Md. Code Regs. 10.09.59.03

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

Section 10.09.59.03 - General Conditions for Provider Participation

To participate in the Program, a provider shall:

A. Meet the conditions for provider participation in the Medical Assistance Program as set forth in COMAR 10.09.36.03;

B. Meet the conditions for licensure and practice as set forth in COMAR 10.63.01, 10.63.02, and 10.63.06;

C. Have clearly defined and written patient care policies; and

D. Maintain, either manually or electronically, adequate documentation of each contact with a participant as part of the medical record, which, at a minimum, meets the following requirements:

(1) Includes the date of service with service start and end times;

(2) Includes the participant's primary behavioral health complaint or reason for the visit;

(3) Includes a brief description of the service provided, including progress notes;

(4) Includes an official e-Signature, or a legible signature, along with the printed or typed name of the individual providing care, with the appropriate title;

(5) Is made available to the following as requested:

(a) The Department;

(b) The ASO;

(c) The Core Service Agency;

(d) The Office of Inspector General; and

(e) The Office of the Attorney General Medicaid Fraud Control Unit; and

(6) Is consistent with the medical records confidentiality and disclosure requirements of:

(a) Maryland Confidentiality of Medical Records Act, Health-General Article, Title 4, Subtitle 3, Annotated Code of Maryland; and

(b) Relevant federal statutes and regulations, including the Health Insurance Portability and Accountability Act, 42 U.S.C. § 1320D et seq., and implementing regulations at 45 CFR Parts 160 and 164.

Md. Code Regs. 10.09.59.03

Regulations .03 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 .03 amended 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Regulations .03 under, Rehabilitation and Other Mental Health Services, repealed and new Regulations .03 under, Specialty Mental Health Services, adopted effective December 22, 2014 (41:25 Md. R. 1479)
Regulation .03 amended effective 42:21 Md. R. 1300, eff.10/26/2015; amended effective 45:8 Md. R. 420, eff. 4/23/2018