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10.22.20.00.htm 10.22.20.00. Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE Subtitle 22 DEVELOPMENTAL DISABILITIES Chapter 20 Organized Health Care Delivery Systems Authority: Health-General Article, §7-904, Annotated Code of Maryland
10.22.20.01.htm 10.22.20.01. 01 Purpose.. The purpose of this chapter is to set forth the designation process and requirements for Organized Health Care Delivery Systems (OHCDS) Entities with this designation may subcontract with Medicaid and Non-Medicaid providers to allow individuals to receive services approved in their Individual Plans in the manner which best suits their needs and results in the more complete fulfillment of their plans.
10.22.20.02.htm 10.22.20.02. 02 Scope.. This chapter establishes the:. A. Methodology that the Department shall use in the designation of entities as Organized Health Care Delivery Systems; andB. Requirements to be fulfilled by Organized Health Care Delivery Systems..
10.22.20.03.htm 10.22.20.03. 03 Additional Regulatory Compliance.. In addition to this chapter, a person who becomes an Organized Health Care Delivery System shall comply with the following regulations, as applicable:A. COMAR 10.22.01―10;. B. COMAR 10.22.17;. C. COMAR 10.22.18; and. D. COMAR 10.09.26..
10.22.20.04.htm 10.22.20.04. 04 Definitions.. A. In addition to the definitions set forth in COMAR 10.22.01, in this chapter, the following terms have the meanings indicated.B. Terms Defined.. 1) "Administration" means the Developmental Disabilities Administration.. 2) "Organized Health Care Delivery System (OHCDS) means, under 42 CFR §447.10, a public or private organization for delivering health services that provides at least one Medicaid service directly and utilizes its own employee
10.22.20.05.htm 10.22.20.05. 05 Designation as an OHCDS.. The Administration shall designate a provider who applies to be an OHCDS if the provider entity:. A. Submits an application on a form approved by the Administration;. B. Is licensed by the Administration to provide one of the following services:. 1) Community supported living arrangements;. 2) Family and individual support services;. 3) Day services;. 4) Supported employment services;. 5) Residential services; and. 6) Other services as applicable;.
10.22.20.06.htm 10.22.20.06. 06 OHCDS Requirements.. An OHCDS may either provide services itself or subcontract with another entity, and shall:. A. Ensure that services provided are consistent with the consumer's Individual Plan and are detailed in the payment agreement with the Administration;B. Submit reports and comply with record keeping in accordance with Health-General Article, §7-306.1 and 7-910, Annotated Code of Maryland; andC. Submit claims for Federal Financial Participation monthly or on an alter
10.22.20.07.htm 10.22.20.07. 07 OHCDS Subcontracting Requirements.. When subcontracting, the OHCDS shall:. A. Ensure that the providers of service meet all applicable provider qualifications set forth in COMAR 10.22 and 10.09.26, and any applicable industry or regulatory standards;B. Enter into a subcontract with each provider of service that:. 1) Contains the scope, frequency, duration, and cost of the services to be provided;. 2) Documents the qualifications of the provider of service;.
10.22.20.08.htm 10.22.20.08. 08 Freedom of Choice of Providers.. This chapter does not infringe on an individual's right to choose freely among qualified providers at any time.
10.22.20.09.htm 10.22.20.09. 09 Termination of Designation.. The Administration may terminate OHCDS designation as set forth in COMAR 10.22.03.06 and 10.22.03.07.
10.22.20.9999.htm 10.22.20.9999. Administrative History Effective date:. Regulations .01―09 adopted as an emergency provision effective June 1, 2004 (31:16 Md. R. 1252) adopted permanently effective September 27, 2004 (31:19 Md. R. 1432)
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