Md. Code Regs. 10.21.15.07

Current through Register Vol. 51, No. 12, June 14, 2024

Section 10.21.15.07 - Subrogation by the Department

A. Before billing the Department, the provider shall:

(1) Take all reasonable steps to collect the charge from the emergency evaluee and, if applicable, from insurers, including Medicare and Medical Assistance; or

(2) Make and document a determination of the evaluee's inability to pay, according to the provisions of Regulation .03 of this chapter.

B. A provider:

(1) Shall accept as payment in full the maximum payment amount allowable under Medicare for services rendered to eligible participants; and

(2) May not bill the Department for any amount in excess of that allowable under §B(1) of this regulation.

C. If a provider receives payment from both the Department and another source, within 30 calendar days of receipt of payment by the other source, the provider shall refund to the Department the amount in excess of the maximum payment allowable under the provisions of §B of this regulation that was paid by the Department.

D. The provider shall immediately reimburse the Department for any overpayment.

Md. Code Regs. 10.21.15.07