Md. Code Regs. 10.09.64.01

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

Section 10.09.64.01 - Definitions

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

B. Terms Defined.

(1) "Behavioral health care manager" means a nurse, clinical social worker, or psychologist working under the oversight and direction of the physician or other primary care provider with formal education or specialized training to provide coordination and intervention in behavioral health.

(2) "Collaborative Care Model" means the Psychiatric Collaborative Care Model, a patient-centered, evidence-based approach for integrating physical and behavioral health services in primary care settings that includes:

(a) Care coordination and management;

(b) Regular, systematic monitoring and treatment using a validated clinical rating scale;

(c) Regular, systematic psychiatric or substance use disorder caseload reviews, or both; and

(d) Regular, systematic consultation for patients who do not show clinical improvement.

(3) "Federally qualified health center (FQHC)" means an entity as defined by Health-General Article, §24-1301, Annotated Code of Maryland, and §1905(l)(2)(B) of the Social Security Act.

(4) "Participant" means an individual who:

(a) Has been determined to meet the qualifications for services under the Collaborative Care Model as specified in Regulation .04 of this chapter; and

(b) Is enrolled with the Department to receive Medicaid services.

(5) "Primary care provider (PCP)" means a physician, or other provider type as defined in COMAR 10.67.05.05, who is the primary coordinator of care for the enrollee, and whose responsibility is to provide accessible, continuous, comprehensive, and coordinated health services covering the full range of benefits required by the Maryland Medical Assistance Program.

(6) "Program" means the Maryland Medical Assistance Program

(7) "Psychiatric consultant" means a licensed psychiatrist, psychiatric nurse practitioner, addiction medicine specialist, or any other behavioral health medicine specialist as allowed under federal regulations governing the model who is trained in psychiatry and qualified to prescribe medication.

Md. Code Regs. 10.09.64.01

Regulations .01 adopted as an emergency provision effective November 8, 1996 (23:25 Md. R. 1730)
Regulations .01 adopted effective March 10, 1997 (24:5 Md. R. 408)
Regulation .01 repealed effective December 27, 2010 (37:26 Md. R. 1787); recodified to 10.67.03.01 effective 46:22 Md. R. 976, eff. 11/1/2019; adopted effective 51:15 Md. R. 707, eff. 8/5/2024.