10.09.88.01

.01 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) “CMS” means Centers for Medicare and Medicaid Services.

(2) “Department” means the Maryland Department of Health.

(3) “Mammography” means the radiographic examination of the soft tissues of the breast.

(4) “Medical Assistance Program” means the program of comprehensive medical and other health-related care for indigent and medically indigent persons.

(5) “Medically necessary” means medically necessary as defined in COMAR 10.09.36.01.

(6) "Medicare" means the insurance program administered by the federal government under Title XVIII of the Social Security Act, 42 U.S.C. §1395 et seq.

(7) “NPI” means National Provider Identifier.

(8) “Program” means the Medical Assistance Program.

(9) “Portable X-ray provider” means an entity that moves its portable X-ray equipment that is separate from and unattached to the vehicle to a fixed location (e.g. a physician’s office or nursing home).

(10) "Provider" means:

(a) An individual, association, partnership, corporation, unincorporated group, or any other person authorized, licensed, or certified to provide services for Program recipients and who, through appropriate agreement with the Department, has been identified as a Program provider by the issuance of an individual account number;

(b) An agent, employee, or related party of a person identified in §B(10)(a) of this regulation; or

(c) An individual or any other person with an ownership interest in a person identified in §B(10)(a) of this regulation.

(11) "Recipient" means an individual who is certified as eligible for, and is receiving, Medical Assistance benefits.