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10.09.37.00.htm 10.09.37.00. Title 10 MARYLAND DEPARTMENT OF HEALTH Subtitle 09 MEDICAL CARE PROGRAMS Chapter 37 Family Planning Program Eligibility Authority: Health-General Article, §2-104(b) and 15-103(a) Annotated Code of Maryland
10.09.37.01.htm 10.09.37.01. 01 Purpose and Scope.. This chapter governs the determination of eligibility for the Family Planning Program..
10.09.37.02.htm 10.09.37.02. 02 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) Applicant.. a) "Applicant" means a woman whose written, signed application for the Family Planning Program has been submitted to the Department but has not received final action.b) “Applicant” includes a non-pregnant woman whose application is submitted through an authorized representative.2) "Application" means the filing of a written and signed application form
10.09.37.03.htm 10.09.37.03. 03 Eligibility for Family Planning Program Coverage.. A. In order to be determined eligible for benefits under the Family Planning Program, an applicant:. 1) Shall:. a) Have a household income that does not exceed 200 percent of the federal poverty level;. b) Meet the following requirements:. i) Citizenship requirements in COMAR 10.09.24.05;. ii) Identity requirements in COMAR 10.09.24.05-1A―F and H; and. iii) Residency requirements in COMAR 10.09.24.05-3; and.
10.09.37.04.htm 10.09.37.04. 04 Application.. A. The Department shall:. 1) Determine initial and continuing eligibility;. 2) Give oral or written information about the eligibility requirements, coverage, scope and related services of the Family Planning Program, and a woman’s rights and obligations under the Family Planning Program, to any individual requesting this information;3) Give a woman requesting Family Planning Program coverage the opportunity to apply; and.
10.09.37.05.htm 10.09.37.05. 05 Consideration of Family Income.. A. In determining an applicant’s financial eligibility for the Family Planning Program for applicants 19 years old or older and for married applicants younger than 19 years old, the income of the following individuals shall be considered:1) Applicant; and. 2) Spouse, if living in the home;. B. In determining an applicant’s financial eligibility for the Family Planning Program, income is not considered for:
10.09.37.06.htm 10.09.37.06. 06 Consideration of Family Income: Earned and Unearned Income.. A. This regulation contains the rules for considering earned and unearned income for the current period under consideration.B. The applicant shall report all income. When there is evidence of regular expenditures which are inconsistent with reported income, the applicant shall be required to offer an explanation and appropriate verification to reconcile the inconsistency.
10.09.37.07.htm 10.09.37.07. 07 Consideration of Family Income: Income Disregards.. A. Income Disregards. The following disregards shall be deducted, in the following order, from the countable gross income:1) $90 monthly for each employed member of the unit whether working full-time or part-time;. 2) A disregard of 1/2 of the gross income amount for the following types of income:. a) Profit from self-employment income, unless an applicant or recipient can document a cost to produce in excess of the disre
10.09.37.08.htm 10.09.37.08. 08 Determining Financial Eligibility.. An applicant is financially eligible for the Family Planning Program if the applicant's countable net family income as determined under Regulations .05, .06 and .07 of this chapter does not exceed 200 percent of the federal poverty level.
10.09.37.09.htm 10.09.37.09. 09 Certification Periods.. A. For a recipient, certification for initial eligibility begins not sooner than the first day of the month of application.B. A recipient’s eligibility under Regulation .03 of this chapter will end as of the:. 1) End of a 12 month certification period;. 2) Date eligibility is determined in another Medicaid coverage group;. 3) Date the Department receives notice of permanent sterilization of a recipient;.
10.09.37.10.htm 10.09.37.10. 10 Covered Services.. A Family Planning Program recipient shall be entitled to services as stated in COMAR 10.09.58..
10.09.37.11.htm 10.09.37.11. 11 Post–Eligibility Requirements.. A. The Department shall inform the applicant of the applicant’s legal rights and obligations and give the applicant written notification of the following:1) For an eligible woman:. a) A finding of eligibility;. b) The beginning and ending dates for coverage; and. c) The right to request a hearing; and. 2) For an ineligible woman:. a) A finding of ineligibility;. b) The reason for the finding;. c) The regulation supporting the finding; and.
10.09.37.12.htm 10.09.37.12. 12 Hearings.. The procedures for the Program granting a hearing to an applicant or a recipient and the status of benefits pending a hearing are set forth in COMAR 10.01.04.
10.09.37.13.htm 10.09.37.13. 13 Fraud and Abuse.. The requirements relating to fraud and abuse under COMAR 10.09.24.14 and COMAR 10.09.24.14-1 shall apply to this chapter.
10.09.37.14.htm 10.09.37.14. 14 Adjustments and Recoveries.. The requirements relating to adjustments and recoveries under COMAR 10.09.24.15, excluding COMAR 10.09.24.15A(2)3) and COMAR 10.09.24.15A(3) shall apply to this chapter.
10.09.37.15.htm 10.09.37.15. 15 Interpretive Regulation.. State regulations shall be interpreted in conformity with applicable federal statutes and regulations.
10.09.37.9999.htm 10.09.37.9999. Administrative History Effective date:. Regulations .01―15 adopted as an emergency provision effective January 1, 2012 (39:2 Md. R. 139) adopted permanently effective June 11, 2012 (39:11 Md. R. 686) ―Chapter revised effective January 6, 2014 (40:26 Md. R. 2163).
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