reglab/statecodes huggingface dataset:
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-124.2 - Maryland Medbank Program

(a)    In this section, “Program” means the Maryland Medbank Program established under this section.
(b)    There is a Maryland Medbank Program.
(c)    The purpose of the Program is to improve the health status of individuals throughout the State who lack prescription drug coverage by providing access to medically necessary prescription drugs through patient assistance programs sponsored by pharmaceutical drug manufacturers.
(d)    (1)    Subject to paragraph (2) of this subsection, the Program shall be administered by the Medbank of Maryland, Inc.
(2)    The Medbank of Maryland, Inc. shall contract with one or more government or nonprofit entities to operate the Program.
(e)    (1)    The Program shall be funded through a grant provided by the Department.
(2)    Program funds may be used in part to:
(i)    Purchase interim supplies of prescription drugs for enrollees who have applied to participate in a manufacturer’s patient assistance program but have not yet received the approved prescription drug; and
(ii)    Distribute medication to enrollees who have been approved to participate in a manufacturer’s patient assistance program.
(f)    (1)    The Medbank of Maryland, Inc. shall ensure that the Program is available to residents in each of the following geographic regions of the State:
(i)    Western Maryland;
(ii)    The Eastern Shore;
(iii)    The Baltimore metropolitan area;
(iv)    The Maryland counties in the Washington, D.C. metropolitan area; and
(v)    Southern Maryland, including Anne Arundel County.
(2)    Medbank of Maryland, Inc. shall be the central coordinating office for the State.
(g)    Eligibility for the Program shall be limited only by the criteria established by pharmaceutical manufacturers for their patient assistance programs.
(h)    (1)    The Department shall require detailed financial reports at least quarterly from Medbank of Maryland, Inc.
(2)    The Medbank of Maryland, Inc. shall release funds to the entities that operate the Program as needed and justified by the quarterly reports filed in accordance with paragraph (1) of this subsection.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-125 - Program for Children With Special Health Care Needs

(a)    (1)    In this section the following words have the meanings indicated.
(2)    “Children” means individuals under the age of 12 years.
(3)    “Youth” means an individual at least 12 years old and under the age of 22 years.
(b)    The Department is the agency of this State to administer a program of services for children and youth who have or are suspected of having special health care needs.
(c)    The purpose of this program is to provide reimbursement for medical, diagnostic, corrective, and other services and care to children and youth who have or are suspected of having special health care needs.
(d)    The Department may:
(1)    Prepare and administer detailed plans for these purposes;
(2)    Adopt rules and regulations for administering these plans;
(3)    Receive and, in accordance with these plans, spend all funds made available to the Department for these purposes; and
(4)    Cooperate with the federal government in extending and improving these services and in administering these plans.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-126 - Educational Programs for Handicapped Children

The Secretary shall provide educational programs to meet the needs of each physically or mentally handicapped child in the custody of the Department. The cost for each child shall be included and identified in the budget of the Department as submitted to the General Assembly by the Governor.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-129 - Durable Medical Equipment

(a)    In this section, “durable medical equipment” means durable medical equipment listed in the medical assistance provider fee manual, as provided in regulations adopted by the Department.
(b)    To determine whether the prices charged for durable medical equipment provided to Program recipients are reasonable, the Department shall establish regulations and procedures for reviewing the prices of durable medical equipment every 3 years.
(c)    The Department, to the extent feasible and appropriate, shall recover all durable medical equipment from Program recipients that:
(1)    Was purchased by the Department; and
(2)    Is no longer required by the recipient.
(d)    Except as provided in subsection (e) of this section and to the extent feasible and appropriate, the Department shall reuse the durable medical equipment recovered under subsection (c) of this section to meet the needs of other Program recipients for the same durable medical equipment.
(e)    If the durable medical equipment recovered under subsection (c) of this section is not in a condition that would enable another Program recipient to use it, the Department may give the equipment to any organization that will:
(1)    Repair or attempt to repair the equipment; and
(2)    Provide the equipment at no charge to other persons who require the same equipment.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-130 - Application for Home- or Community-Based Services Waiver for Seriously Emotionally Disturbed Youth or Autistic or Developmentally Disabled Youth in Order to Receive Federal Matching Funds

(a)    In this section, “seriously emotionally disturbed” means a condition that is:
(1)    Manifest in an individual younger than 18 years or, if the individual is in a residential treatment center, younger than 21 years;
(2)    Diagnosed according to the current diagnostic classification system that is recognized by the Secretary; and
(3)    Characterized by a functional impairment that substantially interferes with or limits the child’s role or functioning in the family, school, or community activities.
(b)    (1)    The Department shall apply to the Health Care Financing Administration of the federal Department of Health and Human Services for a home– and community–based services waiver under § 1915(c) of the federal Social Security Act in order to receive federal matching funds for services to seriously emotionally disturbed individuals who would otherwise require institutionalization in a residential treatment center.
(2)    The Department shall apply to the Health Care Financing Administration of the federal Department of Health and Human Services for a home– and community–based services waiver under § 1915(c) of the federal Social Security Act in order to receive federal matching funds for services to autistic children aged 1 through 21 years who would otherwise require institutionalization in an institution for the developmentally disabled.
(c)    In accordance with subsection (b)(1) and (2) of this section, the services to be provided for seriously emotionally disturbed individuals or autistic children may include:
(1)    Respite services;
(2)    Family training and education;
(3)    Day treatment services;
(4)    Therapeutic integration services;
(5)    Intensive individual support services;
(6)    Therapeutic living services;
(7)    Intensive in–home intervention services; and
(8)    Specialized case management services.
(d)    The State matching funds required to cover the Medicaid costs under the waiver for autistic children shall be certified or otherwise provided by the Maryland State Department of Education, local school systems, and local lead agencies.
(e)    The State matching funds required to cover the Medicaid costs under the waiver for seriously emotionally disturbed individuals shall be certified or otherwise provided by the Maryland State Department of Education, local school systems, local lead agencies, and the Behavioral Health Administration.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-130.1 - Psychiatric Residential Treatment Demonstration Waiver Application

(a)    The Department shall apply to the Centers for Medicare and Medicaid Services of the federal Department of Health and Human Services for a psychiatric residential treatment demonstration waiver if the Centers announce in the Federal Register that the Centers are accepting applications for such a waiver.
(b)    The waiver application required by subsection (a) of this section shall:
(1)    Provide for services for a minimum of 150 individuals; or
(2)    Provide for services for the maximum number of individuals that the Centers for Medicare and Medicaid Services allows, if the maximum number of individuals that the Centers allow to receive services under the waiver is fewer than 150 individuals.
(c)    During the waiver application process, the Department shall conduct an analysis of both the short-term and long-term costs and benefits of implementing the waiver.
(d)    The Department shall report to the General Assembly, in accordance with § 2-1257 of the State Government Article, every 6 months concerning the status of the Department’s application required under this section until the waiver is approved or denied.
(e)    (1)    If the Centers for Medicare and Medicaid Services approve the waiver application required under this section, the Department shall report to the General Assembly, in accordance with § 2-1257 of the State Government Article, on its decision on whether to implement the waiver.
(2)    The report required under this subsection shall include a summary of the analysis required under subsection (c) of this section.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-131 - Application for Home- or Community-Based Services Waiver for Federal Matching Funds for Services to Adults

(a)    The Department shall investigate development of integrated care systems and the feasibility and desirability of applying for a home- and community-based services waiver in order to maximize federal matching funds for the provision of services to adults who:
(1)    Have functional disabilities, including Alzheimer’s disease and related disorders;
(2)    Have family income not greater than 200% of the federal poverty level; and
(3)    Would otherwise require nursing home institutionalization.
(b)    The services covered under the waiver under this section may include:
(1)    Routine and emergency respite care;
(2)    Adult day care;
(3)    Personal care;
(4)    Case management; and
(5)    Homemaker services.
(c)    The Department may place a reasonable limit on the number of individuals or on the geographic area of the State included in the waiver under this section.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-132.1 - Voluntary Tax Withholding

(a)    In this section, “self-employed provider” means an individual who:
(1)    Provides health care services as an attendant, personal care aide, personal care provider, or respite care worker to Program recipients participating in:
(i)    The Home- and Community-Based Services Waiver for Older Adults Program; or
(ii)    The Medical Assistance Personal Care Program; and
(2)    Is not employed by an agency.
(b)    To the extent allowed under federal law, the Department shall provide voluntary withholding of federal income taxes under the Internal Revenue Code and State income taxes under Title 10 of the Tax - General Article for self-employed providers.
(c)    Nothing in this section shall be construed to alter a self-employed provider’s contractual relationship with the Department or to confer to the self-employed provider any status of employment or benefits commensurate with that status.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-133 - Grants to Improve Home- and Community-Based Service Systems

(a)    The State shall apply to the Health Care Financing Administration of the United States Department of Health and Human Services for grants to assist states in improving home– and community–based service systems, including:
(1)    Real choice system change grants;
(2)    Nursing facility transition grants and “access housing” grants; and
(3)    Community–based attendant services with consumer control grants.
(b)    The Department shall seek input from eligible individuals, the individuals’ representatives, and service providers in developing and implementing the Program.
(c)    On or before July 1, 2001, the Department shall notify the Health Care Financing Administration of the United States Department of Health and Human Services of Maryland’s intent to expand the current Medicaid home– and community–based waiver for adults with physical disabilities, under § 1915(c) of the federal Social Security Act to redirect funds to develop appropriate funding for this Program.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-134 - Maryland Medical Assistance Program Waiver

(a)    If the Department applies for a Medical Assistance Program waiver, modifies or amends an existing Medical Assistance Program waiver, or amends the Medicaid State Plan, the Department shall give notice of the application or amendment by:
(1)    Publication in the Maryland Register; and
(2)    Submission of the application or amendment to the Medicaid Advisory Committee for discussion at a Medicaid Advisory Committee meeting.
(b)    For 30 days following publication of any notice published under subsection (a) of this section, the Department shall:
(1)    Make the Medical Assistance Program waiver application or amendment to the Medicaid State Plan available to the public during business hours; and
(2)    Provide an opportunity to receive public comments on the Medical Assistance Program waiver application or amendment to the Medicaid State Plan.
(c)    If the Department submits to the federal Centers for Medicare and Medicaid Services an amendment to the Medicaid State Plan or Medical Assistance Program waiver application, the Department shall submit a copy of the amendment or waiver application to the members of the Medicaid Advisory Committee no later than five business days after the Department submits the amendment or waiver application to the federal Centers for Medicare and Medicaid Services.
(d)    Subject to the limitations of the State budget and notwithstanding any other provision of law, the following are effective on the date specified in a Maryland Register notice:
(1)    Amendments or modifications to the Medicaid State Plan or Medical Assistance Program; and
(2)    Medical Assistance Program waiver applications and modifications.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-134.1 - Military Families

(a)    In this section, “legal resident” means an individual who maintains the State as the individual’s principal establishment, home of record, or permanent home and to where, whenever absent due to military obligation, the individual intends to return.
(b)    A dependent of a legal resident of the State who is determined eligible to receive home– and community–based waiver services or other waiver services from the Department under this title shall retain eligibility for the services:
(1)    Regardless of whether the legal resident leaves the State due to the legal resident’s military assignment outside the State; and
(2)    If the dependent is otherwise eligible for the services.
(c)    If a dependent of a legal resident is on a waiting list for home– and community–based waiver services or other waiver services to be provided under this title, the Department shall allow the dependent to remain on the waiting list for services while the legal resident is outside the State due to the legal resident’s military assignment outside the State.
(d)    The Department shall reinstate services provided under this title to a dependent who resides with the legal resident while the legal resident is outside the State due to the legal resident’s military assignment outside the State:
(1)    On the relocation of the dependent to the State; and
(2)    If a request for services is made.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-136 - Maryland Pharmacy Access Hotline

(a)    The Department shall use existing resources to establish a toll free Maryland Pharmacy Access Hotline that:
(1)    Operates during regular business hours; and
(2)    During nonbusiness hours allows callers to leave a message.
(b)    (1)    The Department shall distribute to all Program recipients information about the Maryland Pharmacy Access Hotline.
(2)    The information shall state clearly in easily readable print:
(i)    The toll free telephone number of the hotline; and
(ii)    That the Program recipient should call the telephone number if the Program recipient is having problems getting necessary medicines.
(c)    The Department shall notify all health care providers who participate in the Program about the Maryland Pharmacy Access Hotline.
(d)    The Department shall:
(1)    Develop a methodology to track the number and type of calls received by the Maryland Pharmacy Access Hotline; and
(2)    Provide a quarterly report to the Pharmacy and Therapeutics Committee that summarizes the number and type of calls received by the Maryland Pharmacy Access Hotline.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-137 - Home-Based and Community Services for Residents of Nursing Facilities -- Denial of Access Prohibited

(a)    The Department may not deny an individual access to a home– and community–based services waiver due to a lack of funding for waiver services if:
(1)    (i)    The individual is living in a nursing facility at the time of the application for waiver services;
(ii)    At least 30 consecutive days of the individual’s nursing facility stay are eligible to be paid for by the Program;
(iii)    The individual meets all of the eligibility criteria for participation in the home– and community–based services waiver; and
(iv)    The home– and community–based services provided to the individual would qualify for federal matching funds; or
(2)    (i)    The individual is living at home or in the community at the time of the application for waiver services;
(ii)    The individual received home– and community–based services through Community First Choice for at least 30 consecutive days;
(iii)    The individual will be or has been terminated from participation in the Program on becoming entitled to or enrolled in Medicare Part A or enrolled in Medicare Part B;
(iv)    The individual meets all of the eligibility criteria for participation in the home– and community–based services waiver within 6 months after the completion of the application; and
(v)    The home– and community–based services provided to the individual would qualify for federal matching funds.
(b)    Nothing in this section is intended to result in a reduction of federal funds available to the Department.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-138 - Employed Persons With Disabilities Program

(a)    To the extent that funding is available in the State budget, the Maryland Department of Health shall implement the Employed Persons with Disabilities Program by July 1, 2005.
(b)    The purpose of the Employed Persons with Disabilities Program is to encourage individuals with disabilities to seek or maintain employment.
(c)    (1)    The Secretary shall adopt regulations that develop specific eligibility criteria for participation in the Employed Persons with Disabilities Program.
(2)    Prior to adopting the regulations required under paragraph (1) of this subsection, the Department shall:
(i)    Consult with the Coalition for Work Incentives Improvement; and
(ii)    Give preference to the recommendations for eligibility criteria developed by the Coalition.
(d)    At least every 3 years after the adoption of the regulations required under subsection (c) of this section, the Department shall review the regulations in consultation with the Coalition for Work Incentives Improvement.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-140 - State Plan Amendment to the Family Planning Program

The Department shall apply to the Centers for Medicare and Medicaid Services for a State plan amendment to the Family Planning Program that:
(1)    Provides, subject to the limitations of the State budget, family planning services to an individual whose individual income is at or below 250% of the poverty level, as allowed by federal law;
(2)    Does not impose age limitations on individuals who are able to receive family planning services;
(3)    Establishes a presumptive eligibility process for enrollment in the Family Planning Program; and
(4)    Exempts the Family Planning Program from federal coordination of benefits requirements if authorized under federal law.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-141 - Pilot Program to Provide Limited Dental Coverage to Adult Maryland Medical Assistance Program Recipients.

** IN EFFECT UNTIL JANUARY 1, 2023 PER CHAPTERS 302 AND 303 OF 2022 **
(a)    On or before September 1, 2018, the Department shall apply to the Centers for Medicare and Medicaid Services for an amendment to the State’s § 1115 HealthChoice Demonstration waiver to implement a pilot program to provide limited dental coverage to adult Program recipients.
(b)    If the amendment is approved under subsection (a) of this section, the Department shall administer the pilot program.
(c)    The Department may limit:
(1)    Participation in the pilot program to Program recipients who are:
(i)    Dually eligible for health care coverage under both the Program and Medicare and for whom the Department may obtain federal matching funds; and
(ii)    Of a certain age;
(2)    The total number of participants in the pilot program; and
(3)    Operation of the pilot program to certain geographic regions of the State.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-142 - Fair Share Health Care Fund

(a)    In this section, “Fund” means the Fair Share Health Care Fund.
(b)    There is a Fair Share Health Care Fund.
(c)    The purpose of the Fund is to support the operations of the Program.
(d)    (1)    The Fund is a special, nonlapsing fund that is not subject to § 7-302 of the State Finance and Procurement Article.
(2)    The Treasurer shall hold the Fund separately, and the Comptroller shall account for the Fund.
(e)    The Fund consists of:
(1)    Any revenue received from payments made by employers under Title 8.5 of the Labor and Employment Article; and
(2)    Any other money from any other source accepted for the benefit of the Fund.
(f)    The Fund may be used only to support the operations of the Program.
(g)    (1)    The Treasurer shall invest the money of the Fund in the same manner as other State money may be invested.
(2)    Any investment earnings of the Fund shall be retained to the credit of the Fund.
(h)    The Fund shall be subject to an audit by the Office of Legislative Audits as provided for in § 2-1220 of the State Government Article.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-143 - Legal Immigrants -- Pregnant Women and Children

The Governor shall include in the budget bill for fiscal year 2008 at least $3,000,000 in General Fund State support for an immigrant health initiative to provide health care services for all legal immigrant children under the age of 18 years and pregnant women who meet program eligibility standards and arrived in the United States on or after August 22, 1996.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-145 - Information From and Liability of Health Insurance Carriers

(a)    In this section, “carrier” means:
(1)    A health insurer;
(2)    A nonprofit health service plan;
(3)    A health maintenance organization;
(4)    A dental plan organization; and
(5)    Any other person included as a third party in § 1902(a)(25)(A) of the Social Security Act, as amended by the federal Deficit Reduction Act of 2005.
(b)    (1)    A carrier shall provide, at the request of the Department, information about individuals who are eligible for benefits under the Program or are Program recipients so that the Department may determine whether an individual, the spouse of an individual, or the dependent of an individual is receiving health care coverage from a carrier and the nature of that coverage.
(2)    A carrier shall provide the information required under this subsection in a manner prescribed by the Department.
(c)    A carrier shall accept the Program’s right of recovery and the assignment to the Program of any right of an individual or other entity to payment from the carrier for an item or service for which payment has been made under the Program if the carrier has a legal obligation to make payment for the item or service.
(d)    As a condition of doing business in the State, a carrier shall comply with the requirements set forth in § 42 U.S.C. 1396a(a)(25)(I)(i) through (iv).
(e)    A carrier subject to this section may not reject, deny, limit, cancel, refuse to renew, increase the rates of, affect the terms or conditions of, or otherwise affect a health insurance policy or contract for a reason based wholly or partly on:
(1)    The eligibility of the individual for receiving benefits under the Program; or
(2)    The receipt by an individual of benefits under the Program.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-146 - Report -- Change to Medical Eligibility for Nursing Facility Level of Care

(a)    In this section, “home– and community–based waiver services” includes services provided under the Living at Home Waiver, the Older Adults Waiver, and the Medical Day Care Waiver.
(b)    At least 90 days prior to making any change to medical eligibility for Program long–term care services, including nursing facility services, home– and community–based waiver services, and other services that require a nursing facility level of care, the Department shall provide a report to:
(1)    The Senate Finance Committee and the House Health and Government Operations Committee, in accordance with § 2–1257 of the State Government Article; and
(2)    The Medicaid Advisory Committee.
(c)    The report required under subsection (b) of this section shall include:
(1)    The details of the intended change in medical eligibility;
(2)    A description of how the intended change will affect current medical eligibility;
(3)    The intended effective date of the change; and
(4)    Whether the change will be pursued through departmental policy, by regulation, or by statute.
(d)    The Department shall discuss any report submitted to the Medicaid Advisory Committee under subsection (b) of this section at a meeting of the Medicaid Advisory Committee.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-147 - Former Officials or Employees -- Participation in Contracts

Notwithstanding § 5–504 of the General Provisions Article, a former official or employee may not be considered to have participated significantly in a contract if the former official or employee:
(1)    Did not develop a request for proposals resulting in the contract;
(2)    Did not participate in an evaluation committee or other State entity charged with selecting a contractor for the contract; and
(3)    Participated only by providing support or other assistance as directed by a senior manager after contract award as part of the transition process from a State–run Medicaid Management Information System to a private contracted operation.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-148 - Prior Authorization Not Required for Contraceptive Drug or Devices

(a)    Except for a drug or device for which the U.S. Food and Drug Administration has issued a black box warning, the Program and the Maryland Children’s Health Program may not apply a prior authorization requirement for a contraceptive drug or device that is:
(1)    (i)    An intrauterine device; or
(ii)    An implantable rod;
(2)    Approved by the U.S. Food and Drug Administration; and
(3)    Obtained under a prescription written by an authorized prescriber.
(b)    The Program and the Maryland Children’s Health Program shall provide coverage for a single dispensing to an enrollee of a supply of prescription contraceptives for a 12–month period.
(c)    The Program and the Maryland Children’s Health Program shall provide coverage for services, to the same extent as services rendered by any other licensed health care practitioner, rendered to an enrollee by a licensed pharmacist under:
(1)    § 12–509 of the Health Occupations Article in administering self–administered medications, maintenance injectable medications, or injectable medications for treatment of sexually transmitted infections; or
(2)    § 12–511 of the Health Occupations Article in screening an enrollee and prescribing contraceptives for the enrollee.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-149 - Application to Epsdt Services for Program Recipients -- Prohibition on Conditioning Reimbursement for Services on Presence or Availability of Parent or Caregiver -- Adoption of Regulations

(a)    (1)    In this section the following words have the meanings indicated.
(2)    (i)    “Applied behavior analysis” means the design, implementation, and evaluation of environmental modifications using behavioral stimuli and consequences to produce significant improvements in human behavior.
(ii)    “Applied behavior analysis” includes the direct observations, measurement, and functional analysis of the relations between environment and behavior.
(3)    “Early and periodic screening, diagnosis, and treatment (EPSDT)” means the provision, to individuals under the age of 21 years, of preventive health care under 42 C.F.R. Part 441, Subpart B, as amended, and other health care services, diagnostic services, and treatment services that are necessary to correct or ameliorate defects, physical and mental illnesses, and conditions discovered by those screening services.
(b)    This section applies to EPSDT services available to Program recipients.
(c)    (1)    Subject to paragraph (2) of this subsection, the Department may not condition reimbursement of applied behavior analysis services provided to a Program recipient on the presence or availability of the parent or caregiver of the Program recipient in the setting where the applied behavior analysis services are provided to the Program recipient.
(2)    Paragraph (1) of this subsection does not prohibit the Program from establishing reasonable standards for the involvement of a parent or caregiver, including requiring notification from the parent or caregiver of the decision of the parent or caregiver not to be present or available when the Program provides applied behavior analysis services to a Program recipient.
(d)    On or before December 1, 2021, the Department, in consultation with stakeholders, shall adopt regulations to implement the provisions of this section.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 1 - Medical and Pharmacy Assistance Programs › Section 15-150 - Plans to Reduce Waitlists for Waiver Programs -- Submission of Plans -- Annual Budget Funds

(a)    (1)    (i)    The Department shall develop plans to reduce the waitlists for the following waiver programs by 50%, beginning in fiscal year 2024:
1.    The Community Pathways Waiver;
2.    The Community Supports Waiver;
3.    The Family Supports Waiver;
4.    The Brain Injury Waiver;
5.    The Home– and Community–Based Options Waiver;
6.    The Medical Day Care Services Waiver; and
7.    The Model Waiver for Medically Fragile Children.
(ii)    The Department shall develop a plan to reduce the registry for the Autism Waiver that includes conducting eligibility determinations of individuals on the registry and, beginning in fiscal year 2024, providing services to at least 50% of individuals determined eligible.
(2)    The plans required under this subsection shall include:
(i)    An assessment of whether each waiver program needs to recruit and retain new providers;
(ii)    Measures to recruit and retain providers for each waiver program to expand the capacity of the programs;
(iii)    Any changes in reimbursement rates needed to ensure provider capacity to provide services under the waiver programs;
(iv)    The expected time frame for conducting eligibility determinations for the Autism Waiver;
(v)    The expected time frame for reducing the waitlist or registry for each waiver program by 50%; and
(vi)    The projected cost of the measures to be implemented under the plans.
(3)    Provisions of the plans relating to the Autism Waiver shall be developed in conjunction with the Maryland State Department of Education.
(b)    On or before January 1, 2023, the Department shall submit the plans to the Governor and, in accordance with § 2–1257 of the State Government Article, the chairs of the Senate Budget and Taxation Committee, the Senate Education, Health, and Environmental Affairs Committee, the Senate Finance Committee, the House Appropriations Committee, and the House Health and Government Operations Committee.
(c)    Beginning in fiscal year 2024, the Governor shall include in the annual budget bill sufficient funds to carry out this section.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 3 - Maryland Children's Health Program › Section 15-301 - Established; Purpose; Administration; Eligible Participants

(a)    There is a Maryland Children’s Health Program.
(b)    The Maryland Children’s Health Program shall provide, subject to the limitations of the State budget and any other requirements imposed by the State and as permitted by federal law or waiver, comprehensive medical care and other health care services to an individual who has a family income at or below 300 percent of the federal poverty guidelines and who is under the age of 19 years.
(c)    The Maryland Children’s Health Program shall be administered:
(1)    Except as provided in item (3) of this subsection, for individuals whose family income is at or below 200 percent of the federal poverty guidelines, through the Program under Subtitle 1 of this title requiring individuals to enroll in managed care organizations;
(2)    For eligible individuals whose family income is above 200 percent, but at or below 300 percent of the federal poverty guidelines, through the MCHP premium plan under § 15-301.1 of this subtitle; or
(3)    In fiscal year 2004 only, for eligible individuals whose family income is above 185 percent, but at or below 300 percent of the federal poverty guidelines, through the MCHP premium plan under § 15-301.1 of this subtitle.
(d)    (1)    The Department shall provide eligible individuals and health care providers with an accurate directory or other listing of all available providers:
(i)    In written form, made available upon request; and
(ii)    On an Internet database.
(2)    The Department shall update the Internet database at least every 30 days.
(3)    The written directory shall include a conspicuous reference to the Internet database.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 3 - Maryland Children's Health Program › Section 15-301.1 - Premium Plans

(a)    (1)    In this section the following words have the meanings indicated.
(2)    “Eligible individual” means an individual who qualifies to participate in the Maryland Children’s Health Program under § 15-301(b) of this subtitle.
(3)    “Family contribution” means the portion of the premium cost paid for an eligible individual to enroll and participate in the Maryland Children’s Health Program.
(4)    “MCHP premium plan” means the plan established under this section to provide access to health insurance coverage to eligible individuals through managed care organizations under the Maryland Children’s Health Program.
(b)    Except as provided in subsection (c) of this section, this section applies only to individuals whose family income is above 200 percent, but at or below 300 percent of the federal poverty guidelines.
(c)    (1)    As a requirement of enrollment and participation in the MCHP premium plan, the parent or guardian of an eligible individual shall agree to pay the following annual family contribution:
(i)    In fiscal year 2004 only, for an eligible individual whose family income is above 185 percent, but at or below 200 percent of the federal poverty guidelines, an amount equal to 2 percent of the annual income of a family of two at 185 percent of the federal poverty guidelines;
(ii)    For an eligible individual whose family income is above 200 percent, but at or below 250 percent of the federal poverty guidelines, an amount equal to 2 percent of the annual income of a family of two at 200 percent of the federal poverty guidelines; and
(iii)    For an eligible individual whose family income is above 250 percent, but at or below 300 percent of the federal poverty guidelines, an amount equal to 2 percent of the annual income of a family of two at 250 percent of the federal poverty guidelines.
(2)    The family contribution amounts required under paragraph (1) of this subsection apply on a per family basis regardless of the number of eligible individuals each family has enrolled in the MCHP premium plan.
(d)    The Department shall adopt regulations necessary to implement this section.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 3 - Maryland Children's Health Program › Section 15-302 - Review, Monitoring, and Disapproval of Applications; Termination of Coverage

(a)    (1)    The Department shall monitor applications to determine whether employers and employees have voluntarily terminated coverage under an employer sponsored health benefit plan that included dependent coverage in order to participate in the Maryland Children’s Health Program established under §§ 15-301 and 15-301.1 of this subtitle.
(2)    The Department, in particular, shall review applications of individuals who qualified for Program benefits under the Maryland Children’s Health Program established under §§ 15-301 and 15-301.1 of this subtitle.
(b)    (1)    An application may be disapproved if it is determined that an individual under the age of 19 years to be covered under the Maryland Children’s Health Program, for whom the application was submitted, was covered by an employer sponsored health benefit plan with dependent coverage which was voluntarily terminated within 6 months preceding the date of the application.
(2)    In determining whether an applicant has voluntarily terminated coverage under an employer sponsored health benefit plan for purposes of paragraph (1) of this subsection, a voluntary termination may not be construed to include:
(i)    Loss of employment due to factors other than voluntary termination;
(ii)    Change to a new employer that does not provide an option for dependent coverage;
(iii)    Change of address so that no employer sponsored health benefit plan is available;
(iv)    Discontinuation of health benefits to all dependents of employees of the applicant’s employer; or
(v)    Expiration of the applicant’s continuation of coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA).
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 3 - Maryland Children's Health Program › Section 15-303 - Enrollment of Program Recipients Into Managed Care Organizations; Expedited Eligibility

(a)    (1)    The Department shall be responsible for enrolling program recipients in managed care organizations under the Maryland Children’s Health Program established under §§ 15–301 and 15–301.1 of this subtitle.
(2)    The Department may contract with an entity to perform any part or all of its enrollment responsibilities under paragraph (1) of this subsection.
(3)    The Department or its enrollment contractor, to the extent feasible in its marketing, outreach, and enrollment programs, shall hire individuals receiving assistance under the Family Investment Program established under Title 5, Subtitle 3 of the Human Services Article.
(b)    (1)    To the extent allowed under federal law and regulations, the Secretary shall implement expedited eligibility for any individual who applies through the local health department for the Maryland Children’s Health Program under §§ 15-301 and 15-301.1 of this subtitle, including any individual with associated food stamp, cash assistance, or medical assistance cases.
(2)    The Secretary shall designate organizations that may:
(i)    Assist individuals in the application process; and
(ii)    Perform other outreach functions.
(3)    In designating the organizations under paragraph (2) of this subsection, the Secretary shall ensure the inclusion of statewide and local organizations that provide services to children of all ages in each region of the State, and shall provide such organizations with:
(i)    Forms that are necessary for parents, guardians, and other individuals to submit applications to the Maryland Children’s Health Program on behalf of a child; and
(ii)    Information on how to assist parents, guardians, and other individuals in completing and filing such applications.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 3 - Maryland Children's Health Program › Section 15-304 - School-Based Outreach Program; Outreach Mechanisms

(a)    (1)    For purposes of increasing the number of eligible individuals who enroll in the Maryland Children’s Health Program established under §§ 15–301 and 15–301.1 of this subtitle, the Department shall develop and implement a school–based outreach program.
(2)    As appropriate to carry out its responsibilities under paragraph (1) of this subsection, the Department may enter into contracts with county boards of education to provide information at public schools on the Maryland Children’s Health Program established under §§ 15–301 and 15–301.1 of this subtitle.
(b)    (1)    For purposes of this subsection, “community–based organization” includes child care centers, schools, and school–based health clinics.
(2)    In addition to the school–based outreach program established under subsection (a) of this section, the Department, in consultation with the Maryland Medicaid Advisory Committee established under § 15–103(b) of this title, shall develop mechanisms for outreach for the program with a special emphasis on identifying children who may be eligible for program benefits under the Maryland Children’s Health Program established under §§ 15–301 and 15–301.1 of this subtitle.
(3)    From the mechanisms to be developed for outreach under paragraph (2) of this subsection, one mechanism shall include the development and dissemination of mail–in applications and appropriate outreach materials through community–based organizations, community–based providers, the Office of the State Comptroller, the Departments of Human Services and Health, county boards of education, and any other appropriate State agency or unit the Department considers appropriate.
(c)    (1)    The Department shall collaborate with the Office of the Comptroller or the Office of the State Treasurer to:
(i)    Form a one–sentence statement advising that individuals who cannot afford health insurance may be eligible to enroll in the Maryland Children’s Health Program; and
(ii)    Print the statement formed under item (i) of this paragraph:
1.    On each State–issued tax refund check stub;
2.    Once each pay quarter, on each State–issued employee paycheck stub; and
3.    On each State–issued child support payment check stub.
(2)    The statement shall contain a telephone number or other contact information that an individual may use to receive more information on eligibility for the Maryland Children’s Health Program.
(3)    The statement may be altered by the Department in collaboration with the Office of the Comptroller or the Office of the State Treasurer to:
(i)    Provide the most current information;
(ii)    Fit within the space constraints of the different types of checks listed in paragraph (1)(ii) of this subsection; or
(iii)    Combine it with the statement required under § 15–102.1(c) of this title, if appropriate.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 4 - Qualified State Long-Term Care Insurance Partnership › Section 15-402 - Program Established; Purposes; Administration

(a)    There is a Qualified State Long–Term Care Insurance Partnership.
(b)    The purposes of the Program are to:
(1)    Provide incentives for individuals to insure against the costs of providing for their long–term care needs;
(2)    Provide mechanisms for individuals to qualify for coverage of the costs of their long–term care needs under the medical assistance program without first being required to substantially exhaust all their resources;
(3)    Assist in developing methods for increasing access to and the affordability of a long–term care policy; and
(4)    Alleviate the financial burden on the State’s medical assistance program by encouraging pursuit of private initiatives.
(c)    The Program shall:
(1)    Be administered by:
(i)    The Department; and
(ii)    The Commissioner;
(2)    Provide for the financing of long–term care services by:
(i)    Private insurance; and
(ii)    State medical assistance; and
(3)    Comply with the requirements of § 1917(b) of the Social Security Act and any applicable federal guidelines.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 4 - Qualified State Long-Term Care Insurance Partnership › Section 15-403 - Eligibility

(a)    To be eligible for the Program, an individual must:
(1)    Be covered by a long–term care policy that is approved for the Program by the Commissioner under § 15–404 of this subtitle; and
(2)    Satisfy any other requirement for eligibility established by the Department.
(b)    Program eligibility may not be denied under this section for policy benefits that are not available or appropriate for treating the insured’s condition.
2023 Maryland Statutes › Health - General › Title 15 - Assistance Programs › Subtitle 4 - Qualified State Long-Term Care Insurance Partnership › Section 15-404 - Qualifying Policy

To qualify under the Program, a long–term care policy shall:
(1)    Satisfy the requirements of § 1917(b) of the Social Security Act and any applicable federal guidelines;
(2)    Satisfy the requirements of Title 18 of the Insurance Article; and
(3)    Alert the purchaser to the availability of consumer information and public education provided by the Commissioner under § 15–406 of this subtitle in accordance with any applicable federal guidelines.