Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 2 › Subtitle 09 - MEDICAL CARE PROGRAMS › Chapter 10.09.51 - Audiology Services › Section 10.09.51.01 - 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) "Audiologist" means a professional who is
				  licensed in accordance with Regulation .02 of this chapter who treats hearing
				  disorders and communication problems.
(2) "Audiology assessment" means procedures performed
				  by an audiologist to evaluate and monitor the status of the peripheral auditory
				  system, auditory nerve, and central auditory system, or to establish the site
				  of the auditory disorder by using procedures to quantify and qualify hearing
				  loss by site of lesion, on the basis of perceptual, physiological, or
				  electrophysiological responses to acoustic stimuli, and to describe any
				  communicative disorders.
(3)
				  Audiology Center.
(a) 'Audiology center"
				  means a multispecialty setting with all necessary equipment for audiology
				  services that operates for the purpose of providing preventive, diagnostic,
				  therapeutic, and rehabilitative audiology services, and other multispecialty
				  services by or under the direction of a licensed physician or
				  audiologist.
(b) "Audiology center"
				  does not include the office of one or more private audiologists.
(4) "Audiology services" means
				  services delivered by an audiologist to eligible participants in order to
				  diagnose and treat hearing problems.
(5) "Auditory osseointegrated device" means a
				  device implanted in the skull that replaces the function of the middle ear and
				  provides mechanical energy to the cochlea via a mechanical
				  transducer.
(6) "Bilateral" means
				  relating to or involving both ears.
(7) "Cochlear implant" means a device that is
				  implanted under the skin that picks up sounds and converts them to impulses
				  transmitted to electrodes placed in the cochlea, restoring some hearing to
				  people with a hearing impairment.
(8) "Department" means the Maryland
				  Department of Health, the single State agency designated to administer the
				  Medical Assistance Program under Title XIX of the Social Security Act,
				  42 U.S.C §
												1396 et seq.
(9) "Designee " means any entity designated
				  to act on behalf of the Department.
(10) "Early and Periodic Screening,
				  Diagnosis, and Treatment (EPSDT)" means the provision of preventive health care
				  under 42 CFR §
												441.50 et seq., including medical and dental
				  services, in order to assess growth and development and to detect and treat
				  health problems in Medical Assistance eligible individuals under 21 years
				  old.
(11) "EPSDT screening
				  provider" means a physician, audiologist, or an authorized practitioner under
				  Health Occupations Article, Annotated Code of Maryland.
(12) "Hearing aid" means an instrument or
				  device that is designed for improving or correcting impaired human hearing, or
				  any part or accessory of the instrument or device.
(13) "Hearing aid dispenser" means a person
				  who is licensed in accordance with Regulation .02 of this chapter to sell
				  hearing aids or provide other hearing aid services.
(14) "Hearing aid evaluation" means services
				  provided to a participant by an audiologist for determining the benefit of
				  hearing aids and, upon the audiologist's recommendation, the dispensing of
				  hearing aids.
(15) "Maryland
				  Medical Assistance Program(Program)" means the program of comprehensive medical
				  and other health-related care for indigent and medically indigent individuals.
(16) "Medically necessary" means
				  that 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
				  currently 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.
(17) "Participant" means an individual who is
				  enrolled with the Department to receive Medical Assistance services.
(18) "Program" has the meaning stated in
				  COMAR 10.09.36.01.
(19) "Provider"
				  means an audiologist, audiology center, or hearing aid dispenser that is
				  licensed and that, through an agreement with the Department, has been
				  identified as a Program provider by the issuance of a provider number.
(20) "Unilateral" means relating
				  to, involving, or affecting one ear.