Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 2 › Subtitle 09 - MEDICAL CARE PROGRAMS › Chapter 10.09.81 - Increased Community Services (ICS) Program › Section 10.09.81.04 - Conditions for Provider Participation - General Requirements

Current through Register Vol. 51, No. 14, July 12, 2024
A. To participate
				  as a provider of a service covered under Regulations .22-.37 of this chapter, a
				  provider shall:
(1) Meet all of the
				  conditions for participation as a Maryland Medical Assistance Program provider
				  as set forth in COMAR 10.09.36, except as otherwise specified in this
				  chapter;
(2) Meet the licensure and
				  certification requirements specified in this chapter, if applicable;
(3) Meet the applicable conditions for
				  provider participation in this chapter;
(4) Apply in accordance with the conditions
				  of participation under Regulations .05-.20 of this chapter, by completing the
				  application forms designated by the Maryland Medical Assistance
				  Program;
(5) Have a signed provider
				  agreement in effect with the Maryland Medical Assistance Program;
(6) Verify the qualifications of all
				  individuals who render ICS services on the provider's behalf, and provide a
				  copy of the current license or credentials of these individuals upon
				  request;
(7) Provide services in
				  accordance with:
(a) A participant's plan of
				  service;
(b) The provider
				  agreement;
(c) The ICS Program;
				  and
(d) All relevant federal,
				  State, and local laws and regulations;
(8) Agree to inform the case manager within
				  24 hours, and within 7 calendar days file a written report on a form designated
				  by the Department, in the case of any threat to the health, safety, or welfare
				  of the participant such as:
(a) Potential
				  eviction;
(b) Suspected abuse or
				  neglect; or
(c) Significant
				  interruption of service;
(9) Immediately notify the Adult Protective
				  Services office at the local department of social services and law enforcement
				  if the provider believes that the participant has been subjected to abuse,
				  neglect, self-neglect, or exploitation in the community, in accordance with
				  COMAR 07.06.14.04D;
(10) Agree to
				  cooperate with required inspections, reviews, and audits by authorized
				  governmental representatives;
(11)
				  Agree to provide services, and to subsequently bill the Department in
				  accordance with the payment procedures specified at Regulation .40 of this
				  chapter for only covered services which have been:
(a) Preapproved in the participant's plan of
				  service;
(b) Provided in a manner
				  consistent with the participant's plan of service; and
(c) Authorized in the provider agreement as
				  within the scope of the provider's Medicaid participation;
(12) Agree to maintain and have available
				  written documentation of ICS services, including dates and hours of services
				  provided to participants for a period of 6 years, in a manner approved by the
				  Department;
(13) Agree not to
				  suspend, terminate, increase, or reduce services for a participant without
				  authorization from the participant's case manager; and
(14) Agree to comply with the requirements in
				  the Department's quality plan for the ICS Program.