reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.18 - Community Supported Living Arrangements Payment System › Section 10.22.18.05 - Supplemental Services

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Supplemental services do not include any services that are in the Maryland
				  Medical Assistance Program and can be provided to an individual and reimbursed
				  under the Medical Assistance Program, or any services covered by private
				  insurance, including Medicare.
B.
				  Supplemental services include:
(1)
				  Respite;
(2) Expenses related to
				  the operation and maintenance of the individual's vehicle;
(3) Medical equipment;
(4) Structural modifications for
				  accessibility;
(5) Habitation
				  start-up;
(6) Assistive
				  technology;
(7) Other services as
				  preauthorized and approved by the Administration; and
(8) Housing costs, if:
(a) The individual is unable to pay the full
				  amount of ongoing housing costs, and
(b) There are no other State or federal
				  resources available to pay for the ongoing housing costs.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.18 - Community Supported Living Arrangements Payment System › Section 10.22.18.06 - Requests For and Approval of Supplemental Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. In order for the Administration to
				  reimburse a licensee for supplemental services, the Administration shall
				  preauthorize the service and approve the cost.
B. To be approved for reimbursement of
				  supplemental services, except housing, the licensee shall:
(1) Submit a written request to the
				  Administration justifying the request, including:
(a) Recommendations from the individual's
				  team,
(b) Documentation from
				  appropriate professionals, and
(c)
				  Other documentation the Administration requires; and
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.18 - Community Supported Living Arrangements Payment System › Section 10.22.18.07 - Payment for Base Services

Current through Register Vol. 51, No. 14, July 12, 2024
The licensee shall submit invoices or electronic claims in
					 the form determined by the Administration.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.18 - Community Supported Living Arrangements Payment System › Section 10.22.18.08 - Payment For Supplemental Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. The Administration shall pay the lower of
				  either:
(1) Reasonable customary and actual
				  costs not to exceed the cost to the general public; or
(2) Medicaid-approved rates.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.18 - Community Supported Living Arrangements Payment System › Section 10.22.18.09 - Contract

Current through Register Vol. 51, No. 14, July 12, 2024
The Administration shall contract for services needed by an
					 individual as documented in the IP and preauthorized but not covered by rates
					 or supplemental services in accordance with the State's procurement
					 requirements.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.18 - Community Supported Living Arrangements Payment System › Section 10.22.18.10 - Rates for Self-Directed Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. If there is an existing contract for
				  family support services or individual support services, the contract amount
				  less the amount to be paid for fiscal management services shall be used in
				  determining the amount of money available for purchasing support services and
				  support brokerage services in an individual's budget.
B. If there is no existing contract for
				  family support services or individual support services, the CSLA rates less the
				  amount to be paid for fiscal management services shall be used in determining
				  the amount of money available for purchasing support services and support
				  brokerage services in an individual's budget.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.19 - Special Programs › Section 10.22.19.01 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this chapter,
				  the following terms have the meanings indicated.
B. Terms Defined.
(1) "Day services" means services provided by
				  a licensed provider under COMAR
				  10.22.07.03E.
(2) "Enclave" means a group of
				  eight or fewer individuals with developmental disabilities that works as a
				  single team in a single community work site.
(3) "Fiscal Incentive Program for Employment
				  (FIPE)" means the program that provides a one-time fiscal incentive to eligible
				  programs to assist individuals with developmental disabilities in securing and
				  maintaining a job of the individual's choice in the community.
(4) "Mobile crew" means a group of eight or
				  fewer individuals with developmental disabilities that operates as a single
				  team moving from one work site to another, performing contracted tasks such as
				  custodial and ground maintenance.
(5) "Self-employed" means an individual who
				  owns and operates a business that generates revenue.
(6) "Sheltered environment" means a setting
				  that is segregated to include only individuals with disabilities who perform
				  work or simulated work training activities for subminimum wages.
(7) "Supported employment" has the meaning
				  stated in COMAR
				  10.22.07.03C.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.19 - Special Programs › Section 10.22.19.02 - Fiscal Incentive Program for Employment

Current through Register Vol. 51, No. 14, July 12, 2024
A. Provider Eligibility. A provider is
				  eligible to be included in the FIPE if the provider:
(1) Is licensed as a vocational or day
				  services program under COMAR 10.22.07; and
(2) Provides services to an eligible
				  individual.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.20 - Organized Health Care Delivery Systems › Section 10.22.20.01 - Purpose

Current through Register Vol. 51, No. 14, July 12, 2024
The purpose of this chapter is to set forth the designation
					 process and requirements for Organized Health Care Delivery Systems (OHCDS).
					 Entities with this designation may subcontract with Medicaid and Non-Medicaid
					 providers to allow individuals to receive services approved in their Individual
					 Plans in the manner which best suits their needs and results in the more
					 complete fulfillment of their plans.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.20 - Organized Health Care Delivery Systems › Section 10.22.20.02 - Scope

Current through Register Vol. 51, No. 14, July 12, 2024
This chapter establishes the:
A. Methodology that the Department shall use
				  in the designation of entities as Organized Health Care Delivery Systems;
				  and
B. Requirements to be fulfilled
				  by Organized Health Care Delivery Systems.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.20 - Organized Health Care Delivery Systems › Section 10.22.20.03 - Additional Regulatory Compliance

Current through Register Vol. 51, No. 14, July 12, 2024
In addition to this chapter, a person who becomes an
					 Organized Health Care Delivery System shall comply with the following
					 regulations, as applicable:
A. COMAR
				  10.22.01-.10;
B. COMAR
				  10.22.17;
C. COMAR 10.22.18;
				  and
D. COMAR 10.09.26.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.20 - Organized Health Care Delivery Systems › Section 10.22.20.04 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In addition to
				  the definitions set forth in COMAR 10.22.01, in this chapter, the following
				  terms have the meanings indicated.
B. Terms Defined.
(1) "Administration" means the Developmental
				  Disabilities Administration.
(2)
				  "Organized Health Care Delivery System (OHCDS)" means, under
				  42 CFR §
												447.10, a public or private organization for
				  delivering health services that provides at least one Medicaid service directly
				  and utilizes its own employees rather than contractors.
(3) "Provider entity" means the OHCDS or
				  potential OHCDS.
(4) "Provider of
				  service" means the person who actually delivers the service to the
				  consumer.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.20 - Organized Health Care Delivery Systems › Section 10.22.20.05 - Designation as an OHCDS

Current through Register Vol. 51, No. 14, July 12, 2024
The Administration shall designate a provider who applies
					 to be an OHCDS if the provider entity:
A. Submits an application on a form approved
				  by the Administration;
B. Is
				  licensed by the Administration to provide one of the following services:
(1) Community supported living
				  arrangements;
(2) Family and
				  individual support services;
(3)
				  Day services;
(4) Supported
				  employment services;
(5)
				  Residential services; and
(6) Other
				  services as applicable;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.20 - Organized Health Care Delivery Systems › Section 10.22.20.06 - OHCDS Requirements

Current through Register Vol. 51, No. 14, July 12, 2024
An OHCDS may either provide services itself or subcontract
					 with another entity, and shall:
A.
				  Ensure that services provided are consistent with the consumer's Individual
				  Plan and are detailed in the payment agreement with the
				  Administration;
B. Submit reports
				  and comply with record keeping in accordance with Health-General Article,
				  §§7-306.1 and 7-910, Annotated Code of Maryland; and
C. Submit claims for Federal Financial
				  Participation monthly or on an alternative time frame established by the
				  Administration of which 50 percent of the OHCDS' quarterly payment may be
				  withheld if required paperwork is not submitted within the designated time
				  frame.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.20 - Organized Health Care Delivery Systems › Section 10.22.20.07 - OHCDS Subcontracting Requirements

Current through Register Vol. 51, No. 14, July 12, 2024
When subcontracting, the OHCDS shall:
A. Ensure that the providers of service meet
				  all applicable provider qualifications set forth in COMAR 10.22 and 10.09.26,
				  and any applicable industry or regulatory standards;
B. Enter into a subcontract with each
				  provider of service that:
(1) Contains the
				  scope, frequency, duration, and cost of the services to be provided;
(2) Documents the qualifications of the
				  provider of service;
(3) Details
				  service termination procedures;
(4)
				  Is consistent with the Individual's Plan; and
(5) Is executed by the individual, the
				  service provider, and the OHCDS; and
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.20 - Organized Health Care Delivery Systems › Section 10.22.20.08 - Freedom of Choice of Providers

Current through Register Vol. 51, No. 14, July 12, 2024
This chapter does not infringe on an individual's right to
					 choose freely among qualified providers at any time.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.20 - Organized Health Care Delivery Systems › Section 10.22.20.09 - Termination of Designation

Current through Register Vol. 51, No. 14, July 12, 2024
The Administration may terminate OHCDS designation as set
					 forth in COMAR
					 10.22.03.06 a and
					 10.22.03.07 a.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 23 - ADVANCE DIRECTIVE REGISTRY › Chapter 10.23.01 - Advance Directive Registry › Section 10.23.01.01 - Scope

Current through Register Vol. 51, No. 14, July 12, 2024
This chapter defines key terms and sets out requirements
					 and procedures for an Advance Directive Registry.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 23 - ADVANCE DIRECTIVE REGISTRY › Chapter 10.23.01 - Advance Directive Registry › Section 10.23.01.02 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this chapter,
				  the following terms have the meanings indicated.
B. Terms Defined.
(1) Advance Directive.
(a) "Advance directive" has the meaning
				  stated in Health-General Article, §5-601, Annotated Code of
				  Maryland.
(b) "Advance directive"
				  includes an Instructions on Current Life-Sustaining Treatment Options form
				  developed under Health-General Article, §5-608.1, Annotated Code of
				  Maryland.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 23 - ADVANCE DIRECTIVE REGISTRY › Chapter 10.23.01 - Advance Directive Registry › Section 10.23.01.03 - Filing and Registration

Current through Register Vol. 51, No. 14, July 12, 2024
A. An
				  individual may submit an advance directive to the Department for
				  registration.
B. In order for the
				  Department to register an advance directive, a registrant shall provide to the
				  Department:
(1) A completed application on
				  the form provided by the Department;
(2) The required fee, as set forth in
				  Regulation .06 of this chapter; and
(3) An advance directive that contains:
(a) The registrant's signature;
(b) The date on which the advance directive
				  was signed by the registrant; and
(c) The signatures of:
(i) Two witnesses as provided in
				  Health-General Article, §5-602, Annotated Code of Maryland; or
(ii) If an Instructions on a Current
				  Life-Sustaining Treatment Options form is submitted and the registrant is
				  incapable of making an informed decision, the registrant's health care agent or
				  surrogate and the registrant's attending physician.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 23 - ADVANCE DIRECTIVE REGISTRY › Chapter 10.23.01 - Advance Directive Registry › Section 10.23.01.04 - Nonregistration of Advance Directive

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  An individual is not required to register an advance directive with the
				  Department.
B. An advance directive
				  that is not submitted to the Registry is valid in accordance with applicable
				  law.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 23 - ADVANCE DIRECTIVE REGISTRY › Chapter 10.23.01 - Advance Directive Registry › Section 10.23.01.05 - Amendment or Revocation of a Registered Advance Directive

Current through Register Vol. 51, No. 14, July 12, 2024
A. The registrant shall notify the Registry
				  if a registered advance directive has been:
(1) Amended; or
(2) Revoked.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 23 - ADVANCE DIRECTIVE REGISTRY › Chapter 10.23.01 - Advance Directive Registry › Section 10.23.01.07 - Disclosure of Information

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Department shall provide access to a registered advance directive to:
(1) The registrant; or
(2) An authorized person.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 23 - ADVANCE DIRECTIVE REGISTRY › Chapter 10.23.01 - Advance Directive Registry › Section 10.23.01.08 - Storage of Data

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Department shall establish a Registry that is:
(1) Secure, in accordance with data security
				  standards customarily applied to the protection of electronic medical records;
				  and
(2) Available 24 hours a day, 7
				  days a week.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 23 - ADVANCE DIRECTIVE REGISTRY › Chapter 10.23.01 - Advance Directive Registry › Section 10.23.01.09 - Public Outreach

Current through Register Vol. 51, No. 14, July 12, 2024
The Department shall carry out educational and outreach
					 efforts to increase public awareness of the Registry.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 23 - ADVANCE DIRECTIVE REGISTRY › Chapter 10.23.01 - Advance Directive Registry › Section 10.23.01.10 - Liability of Health Care Providers

Current through Register Vol. 51, No. 14, July 12, 2024
A health care provider is not subject to criminal
					 prosecution or civil liability and may not be determined to have engaged in
					 unprofessional conduct by the appropriate licensing authority for:
A. Failure to access the Registry;
				  or
B. Relying on information
				  provided by the Registry.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 23 - ADVANCE DIRECTIVE REGISTRY › Chapter 10.23.01 - Advance Directive Registry › Section 10.23.01.11 - Registry Funding

Current through Register Vol. 51, No. 14, July 12, 2024
Implementation of this chapter is contingent on the
					 availability of funds, in accordance with State Finance and Procurement
					 Article, §§
										7-234
					 and
					 7-235,
					 Annotated Code of Maryland.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.01 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this
				  chapter, the following terms have the meanings indicated.
B. Terms Defined.
(1) "Acquisition" means:
(a) Any transfer of stock or assets that
				  results in a change of the person or persons who control a health care
				  facility; or
(b) The transfer of
				  any stock or ownership interest in excess of 25 percent.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.02 - Coverage

Current through Register Vol. 51, No. 14, July 12, 2024
A. Except as
				  provided in Regulations .03-.05 of this chapter or as otherwise provided by
				  law, a CON is required before:
(1) A new
				  health care facility is built, developed, or established;
(2) An existing health care facility is moved
				  to another site, unless the relocation is:
(a)
				  The result of a partial or complete replacement of an existing hospital or
				  related institution, as defined in Health-General Article, §19-301,
				  Annotated Code of Maryland, and is to another part of the site or immediately
				  adjacent to the site of the existing hospital or related institution;
(b) Of an existing health care facility owned
				  or controlled by a merged asset system, subject to the provisions of
				  Regulations .03E or .04A(2) of this chapter, whichever is applicable;
				  or
(c) By a hospital converting to
				  a limited service hospital, subject to the provisions of Regulation .04A(4) of
				  this chapter, and is to a site within the immediate area, as determined by the
				  Commission, as described in §B of this regulation;
(3) The bed capacity of a health care
				  facility is changed;
(4) The type
				  or scope of any health care service offered by a health care facility is
				  changed, and the change:
(a) Establishes a new
				  medical service;
(b) Establishes a
				  new cardiac surgery, organ transplant surgery, burn treatment, or neonatal
				  intensive care program;
(c)
				  Establishes a new home health agency, general hospice care program, or
				  ambulatory surgical facility;
(d)
				  Builds or expands surgical capacity in a hospital, freestanding medical
				  facility subject to rate regulation by the Health Services Cost Review
				  Commission, or ambulatory surgical facility;
(e) Results in:
(i) The establishment of a new parent home
				  health agency; or
(ii) The
				  expansion of an existing home health agency into a jurisdiction in which it was
				  not previously authorized by the Commission to operate;
(f) Eliminates an existing medical service;
				  or
(g) Closes an existing health
				  care facility or converts it to a non-health-related use; or
(5) A hospital makes a capital
				  expenditure, as defined in Health-General Article, §19-120(k), Annotated
				  Code of Maryland, and in this chapter, that exceeds the hospital capital
				  threshold, including a capital expenditure:
(a) For the relocation of an existing health
				  care facility owned or controlled by a merged asset system, except as provided
				  in Regulation .03E of this chapter; and
(b) By a relocated health care facility to
				  permit the facility to offer a new health care service for which CON is
				  otherwise required.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.03 - Non-Coverage by Certificate of Need or Other Commission Approval

Current through Register Vol. 51, No. 14, July 12, 2024
A. Acquisition
				  of an Existing Health Care Facility.
(1) At
				  least 30 days before closing on a contract to acquire a health care facility,
				  the person acquiring the facility shall notify the Commission in writing, with
				  a copy to the local health officer in each affected jurisdiction and the
				  appropriate State licensing agency, of the intent to acquire the facility, and
				  include the following information:
(a) The
				  health care services provided by the facility;
(b) The bed capacity, or jurisdiction served,
				  if a community-based service;
(c)
				  Complete organizational charts that describe the ownership of the health care
				  facility prior to and after the proposed acquisition; and
(d) Any other information required by this
				  chapter, by the State Health Plan chapter applicable to the health care
				  facility, or requested by Commission staff.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.04 - Exemption from Certificate of Need Review

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Commission may exempt from the requirement of CON review and approval the
				  following actions:
(1) Merger or
				  consolidation of two or more hospitals or other health care facilities, if the
				  facilities or an organization that operates the facilities give the Commission
				  45 days written notice of their intent to merge or consolidate;
(2) Relocation of an existing health care
				  facility owned or controlled by a merged asset system, if:
(a) The relocation is to a site outside:
(i) The primary service area of the hospital
				  to be relocated but within the primary service area of the merged asset system;
				  or
(ii) The service area of the
				  non-hospital health care facility to be relocated but within the primary
				  service area of the merged asset system; and
(b) The relocation of the existing health
				  care facility does not:
(i) Change the type or
				  scope of health care services offered; and
(ii) In the case of a hospital, require a
				  capital expenditure for its construction that exceeds the hospital capital
				  threshold, adjusted for inflation, except as provided by Regulation .03J of
				  this chapter;
(3) A change in the bed capacity of an
				  existing health care facility pursuant to the consolidation or merger of two or
				  more health care facilities, or conversion of a health care facility or part of
				  a health care facility to a non-health-related use, except as provided in
				  Regulation .03F of this chapter;
(4) A change in the type or scope of the
				  health care services offered by a health care facility, if, at least 45 days
				  before increasing or decreasing the volume of one or more health care services,
				  the Commission finds that the proposed change is pursuant to the:
(a) Consolidation or merger of two or more
				  health care facilities;
(b)
				  Conversion of all or part of a health care facility to a non-health-related
				  use; or
(c) Conversion of a
				  hospital to a limited service hospital;
(5) A capital expenditure that exceeds the
				  review threshold for capital expenditure made as part of a consolidation or
				  merger of two or more health care facilities, or conversion of a health care
				  facility or part of a health care facility to a non-health-related use;
				  or
(6) The establishment of a
				  freestanding medical facility through the conversion of an acute general
				  hospital, as provided in §F of this regulation and in COMAR
				  10.24.19.04C.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.06 - Access to Information and Facilities

Current through Register Vol. 51, No. 14, July 12, 2024
To the extent permitted by law, an applicant shall provide
					 access to general information, records, plans and specifications, meetings,
					 sites, and facilities to Commission staff upon proper notice and as is
					 reasonable and necessary in the performance of the Commission's
					 responsibilities. The Commission may require other health care providers to
					 provide similar information.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.08 - Procedure for Review of CON Applications

Current through Register Vol. 51, No. 14, July 12, 2024
A. Review
				  Schedule.
(1) An application shall be
				  submitted in accordance with the published review schedule established by the
				  Commission in accordance with §D(1) of this regulation, but if no
				  applicable review schedule has been published, an application may be submitted
				  at any time 60 days after the filing of the letter of intent but no more than
				  180 days after the filing of the letter of intent, unless a shorter period has
				  been approved by the Executive Director.
(2) In a case when need for additional
				  service capacity is projected, the Commission may not docket an application
				  until it has made a final decision on each previously docketed application for
				  a comparable project, unless the most recently published need projections or
				  State Health Plan would support the approval of both projects.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.09 - Commission Decision and Action on CON Applications

Current through Register Vol. 51, No. 14, July 12, 2024
A. Proposed
				  Decision.
(1) Preparation of Proposed
				  Decision.
(a) In a comparative or contested
				  review, or in a review in which an evidentiary hearing is held in accordance
				  with Regulation .11 of this chapter, the Executive Director shall appoint a
				  single Commissioner, who may be assisted by the staff of the Commission, to act
				  as reviewer and prepare a proposed decision for consideration by the
				  Commission.
(b) In all other
				  reviews, Commission staff shall review the application and prepare a staff
				  report and recommendation for consideration by the Commission.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.10 - Miscellaneous Rules and Procedures

Current through Register Vol. 51, No. 14, July 12, 2024
A. Computation
				  of Time.
(1) In computing a period of time
				  prescribed by these regulations, by order of the Commission, or by an
				  applicable statute, the day of the action or default initiating the designated
				  period of time is not included. The last day of the period so computed is to be
				  included unless it is a day on which the office of the Commission is closed, in
				  which event the period extends until the next day on which the office of the
				  Commission is open. Unless otherwise noted, all time periods shall be computed
				  in calendar days.
(2) At the
				  discretion of the reviewer, the Executive Director, or the Executive Director's
				  designee, and upon a showing of good cause by the submitting party, a period of
				  time to submit a document or perform any act permitted or prescribed by these
				  regulations may be extended for a reasonable period of time.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.11 - Evidentiary Hearings

Current through Register Vol. 51, No. 14, July 12, 2024
A. Request for
				  Evidentiary Hearing.
(1) Except as otherwise
				  provided in these regulations, a request for an evidentiary hearing shall be
				  made within 45 days of the docketing of an application or within 30 days after
				  the modification of an application in a review.
(2) At the request of an applicant or
				  interested party, the Commission may hold an evidentiary hearing in the review
				  of a CON application for any health care facility other than an ambulatory
				  surgical facility if, in the judgment of the reviewer, an evidentiary hearing
				  is appropriate due to the magnitude of the impact that the proposed project may
				  have on the health care delivery system and the project, if approved, would
				  result in one of the following:
(a) A
				  substantial negative impact on the costs and charges for the type of the
				  facility, services, or both included in the project;
(b) A substantial negative impact on access
				  to those facilities and services by the population in the proposed project's
				  expected service area;
(c) A
				  significant decrease in the availability and overall quality of health care
				  services in the affected area in a manner not consistent with policies or need
				  projections set forth in the State Health Plan, such as by causing a loss of
				  reasonable access to an essential medical service by a substantial number of
				  patients; or
(d) Any impact that
				  the reviewer concludes may be sufficiently serious to merit an evidentiary
				  hearing.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.12 - Holder Responsibilities and Withdrawal of a Certificate of Need or Other Commission Approval

Current through Register Vol. 51, No. 14, July 12, 2024
A. Project
				  Implementation Schedule.
(1) An application
				  for a CON or other Commission approval shall propose a schedule for
				  implementation of the project that specifies the estimated time for, at a
				  minimum, the following project implementation steps:
(a) The time required to enter a binding
				  obligation following Commission approval of the application for the
				  project;
(b) The time required to
				  initiate construction, renovation, or both following execution of a binding
				  obligation;
(c) The time required
				  to complete the approved construction, renovation, or both following initiation
				  of construction, renovation, or both; and
(d) The time required to place the new
				  facility or modified facility in operation following the completion of approved
				  construction, renovation, or both.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.12 - Holder Responsibilities and Penalties for Noncompliance

Current through Register Vol. 51, No. 14, July 12, 2024
A. Project Implementation Schedule.
(1) An application for a CON or other Commission approval shall propose a schedule for implementation of the project that specifies the estimated time for, at a minimum, the following project implementation steps:
(a) The time required to enter a binding obligation following Commission approval of the application for the project;
(b) The time required to initiate construction, renovation, or both following execution of a binding obligation;
(c) The time required to complete the approved construction, renovation, or both following initiation of construction, renovation, or both; and
(d) The time required to place the new facility or modified facility in operation following the completion of approved construction, renovation, or both.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.13 - Procedures for Certificate of Conformance and Certificate of Ongoing Performance Applications

Current through Register Vol. 51, No. 14, July 12, 2024
A. Coverage.
(1) A certificate of conformance is required
				  to introduce primary or elective percutaneous coronary intervention services at
				  a hospital.
(2) A certificate of
				  ongoing performance is required and shall be periodically renewed to certify
				  that a hospital providing cardiac surgery services or percutaneous coronary
				  intervention services is maintaining an acceptable level of quality and
				  performance in its provision of those services.
(3) A hospital with newly established cardiac
				  surgery services or percutaneous coronary intervention services at an acute
				  general hospital may continue to provide services without a certificate of
				  ongoing performance until the Commission acts on the hospital's first
				  application for a certificate of ongoing performance.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.14 - Special Procedures

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Determination of Coverage. Except as otherwise provided in Regulations .03 or
				  .05 of this chapter, a project that requires a determination of coverage shall
				  be dealt with in the following manner:
(1) A
				  written request for determination of coverage shall be filed with the Center
				  for Health Care Facilities Planning and Development.
(2) The Executive Director of the Commission
				  shall review the request and act on it within 30 business days of receipt of
				  complete information.
(3) The
				  person requesting the determination shall provide all additional information
				  requested by Commission staff.
(4)
				  The Commission shall notify the person, each appropriate local health
				  department, and each agency responsible under the Department's licensure
				  program for the type of project whether it requires a Certificate of Need or
				  other Commission review.
(5)
				  Commission staff's determination of coverage may be appealed by the requesting
				  party to the Commission by use of a motion filed in accordance with Regulation
				  .10C of this chapter.
(6) The
				  Executive Director may issue a determination that:
(a) Certificate of Need or other Commission
				  review is not required; or
(b)
				  Certificate of Need review is required for stated reasons.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.15 - Commission Approval Required Before Certain Actions

Current through Register Vol. 51, No. 14, July 12, 2024
A. Obligation
				  of Capital Expenditure.
(1) A person may not
				  incur an obligation for a capital expenditure for a project that is subject to
				  review under these regulations until the applicant receives a CON or other
				  required Commission approval.
(2)
				  An obligation for capital expenditure is incurred by or on behalf of a health
				  care facility:
(a) When a contract,
				  enforceable under State law, is entered into by or on behalf of the health care
				  facility for the construction, acquisition, lease, or financing of a capital
				  asset;
(b) When a governing body of
				  the health care facility takes formal action to commit its own funds for a
				  construction project undertaken by the health care facility as its own
				  contractor; or
(c) In the case of
				  donated property, on the date on which the gift is completed under applicable
				  State law.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.16 - Voluntary Withdrawal of an Application

Current through Register Vol. 51, No. 14, July 12, 2024
An applicant may voluntarily withdraw its application
					 without prejudice prior to final action by the Commission on the application.
					 Written notice of the withdrawal shall be submitted to the Commission through
					 the Executive Director. A withdrawn application may be resubmitted at a later
					 date as a new application.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.17 - Project Changes After Commission Approval

Current through Register Vol. 51, No. 14, July 12, 2024
A. Filing of
				  Request. A holder that desires to change a project that has received CON or
				  other Commission approval shall submit a request for the proposed change and
				  supporting documentation to the Commission, copying each local health
				  department within the health planning region of the project and, in the case of
				  a change in the location or address of a project involving construction of a
				  new health care facility, to all health care facilities of that type located in
				  the health planning region.
B.
				  Commission Approval Required Before Project Changes. Any of the following
				  proposed changes that would place the project at variance with its CON or other
				  approval issued under this chapter, including any condition placed on the
				  approval, shall be reviewed by the Commission:
(1) A significant change in physical plant
				  design;
(2) A capital cost increase
				  that exceeds the approved capital cost inflated by an amount determined by
				  applying the Hospital Capital Market Baskets published by IHS Markit in Health
				  Care Cost Review or other guidance approved by the Commission and posted on the
				  Commission website from the application submission date to the date of the
				  filing of a request for a project change;
(3) A change in the financing mechanisms of
				  the project; or
(4) A change in the
				  location of the project.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.18 - Review Required Before Licensing or First Use of Project

Current through Register Vol. 51, No. 14, July 12, 2024
A. Request for
				  First Use Review and Approval. Not fewer than 60 days but not more than 120
				  days before the first use of any portion of a facility or service developed
				  under a CON or other Commission approval, the holder shall specify the
				  anticipated date for first use and request in writing, through the Center for
				  Health Care Facilities Planning and Development, a final review and first use
				  approval. The request shall include:
(1)
				  Documentation of the final cost of the project; and
(2) A description of any differences in
				  physical plant design, space, or services in the finished project when compared
				  with the description of the project reviewed and approved by the
				  Commission.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.19 - Reconsideration Procedures

Current through Register Vol. 51, No. 14, July 12, 2024
A. Request for
				  Reconsideration. An aggrieved party may request that the Commission conduct a
				  hearing to reconsider a Commission final decision to grant, to grant with
				  conditions, or to deny a Certificate of Need application, a request for an
				  exemption from CON review, or a certificate of conformance application issued
				  under this chapter. This request shall be in writing and filed with the Center
				  for Health Care Facilities Planning and Development within 15 days of the date
				  upon which the Commission renders its decision and shall show good cause for
				  reconsideration of the decision.
B.
				  Good Cause. For purposes of this regulation, a request for a reconsideration
				  shows good cause if it:
(1) Presents
				  significant, relevant information which was not previously presented to the
				  Commission and which, with reasonable diligence, could not have been presented
				  before the Commission made its decision;
(2) Demonstrates that there have been
				  significant changes in factors or circumstances relied upon by the Commission
				  in reaching its decision; or
(3)
				  Demonstrates that the Commission has materially failed to follow its adopted
				  procedures in reaching its decision.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.20 - Emergency Certificate of Need

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Executive Director may issue an emergency Certificate of Need under the
				  following circumstances that would otherwise require issuance of a CON:
(1) A situation presents hazards to employees
				  or patients of a health care facility, and the project required to address the
				  situation would otherwise require CON review;
(2) The closing of a health care facility by
				  State licensing authorities requires changes or adjustments in other facilities
				  to accommodate displaced patients, and the changes or adjustments would
				  otherwise require that these facilities obtain a CON under these regulations;
				  or
(3) A project that would require
				  CON review is necessary to address a public health emergency and cannot be
				  delayed.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.21 - Severability

Current through Register Vol. 51, No. 14, July 12, 2024
If any provision of this chapter is declared void by a
					 court of law, the remainder of this chapter shall be unaffected and of
					 continued force and effect.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.01 - Procedural Regulations for Health Care Facilities and Services › Section 10.24.01.22 - Effective Date

Current through Register Vol. 51, No. 14, July 12, 2024
A. A letter of
				  intent or application submitted after the effective date of these regulations
				  is subject to their provisions.
B.
				  A request for a determination of coverage under Regulation .14A of this
				  chapter, submitted after the effective date of these regulations, is subject to
				  the provisions of this chapter.
C.
				  Upon request by a holder, a project that has previously received a Certificate
				  of Need or other Commission approval may be governed by this chapter.
D. Pending Reviews.
(1) Except in contested or comparative CON
				  reviews, an application for a CON or other Commission approval pending at the
				  time these regulations become effective shall be subject to their provision
				  upon request of the applicant.
(2)
				  Upon request of an applicant for a CON in a contested or comparative review, an
				  application pending at the time these regulations become effective may be
				  subject to their provisions with the consent of all interested parties and upon
				  a finding of good cause by the reviewer.
(3) If the applicable CON review criteria
				  have materially changed as a result of these regulations, the application of
				  these regulations to a pending CON application shall be deemed a modification
				  and governed by Regulation .08E of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 24 - MARYLAND HEALTH CARE COMMISSION › Chapter 10.24.02 - Data Reporting by Hospitals › Section 10.24.02.01 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this chapter,
				  the following terms have the meanings indicated.
B. Terms Defined.
(1) "Commission" means the Maryland Health
				  Care Commission.
(2) "Hospital"
				  means a facility defined as a hospital in Health-General Article,
				  §19-301(e) and (g), Annotated Code of Maryland, and COMAR 10.07.01
				  including:
(a) All classifications of
				  institutions set forth in Health-General Article, §19-307, Annotated Code
				  of Maryland, and COMAR 10.07.01, including "general", "special", or other types
				  of hospitals specified by rule or regulations pursuant to Health-General
				  Article, §19-307, Annotated Code of Maryland;
(b) "Special rehabilitation" hospital, as set
				  forth in Health-General Article, §19-318, Annotated Code of Maryland, and
				  COMAR 10.07.01; and
(c) "Limited
				  service" hospital, as set forth in Health-General Article, §19-307.1,
				  Annotated Code of Maryland, and COMAR 10.07.17.
(3) "HSCRC" means the Health Services Cost
				  Review Commission.