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

14 records match your request.

FileAbstract
10.09.35.00.htm 10.09.35.00. Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE Subtitle 09 MEDICAL CARE PROGRAMS Chapter 35 Hospice Care Authority: Health-General Article, §2-104(b) 15-103, and 15-105, Annotated Code of Maryland
10.09.35.01.htm 10.09.35.01. 01 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) "Attending physician" means:. a) A doctor of medicine or osteopathy legally authorized to practice medicine and surgery by the State; orb) A nurse practitioner who meets the qualifications set forth in COMAR 10.27.07.. 2) "Bereavement counseling" means counseling services provided to the participant's family after the participant's death.3) "Cap period" means the
10.09.35.02.htm 10.09.35.02. 02 Licensing Requirements.. A. In order to participate in the Program, a provider shall be licensed by the Department pursuant to Health-General Article, Title 19, Subtitle 9, Annotated Code of Maryland, or shall be legally authorized to provide hospice care in the jurisdiction in which the services are provided, and shall obtain other licenses as may be required by applicable State and local laws.B. Employees of the provider who provide hospice care services must be lice
10.09.35.03.htm 10.09.35.03. 03 Conditions of Participation.. A. General requirements for participation in the Program are that providers shall:. 1) Meet all conditions for participation as set forth in COMAR 10.09.36.03, except as otherwise specified in this regulation; and2) Ensure that the licensure requirements as provided in Regulation .02 of this chapter are met.. B. Specific requirements for participation in the Program as a hospice care provider are that the provider shall:
10.09.35.04.htm 10.09.35.04. 04 Duration of Hospice Care.. A. An individual may elect to receive hospice care during one or more of the following election periods:1) An initial 90-day period;. 2) A subsequent 90-day period; or. 3) An unlimited number of subsequent 60-day periods.. B. The periods of care indicated in §A of this regulation are available in the order listed and may be elected separately at different times.C. An election period or an extended election period shall terminate before
10.09.35.05.htm 10.09.35.05. 05 Eligibility for and Election of Hospice Care.. A. To be eligible for hospice care, written certification of terminal illness shall be obtained by the hospice for each of the election periods listed in Regulation .04 of this chapter. Procedures for certification of terminal illness are as follows:1) The hospice shall obtain the written certification before the hospice submits a claim for payment;2) If the hospice is unable to obtain written certification within 2 calend
10.09.35.06.htm 10.09.35.06. 06 Covered Services.. A. Hospice care includes the services listed in §B of this regulation when the services are:. 1) Provided to an eligible recipient who elects hospice care, in accordance with Regulation .05 of this chapter;2) Reasonable and necessary for the palliation or management of the participant's terminal illness and related conditions;3) Consistent with the plan of care established before the services are provided;. 4) Provided by appropriately qualified personnel;.
10.09.35.07.htm 10.09.35.07. 07 Limitations.. When a recipient is enrolled in Medicare Part A, Program payment for hospice care shall be limited to payment of the recipient's Medicare hospice care co-insurance amounts for drugs and biologicals and for respite care and, where applicable, room and board for residents of a nursing facility under Regulation .08E of this chapter.
10.09.35.08.htm 10.09.35.08. 08 Payment Procedures.. A. Reimbursement Principles.. 1) The Program shall pay the provider at one of four rates for each day that the participant is under the provider's care, subject to the conditions, limitations, and exceptions set forth in this chapter.2) The payment rates for providers shall be those established by the Health Care Financing Administration (HCFA) of the U.S. Department of Health and Human Services for hospice care under a Medical As3) The daily rates are pr
10.09.35.09.htm 10.09.35.09. 09 Recovery and Reimbursement.. Recovery and reimbursement shall be as set forth in COMAR 10.09.36.07..
10.09.35.10.htm 10.09.35.10. 10 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.
10.09.35.11.htm 10.09.35.11. 11 Appeal Procedures.. Appeal procedures for providers shall be as set forth in COMAR 10.09.36.09..
10.09.35.12.htm 10.09.35.12. 12 Interpretive Regulation.. State regulations shall be interpreted as set forth in COMAR 10.09.36.10..
10.09.35.9999.htm 10.09.35.9999. Administrative History Effective date: October 1, 1989 (16:16 Md. R. 1751). Regulation .08G amended as an emergency provision effective January 28, 1991 (18:3 Md. R. 301) emergency status expired April 8, 1991 (18:9 Md. R. 1004)Regulation .08G amended as an emergency provision effective April 9, 1991 (18:9 Md. R. 1005) amended permanently effective October 7, 1991 (18:18 Md. R. 2004) ―Chapter revised effective September 16, 1991 (18:18 Md. R. 2005).
<< Back | Return to Main COMAR Search Page