Md. Code Regs. 10.09.09.01

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.09.09.01 - Definitions

A. In addition to the definitions contained in §B of this regulation, definitions set forth in COMAR 10.09.36.01D are applicable to this chapter.

B. Terms Defined.

(1) "Authorized practitioner" means a physician, osteopath, dentist, podiatrist, nurse midwife, nurse anesthetist, nurse practitioner, or physician assistant employed by a physician or clinic.

(2) Freestanding Clinic.

(a) "Freestanding clinic" means a health care facility that is not licensed as a hospital, part of a hospital, or nursing home and is not administratively part of a physician's, dentist's, or osteopath's office, but which has a separate staff functioning under the direction of a clinic administrator or health officer and is organized and operated to provide ambulatory health services.

(b) "Freestanding clinic" does not include a clinic or clinic site located in a participant's home.

(3) "Hospital" means any institution which falls within the jurisdiction of Health-General Article, Title 19, Subtitle 3, Annotated Code of Maryland, and which is licensed pursuant to COMAR 10.07.01 or other applicable standards established by the state in which the service is provided.

(4) "Medical laboratory" means a licensed or certified facility, place, establishment, or institution, operated for the examination of material derived from the human body, by means of one or more of the scientific disciplines, for the purpose of obtaining scientific data that may be used to determine the presence, source, progress, or identity of disease agents, and to aid in the prevention, diagnosis, treatment, and management of human disease.

(5) "Order" means a request, or a copy of a request, initiated by and traceable to an authorized practitioner, authorizing the performance of specific medical laboratory services, that identifies the participant, the authorized ordering practitioner, the medical laboratory services requested, and the date executed.

(6) "Participant" means an individual who is certified as eligible for, and is receiving, Medical Assistance benefits.

(7) "Preauthorization" means the approval required from the Department or its designee before services can be rendered.

(8) "Reference laboratory" means a medical laboratory, which is enrolled with the Program as either a provider or a renderer, to which a medical laboratory provider refers specimens from Medical Assistance participants for analysis.

(9) "Referring laboratory" means a medical laboratory provider that refers specimens from Medical Assistance participants for analysis.

(10) "Special handling" means a circumstance in which specimen collection and pickup are accomplished as independent procedures to be responsive to the medical needs of the participant or to preserve viability or condition of the specimen.

(11) "Standing order" means a request, or a copy of a request, initiated by and traceable to an authorized practitioner, authorizing the performance of specific medical laboratory services to be supplied over a specific time period, that identifies the participant, the authorized ordering practitioner, the medical laboratory services requested, and the date executed.

Md. Code Regs. 10.09.09.01

Regulation .01 amended effective August 22, 1988 (15:17 Md. R. 2049); February 6, 1989 (16:2 Md. R. 159)
Regulation .01B amended effective September 18, 2000 (27:18 Md. R. 1665); April 29, 2002 (29:8 Md. R. 700); amended effective 50:14 Md. R. 593, eff. 7/24/2023