10.45.05.02

.02 Qualification under Health-General Article, §19-2101(c)(1), Annotated Code of Maryland — Primary Health Care Services.

A. Criteria. To qualify as a community health resource pursuant to this regulation and Health-General Article, §19-2101(c)(1), Annotated Code of Maryland, a person shall demonstrate that the person:

(1) Is a nonprofit or for-profit health care center or program;

(2) Provides primary health care services:

(a) In accordance with a sliding scale fee schedule payment policy that is consistent with the guidelines set forth in Regulation .05 of this chapter;

(b) Without regard to an individual's ability to pay; and

(c) Primarily to Maryland residents from service sites located within the State; and

(3) Provides medical care to address a patient's general health needs, including:

(a) Promotion and maintenance of the patient's health;

(b) Treatment of illness;

(c) Prevention of disease;

(d) Maintenance of the patient's health records; and

(e) Making referrals for medically necessary and appropriate specialty care services.

B. Submission Requirements. To demonstrate qualification as a community health resource under this regulation, a person shall submit, on or before the date and time specified by the Commission, the information and documentation that the person meets the criteria set forth in §A of this regulation, including:

(1) A written statement that includes the applicant's name, the addresses of all its service locations, and a description of how the applicant meets the requirements of §A of this regulation;

(2) A copy of the applicant's written procedures for consistent application of the applicant's policies concerning:

(a) Uncompensated care;

(b) Its sliding scale fee schedule, consistent with the requirements of Regulation .05 of this chapter; and

(c) Provision of services regardless of a patient's ability to pay;

(3) A list of services offered by the applicant;

(4) A calculation of the proportion of patients served by the applicant who are Maryland residents;

(5) An explanation of how the services offered by the applicant are provided, specifying practitioners' licensure categories, such as physician, nurse-practitioner, or other; and

(6) Upon the Commission's request, any additional information the Commission requires to complete its determination.

C. The Commission shall determine that a person does not qualify as a community health resource pursuant to this regulation if:

(1) Unless COMAR 10.45.08.01G applies, the person does not submit to the Commission, on or before the date and time specified by the Commission, the documentation required by §B of this regulation;

(2) The Commission requests additional information or materials pursuant to COMAR 10.45.08.01G, and:

(a) The person does not submit the information or materials requested by the Commission within the time allowed; or

(b) The additional information and material submitted by the person do not establish the person's qualification as a community health resource; or

(3) The Commission determines that the person does not meet the qualification criteria specified in §A of this regulation.