10.09.07.06

.06 Limitations.

A. Medical day care services are not covered for:

(1) Individuals who do not meet the definition of "participant" in Regulation .01B of this chapter; and

(2) Individuals younger than 16 years old.

B. Covered services do not include:

(1) Days of service in excess of the frequency specified in the participantís home and community based services waiver service plan;

(2) Services which are not part of those services listed in Regulation .05 of this chapter;

(3) Services for a number of participants that exceeds the providerís licensed capacity on a given day;

(4) More than one day of care, per participant, per day; and

(5) A day of care provided on the same day that the following services are provided and billed to the Department:

(a) Day habilitation services under COMAR 10.09.26;

(b) Supported employment services under COMAR 10.09.26;

(c) Programs of All-Inclusive Care for the Elderly under COMAR 10.09.44;

(d) Senior center plus services under COMAR 10.09.54;

(e) Adult day care reimbursed under the State of Maryland's human service contracts; or

(f) On-site psychiatric rehabilitation services under COMAR 10.09.59.