Md. Code Regs. 10.09.07.06

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.09.07.06 - 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 participant's 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 provider's 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.

Md. Code Regs. 10.09.07.06

Regulation .06 amended as an emergency provision effective July 1, 2008 (35:17 Md. R. 1480); amended permanently effective December 15, 2008 (35:25 Md. R. 2150); amended effective 43:03 Md. R. 272, eff.2/15/2016; amended effective 46:10 Md. R. 485, eff. 5/20/2019