Md. Code Regs. 10.09.76.05

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

Section 10.09.76.05 - Limitations

The Program does not cover the following:

A. Services not specified in Regulation .04 of this chapter;

B. Services not medically necessary;

C. Investigational and experimental drugs and procedures;

D. Basic school health services as defined in COMAR 13A.05.05.05-.15;

E. Nursing or other health services provided as part of a participant's individualized educational program (IEP) as defined in COMAR 10.09.50.01B or individualized family service plan (IFSP) as defined in COMAR 10.09.50.01B;

F. Skilled nursing services provided to enable a participant to be safely maintained in the school setting such as:

(1) Nasogastric tube feedings;

(2) Catheterization;

(3) Oral, nasotracheal, or tracheal suctioning; and

(4) Nebulizer treatments;

G. School health services which are required in all school settings such as:

(1) Hearing and vision screening unless completed as part of an EPSDT well-child check-up;

(2) Routine assessment of minor injuries;

(3) First aid;

(4) Administration of medications including supervision of self-administered medications;

(5) General health promotion counseling; and

(6) Review of health records;

H. Routine sports physicals;

I. Vaccines supplied by Vaccines for Children (VFC);

J. Visits for the sole purpose of:

(1) Administering medication;

(2) Checking blood pressure;

(3) Measuring weight;

(4) Interpreting lab results; or

(5) Group or individual health education; and

K. Services provided outside of the physical location of the approved SBHC, unless services are rendered via telehealth in accordance with COMAR 10.09.49 and any subregulatory guidance issued by the Department.

Md. Code Regs. 10.09.76.05

Regulations .05 adopted as an emergency provision effective July 1, 2006 (33:15 Md. R. 1274); adopted permanently effective September 25, 2006 (33:19 Md. R. 1560)
Regulation .05A amended effective June 30, 2008 (35:13 Md. R. 1180)
Regulations .05 repealed effective 41:13 Md. R. 752, eff.7/7/2014 ; adopted effective 44:7 Md. R. 355, eff. 4/10/2017; amended effective 50:22 Md. R. 973, eff. 11/13/2023