Md. Code Regs. 10.25.10.05

Current through Register Vol. 52, No. 1, January 10, 2025

Section 10.25.10.05 - [Effective 1/20/2025] Who May Request Payment

A. A trauma physician or trauma health care practitioner as defined in Regulation .02 of this chapter may request payment under this chapter.

B. Medicaid and Uncompensated Care Reimbursement.

(1) Trauma Practitioner Services. A faculty practice plan, a physician practice, a trauma center on behalf of the trauma physician or trauma health care practitioner, or an individual trauma physician or individual health care practitioner allowed to bill Medicaid may submit requests for payment for trauma services provided to a Medicaid trauma patient or for uncompensated care trauma services if:

(a) Those services are provided to a trauma patient during the service period as defined in this chapter; and

(b) The practitioner meets the definition of a trauma physician or trauma health care practitioner under Regulation .02 of this chapter.

(2) Emergency Physician Services.

(a) The total reimbursement from the Fund to emergency physicians practicing at any one trauma center may not exceed $300,000 annually.

(b) An emergency room physician:

(i) Is eligible for uncompensated care shortfall payments only; and

(ii) May not receive Medicaid differential payments or on-call payments from the Fund.

C. On-Call Payments. The following trauma centers may apply for on-call payments:

(1) A MIEMSS-designated Level I trauma center or pediatric trauma center;

(2) Level II and Level III trauma centers; and

(3) The Specialty Referral Centers.

D. Standby Payments. An out-of-State pediatric trauma center that has entered into an agreement with MIEMSS may apply for an annual grant to subsidize standby costs.

Md. Code Regs. 10.25.10.05

Regulations .05 adopted as an emergency provision effective July 1, 2003 (30:19 Md. R. 1327); adopted permanently effective December 22, 2003 (30:25 Md. R. 1846)
Regulations .05 adopted as an emergency provision effective July 1, 2006 (33:21 Md. R. 1672); adopted permanently effective October 23, 2006 (33:21 Md. R. 1676)
Regulations .05 adopted effective June 15, 2009 (36:12 Md. R. 837); amended effective 52:1 Md. R. 1-46, eff. 1/20/2025.