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10.09.45.00.htm 10.09.45.00. Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE Subtitle 09 MEDICAL CARE PROGRAMS Chapter 45 Mental Health Case Management: Care Coordination for Adults Authority: Health-General Article, §2-104(b) 15-103, and 15-105, Annotated Code of Maryland
10.09.45.01.htm 10.09.45.01. 01 Scope.. A. This chapter applies to providers organized to deliver mental health case management services to adults.B. The purpose of mental health case management is to assist participants in gaining access to needed medical, mental health, social, educational, and other services.
10.09.45.02.htm 10.09.45.02. 02 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) "Administrative services organization (ASO) means the entity with which the Mental Hygiene Administration may contract to provide the services described in COMAR 10.09.70 for the public mental health system.2) ”Adult” means an individual 18 years and older.. 3) "Care plan" means the plan prepared according to the requirements outlined in this chapter that d
10.09.45.03.htm 10.09.45.03. 03 Participant Eligibility.. A. A recipient is eligible for mental health case management services if the recipient:. 1) Is in a federal eligibility category for Maryland Medical Assistance according to COMAR 10.09.24, which governs the determination of eligibility for the Maryland Medical Assistance Program; and2) Has a serious and persistent mental health disorder and is:. a) In, at risk of, or needs continued community treatment to prevent, inpatient psychiatric treatment;
10.09.45.04.htm 10.09.45.04. 04 Conditions for Mental Health Case Management Provider Participation.. A. The local core service agencies shall select mental health case management providers through a competitive procurement process, at least once every 5 years.B. Mental health case management services may be provided by local health departments according to COMAR 10.04.04, which allows the Director of the MHA to utilize the local health departments as vendors unless the health officer believes the service
10.09.45.05.htm 10.09.45.05. 05 Mental Health Case Management Provider Staff.. Required Staff. The mental health case management provider shall have staff that is sufficient in numbers and qualifications to provide appropriate services to the participants served and shall include, at a minimum:A. A community support specialist supervisor who:. 1) Is a mental health professional who is licensed and legally authorized to practice under the Health Occupations Article, Annotated Code of Maryland
10.09.45.06.htm 10.09.45.06. 06 Covered Services.. A. The Department shall reimburse for the services in §C―I of this regulation under mental health case management when these services have been documented, pursuant to the requirements in this chapter, as necessary.B. Case management services shall be coordinated with, and may not duplicate activities provided as part of, institutional services and discharge planning activities.C. Comprehensive Assessment and Periodic Reassessment.. 1) Assessment or reassess
10.09.45.07.htm 10.09.45.07. 07 Limitations.. A. Mental health case management services are advisory in nature.. B. A restriction may not be placed on a qualified recipient's option to receive mental health case management services.C. Mental health case management services do not restrict or otherwise affect:. 1) Eligibility for Title XIX benefits or other available benefits or programs, except as limited by §E of this regulation;2) The freedom of a participant to select from all available services for w
10.09.45.08.htm 10.09.45.08. 08 Preauthorization.. All covered services under this chapter shall be preauthorized and comply with the requirements of COMAR 10.09.70.07.
10.09.45.09.htm 10.09.45.09. 09 Payment Procedures.. A. The Program shall reimburse the provider according to the requirements in this chapter and the fees established under COMAR 10.21.25.B. Request for Payment.. 1) Requests for payment of mental health case management services shall be submitted by an approved provider according to procedures established by the Department. The Department reserves the right to return to the provider, before payment, all invoices not properly signed a2) A provider shall submi
10.09.45.10.htm 10.09.45.10. 10 Recovery and Reimbursement.. Recovery and reimbursement are as set forth in COMAR 10.09.36.07..
10.09.45.11.htm 10.09.45.11. 11 Cause for Suspension or Removal and Imposition of Sanctions.. Cause for suspension or removal and imposition of sanctions is as set forth in COMAR 10.09.36.08..
10.09.45.12.htm 10.09.45.12. 12 Appeal Procedures.. Appeal procedures are those set forth in COMAR 10.09.36.09..
10.09.45.13.htm 10.09.45.13. 13 Interpretive Regulation.. State regulations are interpreted as those set forth in COMAR 10.09.36.10..
10.09.45.9999.htm 10.09.45.9999. Administrative History Effective date: January 20, 1992 (19:1 Md. R. 32). Regulations .01―06 amended as an emergency provision effective July 1, 1992 (19:15 Md. R. 1383) amended permanently effective October 26, 1992 (19:21 Md. R. 1891)Regulations .01B and .02B amended as an emergency provision effective June 1, 1993 (20:12 Md. R. 995) adopted permanently effective September 1, 1993 (20:17 Md. R. 1346)Regulations .01 and .02 amended as an emergency provision effective Februar
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