Md. Code Regs. 10.09.59.01

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

Section 10.09.59.01 - Definitions

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) "Administrative services organization (ASO)" means the contactor procured by the State to provide the Department with administrative support services to operate the Maryland Public Behavioral Health System.

(2) "Definitive drug test" means a drug screening test that includes:

(a) The ability to identify individual drugs and distinguish between structural isomers, but not necessarily stereoisomers, using gas chromatography or mass spectrometry and liquid chromatography or mass spectrometry;

(b) Qualitative or quantitative results;

(c) All source types for specimen selection; and

(d) Specimen validity testing, per day, 1-22 or more drug classes including metabolites, if performed.

(3) "Department" means the Department of Health and Mental Hygiene, as defined in COMAR 10.09.36.01, or its authorized agents acting on behalf of the Department.

(4) "Hospital" means an institution which:

(a) Falls within the jurisdiction of Health-General Article, Title 19, Subtitle 3, Annotated Code of Maryland; and

(b) Is licensed under COMAR 10.07.01 or is licensed by the state in which the service is provided.

(5) "Medicaid Emergency Psychiatric Demonstration" means the federal demonstration program established under Section 2707o f the Patient Protection and Affordable Care Act.

(6) "Medical Assistance" has the meaning stated in COMAR 10.09.24.02.

(7) "Medically necessary" has the meaning stated in COMAR 10.09.36.01.

(8) "Medicare" means the insurance program administered by the federal government under Title XVIII of the Social Security Act, 42 U.S.C. § 1395 et seq.

(9) "Office of Health Care Quality" means the office within the Department responsible for the certification and inspection of programs.

(10) "Participant" means an individual who is certified as eligible for, and is receiving, medical assistance benefits.

(11) "Presumptive drug test" means a drug screening test that includes:

(a) Any number of drug classes;

(b) Any number of devices;

(c) The use of direct optical observation, instrument assisted direct optical observation or instrumented chemistry analyzers; and

(d) Sample validation.

(12) "Program" has the meaning stated in COMAR 10.09.36.01.

(13) "Provider" means an organization or an individual practitioner furnishing the services covered under this chapter which, through appropriate agreement with the Department, has been identified as a Program provider by the issuance of a provider account number.

(14) "Public Behavioral Health System" means the system that provides medically necessary behavioral health services, including mental health and substance use disorder services, for Medical Assistance participants and certain other uninsured individuals.

(15) "Specialty mental health services" means services for which a participant's diagnosis and treatment provider meet the criteria specified in COMAR 10.09.70 and this chapter.

Md. Code Regs. 10.09.59.01

Regulations .01 adopted as an emergency provision effective February 3, 1995 (22:4 Md. R. 232); adopted permanently effective June 5, 1995 (22:11 Md. R. 821)
Regulations .01amended as an emergency provision effective July 1, 1997 (24:18 Md. R. 1291); emergency status expired December 31, 1997; amended permanently effective February 9, 1998 (25:3 Md. R. 144)
Regulations .01 under, Rehabilitation and Other Mental Health Services, repealed and new Regulations .01 under, Specialty Mental Health Services, adopted effective December 22, 2014 (41:25 Md. R. 1479)
Regulation .01 amended effective 42:21 Md. R. 1300, eff.10/26/2015; amended effective 43:20 Md. R. 1109, eff. 10/10/2016