and Medical Assistance number;.
10.09.32.07.htm 10.09.32.07. 07 Recovery and Reimbursement.. Recovery and reimbursement shall be as set forth in COMAR 10.09.36.07..
10.09.32.08.htm 10.09.32.08. 08 Cause for Suspension or Removal and Imposition of Sanctions.. Cause for suspension or removal and imposition of sanctions shall be as set forth in COMAR 10.09.36.08.
10.09.32.09.htm 10.09.32.09. 09 Appeal Procedures.. Appeal procedures shall be as set forth in COMAR 10.09.36.09..
10.09.32.10.htm 10.09.32.10. 10 Interpretive Regulation.. State regulations shall be interpreted as set forth in COMAR 10.09.36.10..
10.09.32.9999.htm 10.09.32.9999. Administrative History Effective date: July 11, 1988 (15:14 Md. R. 1655). Regulations .01―06 amended as an emergency provision effective December 26, 1988 (15:27 Md. R. 3123) adopted permanently effective April 25, 1989 (16:7 Md. R. 811)Regulations .01―06 amended as an emergency provision effective August 28, 1990 (17:19 Md. R. 2318) emergency status expired November 11, 1990; amended permanently effective November 26, 1990 (17:23 Md. R. 2732)Regulation .06B amended a
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