Maryland Administrative Code

.08 Confidentiality. Except when communicating with the parties listed in §B of this regulation and unless otherwise authorized by law, the agent of an applicant, or the agent of a recipient, the Department: A. Shall keep all applicant and recipient personal information confident…

.09 Availability of Funding and Program Termination. A. If sufficient monies are not available to fund TAP, the Department shall take the action necessary to eliminate a deficit which may include program termination. B. If TAP is terminated, the Department shall provide benefits …

.01 Scope. A. This chapter establishes the requirements for: (1) Physician reporting of a: (a) Case of human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS); and (b) Birth of an infant whose mother has tested positive for HIV; (2) Institution reporting o…

.02 Exemptions. A. Qualifications for Exemption. A research project that meets both of the following criteria may be eligible for exemption from the HIV reporting requirements of Regulation .06 of this chapter: (1) The research project has been approved by an institutional review…

.03 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Acquired immunodeficiency syndrome (AIDS)” has the meaning stated in Health-General Article, §§18-201.1(a) and 18-202.1(b), Annotated Code of Maryland. (2) “Anonymous” mea…

.04 Physician Responsibility. A. A physician shall: (1) Report a case of HIV or AIDS or newborn HIV exposure for a patient under the physician's care to the health officer within 48 hours, by phone or in writing on a form provided by the Secretary; and (2) Include the information…

.05 Responsibilities of Clinical and Infection Control Practitioners in Institutions. A. A clinical or infection control practitioner working in an institution required to report as set forth in Health-General Article, §18-202.1, Annotated Code of Maryland, shall: (1) Report a ca…

.06 Responsibilities of Laboratory Directors. A. Except as provided in Regulations .01C and .02 of this chapter, the director of a medical laboratory shall: (1) Submit a report to the health officer for the jurisdiction where the laboratory is located, within 48 hours after an ex…

.07 Out-of-State Laboratories. An out-of-State laboratory that holds a permit to operate issued by Maryland and performs HIV detection, HIV viral load, CD4+ cell count or percentage, or HIV genotype sequence tests shall submit the report required under Regulation .06 of this chap…

.08 Responsibility of Health Officer. A. This regulation establishes requirements for follow-up by the health officer of a report of HIV or AIDS or newborn HIV exposure or laboratory report of HIV detection, HIV viral load, CD4+ cell count or percentage, or HIV genotype sequence.…

.09 Record Maintenance and Confidentiality. A. A person that submitted a report of HIV or AIDS or newborn HIV exposure shall make available to the health officer or the Secretary the information necessary to compile an HIV/AIDS case report, according to Regulations .04—.06 of thi…

.01 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Acquired Immunodeficiency Syndrome (AIDS)” means the medical condition caused by the Human Immunodeficiency Virus. (2) “Applicant” means an individual who has submitted an…

.02 Eligibility. A. Except when an individual is enrolled in Medical Assistance but does not have prescription coverage assistance, an individual who is eligible for Medical Assistance is not eligible for MADAP. B. To be eligible for benefits, an individual shall meet the followi…

.03 Application and Enrollment. A. Application. (1) Applicant. (a) An applicant shall submit a completed application to the Department on the form designated by the Department that includes: (i) Responses to all required fields and applicable questions; and (ii) Supporting docume…

.04 Changes in Eligibility and Disenrollment. A. A recipient shall notify the Department within 10 business days of a change in: (1) Availability of third-party payment for services covered under MADAP; (2) Gross household income; or (3) Address. B. If a change reported in §A of …

.05 Reconsideration and Appeal. A. An applicant or recipient who has been notified by the Department of ineligibility for or disenrollment from MADAP benefits may request reconsideration of the decision by submitting additional supporting documentation or information to the Depar…

.06 Recovery of Payments. If MADAP benefits have been incorrectly paid or another payer has been identified, the Department shall seek recovery of the amount of those payments.

.07 Fraud. The Department shall pursue cases of suspected misrepresentation or fraud pursuant to Criminal Law Article, §8-503, Annotated Code of Maryland, or any other applicable statutory provision.

.08 Confidentiality. Unless otherwise authorized by law, the Department: A. Shall keep all applicant and recipient personal information confidential; B. May not disclose personal information kept on an applicant or recipient without written consent of the: (1) Applicant; (2) Reci…

.09 Availability of Funding and Program Termination. A. If sufficient monies are not available to fund MADAP, the Department shall take the action necessary to eliminate a deficit which may include MADAP termination. B. If MADAP is terminated the Department shall provide benefits…

.01 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Acquired Immunodeficiency Syndrome (AIDS)” means the medical condition caused by the Human Immunodeficiency Virus. (2) “Department” means the Maryland Department of Health…

.02 Permit and License Requirements. A. To qualify for participation in MADAP, a pharmacy shall first obtain a permit from: (1) The State Board of Pharmacy, pursuant to Health Occupations Article, Title 12, Annotated Code of Maryland; or (2) The appropriate agency in the state in…

.03 Conditions for Participation. A. To participate in MADAP, a pharmacy shall: (1) Be enrolled in Medical Assistance, be a mail order company that accepts payments from the Department, or submit a request for exception to, and receive approval from, the Department; (2) Accept pa…

.04 Covered Services. A. The recipient shall obtain a prescription for each drug or other product ordered for the recipient. B. The Department shall pay for a prescription drug or other product not excluded from the open formulary if the prescription is ordered and signed by a he…

.04-1 Formulary. The Department shall: A. Maintain a list of drugs and other products excluded from the open formulary; and B. Make available electronically the list of drugs and other products excluded from the open formulary. Cross References 10.18.06.01B(9)

.05 Limitations on Covered Services. A. A pharmacist may not dispense more than a 100-day supply of a prescribed drug or other product. B. The Department may not pay for: (1) A drug or other product prescribed as part of a recipient’s care in a correctional institution, inpatient…

.06 Preauthorization Requirement. A pharmacist shall obtain preauthorization for each prescription or refill before dispensing a drug or other product marked as restricted.

.07 Payment Procedures. A. Except as provided in §§B and C of this regulation, the Department shall pay a pharmacy in accordance with the procedures of the Medical Assistance Pharmacy Services Program set forth at COMAR 10.09.03.07. B. If the Department or the recipient tells the…

.08 Recovery and Reimbursement. The Department shall follow the same procedures for recovery and reimbursement as the Medical Assistance Program in COMAR 10.09.03.08.

.09 Cause for Suspension or Removal and Imposition of Sanctions. A. If the Department determines that a pharmacy or the pharmacy’s employee, or both, has failed to comply with federal or State laws and regulations, the Department may: (1) Suspend the pharmacy from MADAP; (2) With…

.10 Appeal Procedures. A pharmacy filing an appeal shall do so in accordance with the Medical Assistance Program as set forth at COMAR 10.09.03.10.

.11 Confidentiality. Unless otherwise authorized by law, the Department: A. Shall keep all applicant and recipient personal information confidential; B. May not disclose personal information kept on a recipient without written consent of the: (1) Recipient; or (2) Recipient’s par…

.12 Availability of Funding and Program Termination. A. If sufficient monies are not available to fund MADAP, the Department shall take the action necessary to eliminate a deficit which may include MADAP termination. B. If MADAP is terminated, the Department shall provide benefit…

.01 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Acquired Immunodeficiency Syndrome (AIDS)” means the medical condition caused by the Human Immunodeficiency Virus. (2) “Applicant” means an individual who has submitted an…

.02 Eligibility. A. To be eligible for MADAP-Plus coverage, an individual shall be: (1) Enrolled in MADAP; and (2) Receiving or eligible to receive health insurance and prescription drug coverage. B. An individual who is eligible for employer-sponsored health insurance with a pre…

.03 Application and Enrollment. A. An applicant shall apply in the manner set forth in COMAR 10.18.05.03A. B. A recipient and the Department shall meet the enrollment responsibilities set forth in COMAR 10.18.05.03B. C. The duration of the recipient’s enrollment in MADAP-Plus may…

.04 Covered Services. A. The Department shall pay for health and prescription plan premiums with a prescription drug formulary that includes antiretroviral medications. B. Within the limits established by the Department and in accordance with policy guidance issued by the Health …

.05 Changes in Eligibility and Disenrollment. A. A recipient shall inform the Department of a change in eligibility as set forth in COMAR 10.18.05.04A. B. If a change reported in §A of this regulation results in a recipient no longer qualifying for MADAP-Plus, the Department shal…

.06 Reconsideration and Appeal. A. An applicant or recipient who has been notified by the Department of disenrollment or ineligibility for MADAP-Plus benefits may request reconsideration of the decision by submitting additional supporting documentation or information to the Depar…

.07 Payment Procedures. A. A recipient, recipient’s representative, health care provider, insurer, employer, or health plan administrator, as applicable: (1) May request payment costs allowed under this chapter on behalf of the recipient according to procedures established by the…

.08 Recovery of Payments. If MADAP-Plus payments have been incorrectly paid or another payer has been identified, the Department shall seek recovery of the amount of those payments. Cross References 10.18.07.06F

.09 Fraud. The Department shall pursue cases of suspected misrepresentation or fraud pursuant to Criminal Law Article, §8-503, Annotated Code of Maryland, or any other applicable statutory provision.

.10 Confidentiality. Unless otherwise authorized by law, the Department: A. Shall keep all applicant and recipient personal information confidential; B. May not disclose personal information kept on an applicant or recipient without the written consent of the: (1) Applicant; (2) …

.11 Availability of Funding and Program Termination. A. If sufficient monies are not available to fund MADAP-Plus, the Department shall take the action necessary to eliminate a deficit which may include MADAP-Plus termination. B. If MADAP-Plus is terminated, the Department shall …

.01 Scope. A. Except as provided in §§C—F of this regulation, this chapter governs: (1) Pretest and post-test information; (2) Requirements for reporting and control efforts; (3) Requirements for informed consent; and (4) Specific counseling for patients, including when HIV testi…

.02 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Acquired immunodeficiency syndrome (AIDS)” means the medical condition caused by the human immunodeficiency virus. (2) “Anonymous” means that: (a) A patient’s name is not …

.03 Requirements for Designated Anonymous Testing Sites. A. An applicant shall seek approval from an appropriate entity to become a designated anonymous testing site from the: (1) Baltimore City Health Department for an applicant offering services in Baltimore City; or (2) Depart…