Maryland Administrative Code

.01 Purpose and Scope. This chapter governs the determination of eligibility for the Family Planning Program.

.02 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) Applicant. (a) “Applicant” means an individual whose written, signed application for the Family Planning Program has been submitted to the Department but has not received f…

.03 Eligibility for Family Planning Program Coverage. A. In order to be determined eligible for benefits under the Family Planning Program, an applicant: (1) Shall: (a) Have a household income that does not exceed 250 percent of the federal poverty level; and (b) Meet the followi…

.03-1 Family Planning Program Presumptive Eligibility. A. Definitions. (1) In this regulation, the following terms have the meanings indicated. (2) Terms Defined. (a) “Applicant” means an individual who has applied for presumptive eligibility at a participating family planning cl…

.04 Application. For individuals not described in .03B of this chapter, application for Family Planning Program services will be conducted pursuant to the provisions of COMAR 10.09.24.04.

.05 Consideration of Income. Determination of an applicant’s income for purposes of the Family Planning Program shall be determined under the household provisions of COMAR 10.09.24.06-1 and the income provisions applicable to MAGI household units of COMAR 10.09.24.07.

.06 Determining Financial Eligibility. An applicant is financially eligible for the Family Planning Program if the applicant's MAGI household income as determined under COMAR 10.09.24.06-1 and .07 does not exceed 250 percent of the federal poverty level.

.07 Certification Periods. A. For a participant, certification for initial eligibility begins not sooner than the first day of the month of application. B. A participant’s eligibility under Regulation .03 of this chapter will end as of the: (1) End of a 12 month certification per…

.08 Covered Services. A Family Planning Program recipient shall be entitled to services as stated in COMAR 10.09.58.

.09 Post–Eligibility Requirements. Post-eligibility requirements for the Family Planning Program are set forth at COMAR 10.09.24.12.

.10 Hearings. The procedures for the Program granting a hearing to an applicant or a recipient and the status of benefits pending a hearing are set forth in COMAR 10.01.04.

.11 Fraud and Abuse. The requirements relating to fraud and abuse under COMAR 10.09.24.14 and COMAR 10.09.24.14-1 shall apply to this chapter.

.12 Adjustments and Recoveries. The requirements relating to adjustments and recoveries under COMAR 10.09.24.15, excluding COMAR 10.09.24.15A(2)—(3) and COMAR 10.09.24.15A(3), shall apply to this chapter.

.13 Interpretive Regulation. State regulations shall be interpreted in conformity with applicable federal statutes and regulations.

.01 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Department” means the Maryland Department of Health. (2) “Dietitian or nutritionist” means an individual who: (a) Meets the licensing requirements in Regulation .02D of th…

.02 Licensing Requirements. A. A certified nurse midwife providing Healthy Start services shall be: (1) Licensed as a registered nurse in the state in which services are provided; (2) Certified as a nurse midwife by the American College of Nurse-Midwives; and (3) In compliance wi…

.03 Conditions for Participation. A. General requirements for participation in the Medical Assistance Program are that providers shall: (1) Meet the licensure requirements in Regulation .02 of this chapter, and verify the licenses and credentials of all professionals employed by …

.04 Covered Services. Effective July 1, 2006, the Program shall reimburse for the following services: A. Risk Assessment — Plan of Care. (1) One unit of service is to be reimbursed for each pregnancy. (2) A risk assessment is an appraisal of the participant's medical history and …

.05 Limitations. The Healthy Start Program may not restrict or otherwise affect: A. Eligibility for benefits under Title XIX of the Social Security Act or other available benefits or programs; and B. The provider's right to bill the Program for other covered program services.

.06 Payment Procedures. A. Request for Payment. (1) Requests for payment of Healthy Start Program services rendered and completed shall be submitted by an approved provider according to procedures established by the Department. Payment requests which are not properly prepared or …

.07 Recovery and Reimbursement. Recovery and reimbursement are as set forth in COMAR 10.09.36.07.

.08 Cause for Suspension or Removal and Imposition of Sanctions. Cause for suspension or removal and imposition of sanctions are set forth in COMAR 10.09.36.08.

.09 Appeal Procedures. Appeal procedures are as set forth in COMAR 10.09.36.09.

.10 Interpretive Regulation. State regulations are interpreted as set forth in COMAR 10.09.36.10.

.01 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Birthing parent” means the participant giving birth, who is receiving doula services throughout their pregnancy, including the prenatal, labor, and postpartum periods. (2)…

.02 Certification Requirements. A provider shall be certified as described in the Professional Services Provider Manual and Fee Schedule under COMAR 10.09.02.07D. Cross References 10.09.39.03B(1)

.03 Conditions for Participation. A. General requirements for participation in the Program are that a provider shall meet all conditions for participation as set forth in COMAR 10.09.36.03. B. Specific requirements for participation in the Program as a certified doula provider re…

.04 Covered Services. A. Effective January 1, 2022, the Program covers doula services as defined in Regulation .01 of this chapter when the services: (1) Are medically necessary; (2) Are rendered during a birthing parent’s prenatal period, labor and delivery, and postpartum perio…

.05 Limitations. Doula services covered under this chapter are subject to the following limitations: A. One of the following providers shall be present while doula services are provided during the delivery: (1) An obstetrician-gynecologist; (2) A family medicine practitioner; or …

.06 Payment Procedures. A. The provider shall submit the request for payment in the format designated by the Program. B. The Program reserves the right to return to the provider, before payment, all invoices not properly signed, completed, and accompanied by properly completed fo…

.07 Recovery and Reimbursement. Recovery and reimbursement regulations are set forth in COMAR 10.09.36.07.

.08 Cause for Suspension or Removal and Imposition of Sanctions. Cause for suspension or removal and imposition of sanctions are set forth in COMAR 10.09.36.08.

.09 Appeal Procedures. Providers filing appeals from administrative decisions made in connection with these regulations shall do so according to COMAR 10.09.36.09.

.10 Interpretive Regulation. Interpretive regulatory requirements shall be as set forth in COMAR 10.09.36.10.

.11 Implementation Date. This chapter shall be implemented on January 1, 2022.

.01 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Department” means the Department as defined in COMAR 10.09.36.01. (2) “Developmental areas” means cognitive development, physical development (including fine and gross mot…

.02 Licensing Requirements. A. Social workers participating as service coordinators shall be licensed pursuant to Health Occupations Article, Title 18, Annotated Code of Maryland, or meet the social worker licensure and regulatory requirements of the state in which the services a…

.03 Conditions for Participation. A. General requirements for participation in the Program are that providers shall do the following, either directly through staff or by agreement: (1) Meet all conditions for participation as set forth in COMAR 10.09.36.03; and (2) Maintain a fil…

.04 Covered Services. A. The Program shall reimburse for the services in §§B, C, and D of this regulation, when they have been documented as necessary. B. Initial Service Coordination. (1) A unit of service is defined as a completed initial Individualized Family Service Plan (IFS…

.05 Limitations. A. Early intervention service coordination is advisory in nature. B. A restriction may not be placed on a qualified participant’s option to receive early intervention service coordination. C. Early intervention service coordination does not restrict or otherwise …

.06 Payment Procedures. A. Request for Payment. (1) Requests for payment of early intervention service coordination shall be submitted by an approved provider according to procedures established by the Department. The Department reserves the right to return to the provider, befor…

.07 Recovery and Reimbursement. Recovery and reimbursement shall be as set forth in COMAR 10.09.36.07.

.08 Cause for Suspension or Removal and Imposition of Sanctions. Cause for suspension or removal and imposition of sanctions shall be as set forth in COMAR 10.09.36.08.

.09 Appeal Procedures. Appeal Procedures shall be as set forth in COMAR 10.09.36.09.

.10 Interpretive Regulation. State regulations shall be interpreted as set forth in COMAR 10.09.36.10.

.01 Purpose. The purpose of this chapter is to increase employment opportunities by making Medical Assistance coverage available to employed individuals with disabilities who meet: A. The disability criteria under Title II or XVI of the Social Security Act; and B. The nonfinancia…

.02 Definitions. A. Applicability of COMAR 10.09.24.02 Definitions. (1) Except as provided in §A(2) of this regulation, terms used in this chapter that are not defined in §C of this regulation have the meanings stated for the same terms in COMAR 10.09.24.02. (2) If a term's defin…