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10.48.01.00.htm 10.48.01.00. Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE Subtitle 48 CHILD ABUSE AND NEGLECT MEDICAL REIMBURSEMENT PROGRAM Chapter 01 Services Authority: Family Law Article, §5-701―5-910, Annotated Code of Maryland
10.48.01.01.htm 10.48.01.01. 01 Scope.. This chapter:. A. Defines the emergency medical treatment and the limitations on this treatment paid for by the Department for the victims of child abuse and neglect;B. Defines provider license requirements and conditions for participation, payment, and reimbursement provisions; andC. Establishes appeal procedures..
10.48.01.02.htm 10.48.01.02. 02 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) "Abuse" means:. a) The physical or mental injury of a child by any parent or other person who has permanent or temporary care or custody or responsibility for supervision of a child, or by any household or family member, under circumstances that indicate that the child's health or welfare is harmed or at substantial risk of being harmed; or
10.48.01.03.htm 10.48.01.03. 03 License Requirements.. A. A doctor of medicine shall be licensed and legally authorized to practice medicine and surgery in Maryland.B. A hospital shall be licensed by the Department as a hospital, pursuant to Hospital and Related Institutions subtitle, Health-General Article, Title 19, Subtitle 3, Annotated Code of Maryland, and shall obtain other licenses as may be required by applicable State and local laws.
10.48.01.04.htm 10.48.01.04. 04 Conditions for Participation.. A. To be reimbursed by the Program, the provider shall:. 1) Accept payment by the Program as payment in full for the services rendered to an eligible child and make no additional charge to any person for covered services;2) Agree that if the Program denies payment or requests repayment on the basis that an otherwise covered service was not medically necessary, the provider may not seek payment for that service from the child or child's parent
10.48.01.05.htm 10.48.01.05. 05 Covered Services.. The Program covers emergency medical treatment rendered to children who are alleged victims of abuse or neglect. This treatment includes:A. Medical or surgical care rendered by a physician or health care institution; and. B. Diagnostic tests..
10.48.01.06.htm 10.48.01.06. 06 Limitations.. The Program does not cover the following:. A. Nonemergency outpatient treatment;. B. Periodic nonemergency health care;. C. Services which are investigational or experimental; or. D. Services related to the assessment and treatment of mental injury..
10.48.01.07.htm 10.48.01.07. 07 Payment Procedures.. A. The provider shall submit the request for payment on the appropriate Medical Assistance Program invoice form.B. The Department reserves the right to return to the provider, before payment, all invoices not properly signed, completed, and accompanied by properly completed forms required by the Department.C. Providers shall charge the Program their usual and customary charge to the general public for similar services.D. The fee schedule for c
10.48.01.08.htm 10.48.01.08. 08 Recovery and Reimbursement.. A. The child's parent or guardian is liable to the Department of Health and Mental Hygiene for all payments made on behalf of the child by this Program.B. The child's parent or guardian shall take any steps necessary to secure health benefits available for the child from a public or private benefit program.C. Upon notification to the provider that the child has insurance or other coverage for services covered by this chapter, the
10.48.01.09.htm 10.48.01.09. 09 Appeal Procedures.. A. Providers filing appeals from administrative decisions made in connection with these regulations shall do so according to State Government Article, Title 10, Subtitle 2, and Health-General Article, 2-201-2-207, Annotated Code of Maryland.B. Appeals shall be filed within 30 days of receipt of notice of administrative decisions..
10.48.01.10.htm 10.48.01.10. 10 Funding Availability.. Payment under this chapter is contingent on the availability of funds in accordance with State Finance and Procurement Article, 7-234 and 7-235, Annotated Code of Maryland.
10.48.01.9999.htm 10.48.01.9999. Administrative History Effective date: March 10, 1986 (13:5 Md. R. 546) ―. Chapter revised effective October 20, 1997 (24:21 Md. R. 1450). Regulation .07D amended effective February 27, 2017 (44:4 Md. R. 252).
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