Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 2 › Subtitle 09 - MEDICAL CARE PROGRAMS › Chapter 10.09.80 - Community-Based Substance Use Disorder Services › Section 10.09.80.01 - 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) Administrative Service Organization
				  (ASO)" means the contractor procured by the State to provide the Department
				  with administrative support services to operate the Maryland Public Behavioral
				  Health System.
(2) "Behavioral
				  Health Administration (BHA)" means the administration within the Department
				  that establishes regulatory requirements that behavioral health programs are to
				  maintain in order to become licensed by the Department.
(3) "Community-based substance use disorder
				  program" means a program that provides services in community settings not
				  regulated by the Health Services Cost Review Commission.
(4) "DATA 2000 waived provider" means a
				  provider who has received a waiver under the Drug Addiction and Treatment Act
				  of 2000 which expands the clinical context of medication assisted opioid
				  dependency treatment and permits qualified physicians, nurse practitioners, and
				  physician assistants to dispense or prescribe certain narcotic medications that
				  have a lower risk of abuse, like buprenorphine, in settings other than an
				  opioid treatment program
(5)
				  "Department" means the Department of Health and Mental Hygiene, as defined in
				  COMAR 10.09.36.01, or its authorized
				  agents acting on behalf of the Department
(6) "Discharge plan" means a written
				  description of specific goals and objectives to assist the participant upon
				  leaving treatment.
(7)
				  "Documentation" means the written medical record.
(8) "Individualized treatment plan" means a
				  written plan of action that is developed and periodically updated and revised
				  to address a participant's specific service needs.
(9) "License" means the approval issued to a
				  program by the BHA or its designee that permits a behavioral health provider to
				  operate in Maryland.
(10) "Medical
				  Assistance" has the meaning stated in COMAR 10.09.24.02.
(11) "Medically necessary" means the service
				  or benefit is:
(a) Directly related to
				  diagnostic, preventive, curative, palliative, rehabilitative, or ameliorative
				  treatment of an illness, injury, disability, or health condition;
(b) Consistent with current accepted
				  standards of good medical practice;
(c) The most cost efficient service that can
				  be provided without sacrificing effectiveness or access to care; and
(d) Not primarily for the convenience of the
				  consumer, family, or provider.
(12) "Medication management" means a visit
				  with a physician, nurse practitioner, or physician assistant for the purpose of
				  evaluation, prescribing, and providing medications for substance use disorder
				  symptom reduction, withdrawal management, or medication assisted
				  treatment.
(13) "Participant" means
				  an individual who is certified as eligible for, and is receiving, Medical
				  Assistance benefits.
(14) "Peer
				  recovery support services" means a set of nonclinical activities provided by
				  individuals in recovery from behavioral health concerns, including substance
				  use or addictive disorders or mental health concerns, who use their personal,
				  lived experiences and training to support other individuals with substance use
				  or addictive disorders.
(15)
				  "Program" means the Maryland Medical Assistance Program.
(16) "Progress note" means an objective
				  documentation of the recipient's progress in relation to specific treatment
				  goals and objectives.
(17)
				  "Recovery support services" means community-based services provided to people
				  and their families during the initiation, on-going, and post-acute stages of
				  their recovery from substance abuse.
(18) Substance use disorder" means a
				  maladaptive pattern of substance use leading to clinically significant
				  impairment or distress and manifested by recurrent and significant adverse
				  consequences related to the repeated use of substances.
(19) "Substance use disorder services" means
				  the services for which a participant's diagnosis and treatment provider meet
				  the criteria specified in COMAR 10.09.70 and this chapter.
(20) "Telehealth" has the meaning stated in
				  COMAR 10.09.49.02.
(21) "Treatment
				  plan" means a written plan that addresses the individual's biopsychosocial
				  needs through goals and objectives and is updated as needed according to the
				  treatment modality.