Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 2 › Subtitle 09 - MEDICAL CARE PROGRAMS › Chapter 10.09.22 - Free-Standing Dialysis Facility Services › Section 10.09.22.01 - 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) "CMS" means Centers for Medicare and
				  Medicaid Services.
(2) "Continuous
				  ambulatory peritoneal dialysis (CAPD)" means a dialysis treatment method
				  performed manually during the day by patient in which the patient's peritoneal
				  membrane is used as a dialyzer.
(3)
				  "Continuous cycling peritoneal dialysis (CCPD)" means a dialysis treatment
				  method performed automatically during the night with a peritoneal dialysis
				  cycler in which the patient's peritoneal membrane is used as a
				  dialyzer.
(4) "Department" means
				  the Department of Health and Mental Hygiene, the single State agency designated
				  to administer the Maryland Medical Assistance Program under Title XIX of the
				  Social Security Act, 42
				  U.S.C. §
												1396 et seq.
(5) "Dialysis" means a treatment method in
				  which waste products are removed from the body by diffusion from one fluid
				  compartment to another across a semi-permeable membrane.
(6) "Dietitian-nutritionist" means an
				  individual who is licensed as a dietitian-nutritionist by the Board of Dietetic
				  Practice to practice dietetics in Maryland.
(7) "Free-standing dialysis facility" means a
				  dialysis unit capable of providing staff-assisted dialysis, which is not
				  located in an acute hospital setting.
(8) "Hemodialysis" means a dialysis treatment
				  method in which blood passes through an artificial kidney machine and the waste
				  products diffuse across a manmade membrane into a bath solution known as
				  dialysate after which the cleansed blood is returned to the patient's
				  body.
(9) "Home dialysis" means hemodialysis or peritoneal
				  dialysis performed regularly in the home with the assistance of a family member
				  or the patient's caregiver.
(10)
				  "Home dialysis training" means instructions on how to perform dialysis services
				  in a home setting.
(11) "Licensed
				  practical nurse (LPN)" means an individual licensed to practice licensed
				  practical nursing as defined in Health Occupations Article, §
											8-301, Annotated
				  Code of Maryland.
(12) "Medical
				  Assistance Program" means a program of comprehensive medical and other
				  health-related care for indigent and medically indigent persons.
(13) "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.
(14) "Medicare" means the insurance program
				  administered by the federal government under Title XVIII of the Social Security
				  Act, 42 U.S.C. §
												1395 et seq.
(15) "Nurse practitioner" means an individual
				  who is licensed and certified to practice as a nurse practitioner as defined in
				  Health Occupations Article, §
											8-301, Annotated
				  Code of Maryland.
(16)
				  "Participant" means a person who is certified as eligible for, and is
				  receiving, Medical Assistance benefits.
(17) "Patient care
				  policies" means written policies and protocols describing patient care
				  practices and procedures established by a group of professional personnel
				  (including one or more physicians affiliated with the free-standing dialysis
				  facility) and approved in writing by the facility's medical director.
(18)
				  "Peritoneal dialysis" means a dialysis treatment method in which waste products
				  pass from the patient's body through the peritoneal membrane into the
				  peritoneal cavity where the bath solution (dialysate) is introduced and removed
				  periodically.
(19) "Physician "
				  means an individual who is authorized under the Maryland Medical Practice Act
				  to practice medicine in this State as stated in Health-General Article
				  §1-101, Annotated Code of Maryland.
(20) "Physician assistant" means an
				  individual who is licensed to practice medicine with physician supervision as
				  stated in Health Occupations Article, §§
											15-301(d)
				  and (e) and 15-302, Annotated Code of Maryland.
(21) "Plan of care" means a written plan for
				  evaluation, treatment, and follow-up of each participant documented in the
				  participant's medical record that should include, at a minimum, the following
				  information:
(a) Patient identification
				  data;
(b) Date of
				  service;
(c) Reason for
				  visit;
(d) Medical
				  history;
(e) Plan for treatment;
(f) Results of all laboratory
				  tests ordered and performed; and
(g) Interpretation of all diagnostic
				  radiology procedures ordered and performed.
(22) "Program" means the Maryland Medical
				  Assistance Program.
(23)
				  "Registered nurse (RN) " means an individual licensed to practice registered
				  nursing as defined in Health Occupations Article, §
											8-301, Annotated
				  Code of Maryland.
(24) "Social
				  worker" means a person who is licensed as a social worker in accordance with
				  COMAR 10.42.01.05.