Md. Code Regs. 10.09.08.03

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

Section 10.09.08.03 - Conditions for Participation

A. General requirements for participation in the Program are that a provider shall:

(1) Meet all the conditions for participation as set forth in COMAR 10.09.36; and

(2) If delivering services via telehealth, comply with COMAR 10.09.49 and any subregulatory guidance issued by the Department.

B. Specific requirements for participation in the Program as a freestanding clinic provider require that the provider:

(1) Meet the applicable standards and requirements of Regulation .04 of this chapter;

(2) Verify the licenses and credentials of all professionals employed by or under contract with the freestanding clinic to provide services;

(3) Have clearly defined, written, patient care policies;

(4) Maintain adequate documentation of each contact with each participant as part of the plan of care, which, at a minimum, shall include:

(a) Date of service;

(b) Participant's chief medical complaint or reason for visit;

(c) A brief description of the physical findings and the service provided, including procedures and progress notes; and

(d) A legible signature and printed or typed name of professional providing care, with the appropriate title;

(5) Have written, effective procedures for infection control under COMAR 10.06.01 Communicable Diseases;

(6) Maintain adequate administrative and medical records which are defined as having documentation sufficient in quantity, scope, and detail to confirm that the freestanding clinic services are provided in accordance with this chapter;

(7) Be approved by the Medicaid program in the state in which the service is provided; and

(8) Provide for in-house program evaluation and clinical record review which assess use of services for appropriateness in meeting client's needs.

C. In the absence of specifically applicable regulations, a freestanding clinic shall:

(1) Comply with §A of this regulation;

(2) Comply with specific conditions, which may be included in the written agreement; and

(3) Accept reimbursement according to COMAR 10.09.02 Physicians' Services.

D. Abortion clinics shall provide services in accordance with Health-General Article, §20-209, Annotated Code of Maryland.

Md. Code Regs. 10.09.08.03

Regulations .03A amended effective November 23, 1981 (8:23 Md. R. 1856)
Regulation .03A amended effective January 6, 1983 (9:26 Md. R. 2572); January 30, 1984 (11:2 Md. R. 113)
Regulations .03 repealed effective October 1, 1985 (12:19 Md. R. 1849)
Regulations .03 adopted effective October 1, 1985 (12:19 Md. R. 1849)
Regulation .03A amended effective February 6, 1989 (16:2 Md. R. 159)
Regulation .03B amended effective May 28, 1990 (17:10 Md. R. 1219)
Regulations .03 amended as an emergency provision effective September 16, 1992 (19:20 Md. R. 1812); amended permanently effective January 1, 1993 (19:25 Md. R. 2205)
Regulation .03 adopted effective 42:6 Md. R. 512, eff.4/1/2015; amended effective 50:20 Md. R. 886, eff. 10/16/2023