reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 13 - DRUGS › Chapter 10.13.05 - AIDS Education Program for Persons Convicted of Drug/Sex-Related Crimes (Repealed) › Section 10.13.05.04 - Responsibilities of the Local Health Department (Repealed)

Current through Register Vol. 51, No. 14, July 12, 2024
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 13 - DRUGS › Chapter 10.13.05 - AIDS Education Program for Persons Convicted of Drug/Sex-Related Crimes (Repealed) › Section 10.13.05.05 - Responsibilities of the Contractor (Repealed)

Current through Register Vol. 51, No. 14, July 12, 2024
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 13 - DRUGS › Chapter 10.13.05 - AIDS Education Program for Persons Convicted of Drug/Sex-Related Crimes (Repealed) › Section 10.13.05.06 - Responsibilities of an Individual Attending an SASOE Educational Session (Repealed)

Current through Register Vol. 51, No. 14, July 12, 2024
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 13 - DRUGS › Chapter 10.13.08 - Sale of Needles and Syringes or Other Paraphernalia › Section 10.13.08.01 - Identification of Purchaser, and Record of Sale

Current through Register Vol. 51, No. 14, July 12, 2024
The sale of needles and syringes or other paraphernalia
					 shall be made by the pharmacist only in good faith to patients showing proper
					 identification and indication of need.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 13 - DRUGS › Chapter 10.13.11 - Sale of Drugs by Vending Machine › Section 10.13.11.01 - Exemption to Allow Sale of Drugs in Vending Machine

Current through Register Vol. 51, No. 14, July 12, 2024
A. A person may sell by vending machine or
				  other similar device, nonprescription drugs that alleviate pain in the
				  quantities and form specified in §B of this regulation, and which are
				  exempted from the prohibition of Health-General Article, §21-1111,
				  Annotated Code of Maryland.
B.
				  Nonprescription drugs that alleviate pain may be sold by vending machine or
				  other similar devices in:
(1) Solid oral
				  dosage form only; and
(2) Single
				  dose quantities of not more than three tablets or capsules per dose.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 13 - DRUGS › Chapter 10.13.12 - Impoundment and Disposal of Drugs and Prescription Records › Section 10.13.12.01 - 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) "Authorized prescriber" means:
(a) A licensed dentist, licensed physician,
				  licensed podiatrist, licensed veterinarian, or to the extent permitted under
				  Health Occupations Article, §
												8-601, Annotated
				  Code of Maryland, certified nurse midwife;
(b) A certified nurse practitioner to the
				  extent permitted under Health Occupations Article, §
												8-508, Annotated
				  Code of Maryland; or
(c) Another
				  individual authorized by law to prescribe prescription or nonprescription drugs
				  or devices.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 13 - DRUGS › Chapter 10.13.12 - Impoundment and Disposal of Drugs and Prescription Records › Section 10.13.12.02 - Requirements for an Impoundment Order

Current through Register Vol. 51, No. 14, July 12, 2024
A. The Department may issue an impoundment
				  order if:
(1) A permit holder's permit or
				  authorized prescriber's license has expired or has been revoked or
				  suspended;
(2) An application for a
				  permit or license has been denied;
(3) A board has:
(a) Determined that the permit holder or
				  authorized prescriber failed to comply with a board order, letter of surrender,
				  or law regarding the disposition of drugs or prescription records;
				  and
(b) Requested that the
				  Department impound the drugs or prescription records;
(4) The drugs pose an imminent threat to the
				  public health, safety, or welfare; or
(5) The confidentiality of the prescription
				  records is in imminent danger of being compromised.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 13 - DRUGS › Chapter 10.13.12 - Impoundment and Disposal of Drugs and Prescription Records › Section 10.13.12.03 - Disposition of Impounded Drugs or Prescription Records

Current through Register Vol. 51, No. 14, July 12, 2024
A. If the Department executes an impoundment
				  order against a permit holder or authorized prescriber, the Department shall:
(1) Arrange for the drugs or prescription
				  records to be kept in a secure location;
(2) Ensure that any location which stores
				  impounded drugs provides the necessary temperature controls and equipment to
				  properly maintain the drugs; and
(3) Provide the permit holder or authorized
				  prescriber with a list of all drugs and prescription records
				  impounded.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.01 - Cancer Registry › Section 10.14.01.01 - Scope

Current through Register Vol. 51, No. 14, July 12, 2024
This chapter establishes a cancer registry within the
					 Department, defines key terms, details the information to be contained in a
					 cancer report, and specifies requirements of reporting facilities, nursing
					 facilities, assisted living programs, and general hospice care programs. In
					 addition, this chapter identifies requestors authorized to receive confidential
					 data, allows a fee to be charged for data reports, and incorporates by
					 reference the Maryland Cancer Registry Data Use Manual and Procedures (July
					 2016).
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.01 - Cancer Registry › Section 10.14.01.02-1 - Incorporation by Reference

Current through Register Vol. 51, No. 14, July 12, 2024
The Maryland Cancer Registry Data Use Manual and Procedures
					 (Maryland Department of Health and Mental Hygiene, July 2016) is incorporated
					 by reference.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.01 - Cancer Registry › Section 10.14.01.03 - Establishment of a Cancer Registry

Current through Register Vol. 51, No. 14, July 12, 2024
There is a cancer registry established within the
					 Department, whose purpose is to collect reportable human cancer data and
					 reportable human CNS tumor data to further the cancer control goals of the
					 State.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.01 - Cancer Registry › Section 10.14.01.04 - Cancer Control Goals of the State

Current through Register Vol. 51, No. 14, July 12, 2024
A. The cancer control goals of the State are
				  to reduce the incidence and mortality of reportable human cancer and reportable
				  human CNS tumors and racial, ethnic, gender, age, and geographic disparities in
				  reportable human cancer and CNS tumor incidence and mortality in Maryland, by:
(1) Advancing the understanding of reportable
				  human cancer and reportable human CNS tumor demographics;
(2) Describing reportable human cancer and
				  reportable human CNS tumor sources, causes, risk factors, preventive measures,
				  diagnostic tests, screening tests, treatment, and survival; and
(3) Evaluating the cost, quality, efficacy,
				  and appropriateness of diagnostic, therapeutic, rehabilitative, and preventive
				  services and programs related to reportable human cancer and reportable human
				  CNS tumors.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.01 - Cancer Registry › Section 10.14.01.05 - Content of a Cancer Report

Current through Register Vol. 51, No. 14, July 12, 2024
A cancer report shall contain the following information,
					 using the standard nomenclature contained in the North American Association of
					 Central Cancer Registries' Standards for Cancer Registries, Volume II, Data
					 Standards and Data Dictionary:
A.
				  Reasonably obtained patient demographic information, including risk
				  factors;
B. Information on the
				  industrial or occupational history of an individual with cancer, to the extent
				  such information is available;
C.
				  Relevant information on the:
(1) Initial
				  diagnosis, including the date of the diagnosis;
(2) Initial treatment;
(3) Extent of the disease by the end of the
				  first hospitalization; and
(4)
				  Extent of the disease within 2 months of diagnosis, if the information is
				  available to the reporting facility, nursing facility, assisted living program,
				  or general hospice care program;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.01 - Cancer Registry › Section 10.14.01.06 - Reporting Requirements

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  reporting facility shall submit a:
(1) Cancer
				  report to the Secretary in a computerized file containing standard information
				  required by the Secretary;
(2)
				  Computerized file not less than quarterly; and
(3) Completed report of any new individual
				  case of a reportable human cancer or reportable human CNS tumor not later than
				  6 months after diagnosis or treatment.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.01 - Cancer Registry › Section 10.14.01.07 - Confidentiality of Cancer Reports

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Information obtained under this chapter is not a medical record under
				  Health-General Article, §4-301, Annotated Code of Maryland, but is subject
				  to the confidentiality requirements of Health-General Article,
				  §§4-101 -4-103, Annotated Code of Maryland.
B. The Secretary may release confidential
				  data to:
(1) An institution or individual
				  researcher for medical, epidemiological, health care, or other cancer-related
				  or CNS tumor-related research approved by the Secretary and the Department's
				  Institutional Review Board (IRB) in order to further the cancer control goals
				  of the State set forth in Regulation .04 of this chapter;
(2) A reporting facility which:
(a) Routinely submits information on cases of
				  reportable human cancer or reportable human CNS tumors to the cancer
				  registry;
(b) Has been formally
				  accepted as a participant in the cancer registry system; and
(c) Requests data relating to patients
				  reported by the facility;
(3) An out-of-State cancer registry or cancer
				  control agency which requests routine data if the:
(a) Patient is a resident of the other state;
				  and
(b) Other state has authority
				  to provide equivalent information on Maryland residents to this
				  State;
(4) Each county
				  health officer and the Baltimore City Commissioner of Health; and
(5) Another governmental agency performing
				  its lawful duties pursuant to State or federal law.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.01 - Cancer Registry › Section 10.14.01.08 - Authority and Requirements of the Secretary

Current through Register Vol. 51, No. 14, July 12, 2024
A. To assure compliance by a reporting
				  facility, nursing facility, assisted living program, or general hospice care
				  program with Regulation .05 of this chapter, the Secretary may, upon advance
				  notice, inspect a representative sample of medical records, pathology reports,
				  or radiological reports maintained by the facility of cases of reportable human
				  cancer and reportable human CNS tumors.
B. The Secretary may charge a reasonable fee
				  to cover the cost of providing data reports to appropriate requestors, as
				  allowed by COMAR
				  10.01.08.04B. ll
				  applicable fees shall be paid in full in advance of filling the
				  request.
C. After receiving all
				  necessary information to support a request to release cancer registry data, the
				  Secretary shall act in a timely manner and decide on the request with one of
				  the following outcomes:
(1) Final
				  approval;
(2) Interim approval, if
				  the request has been accepted with one or more conditions which shall be met
				  before final approval is granted; or
(3) Disapproval.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.01 - Scope

Current through Register Vol. 51, No. 14, July 12, 2024
A. This chapter
				  defines the reimbursed services for the diagnosis and treatment of breast
				  cancer, cervical cancer, or precancerous cervical lesions, outlines the
				  requirements for patient eligibility, and outlines the reimbursement and
				  billing procedures for the reimbursed services.
B. This chapter also defines the:
(1) Responsibilities and duties of the
				  Department, the participating local health department, the hospital-coordinated
				  breast and cervical cancer screening program, the health care provider who
				  determines patient eligibility and refers patients to the Program, and the
				  following participating providers:
(a)
				  Physician;
(b) Physician
				  assistant;
(c) Certified nurse
				  midwife;
(d) Nurse
				  practitioner;
(e) Nurse
				  anesthetist;
(f) Physical
				  therapist;
(g) Pharmacy;
(h) Hospital;
(i) Medical supply company;
(j) Home health services provider;
(k) Medical laboratory;
(l) Freestanding ambulatory surgical center;
				  and
(m) Occupational therapist;
				  and
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.03 - Patient Eligibility

Current through Register Vol. 51, No. 14, July 12, 2024
A. To be
				  eligible to have a covered service reimbursed under the Program, an applicant
				  shall:
(1) Be a resident;
(2) Be screened for breast cancer or cervical
				  cancer, or both, by a:
(a) Hospital;
(b) Local health department; or
(c) Health care provider;
(3) Be found to have an eligible
				  medical condition as described in §B of this regulation;
(4) Meet the health insurance criteria
				  specified in §C of this regulation;
(5) Meet the financial eligibility criteria
				  of an annual gross income that is not more than 250 percent of the federal
				  poverty guidelines, as amended, which are incorporated by reference and updated
				  periodically in the Federal Register by the U.S. Department of Health and Human
				  Services; and
(6) Receive a medical
				  service only from participating health care providers for breast cancer
				  diagnosis, breast cancer treatment, cervical cancer diagnosis, or cervical
				  cancer or precancer treatment, or any combination of these services.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.04-1 - Physician Assistant Services

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  To be considered a participating physician assistant in the Program, the
				  provider shall:
(1) Be licensed to practice
				  as a physician assistant in Maryland or a jurisdiction bordering
				  Maryland;
(2) Have a current
				  written executed delegation agreement with a licensed supervising physician who
				  is licensed to practice medicine in Maryland or a jurisdiction bordering on
				  Maryland, if required by that jurisdiction;
(3) Agree to accept, for each reimbursed
				  medical procedure performed or service provided, the following reimbursement
				  including, if applicable, a medical management fee as described in Regulation
				  .15 of this chapter:
(a) The current Medical
				  Assistance approved rate in the State of an eligible patient who is uninsured
				  or has insurance that does not provide coverage for a certain procedure or
				  services;
(b) The reimbursement
				  rate approved by the insurer plus the payment of the deductible and patient
				  contribution amount by the Department for an eligible patient who has
				  insurance, other than Medicare, that provides coverage for a certain procedure
				  or service;
(c) The reimbursement
				  rate approved by Medicare plus the payment of the deductible and patient
				  contribution amount by the Department for an eligible patient who is covered by
				  Medicare only; or
(d) For an
				  eligible patient who has insurance that provides coverage for a reimbursed
				  procedure or service that is less than the current Medical Assistance approved
				  rate, the reimbursement rate approved by the insurer plus the difference
				  between the reimbursement rate approved by the insurer, and the Medical
				  Assistance approved rate in the State plus the payment of the deductible and
				  patient contribution amount by the Department;
(4) Agree to abide by the provisions set
				  forth in this section by signing and sending to the Department the designated
				  Departmental form; and
(5) Agree to
				  the medical, financial, and reporting requirements of the Program pursuant to
				  Regulation .04A(5), (6), (7)(a)-(e), and (8)-(10) of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.04-2 - Certified Nurse Midwife Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. To be considered a participating certified
				  nurse midwife in the Program, the provider shall:
(1) Be a certified nurse midwife in Maryland
				  or a jurisdiction bordering on Maryland and hold all certifications as required
				  by the Maryland Board of Nursing;
(2) Agree to accept, for each reimbursed
				  medical procedure performed or service provided, the following reimbursement
				  including, if applicable, a medical management fee as described in Regulation
				  .15 of this chapter:
(a) The current Medical
				  Assistance approved rate in the State for an eligible patient who is uninsured
				  or has insurance that does not provide coverage for a certain procedure or
				  service;
(b) The reimbursement rate
				  approved by the insurer plus the payment of the deductible by the Department
				  for an eligible patient who has insurance, other than Medicare, that provides
				  coverage for a certain procedure or service;
(c) The reimbursement rate approved by
				  Medicare plus the payment of the deductible and patient contribution amount by
				  the Department for an eligible patient who is covered by Medicare only;
				  or
(d) For an eligible patient who
				  has insurance that provides coverage for a reimbursed procedure or service that
				  is less than the current Medical Assistance approved rate, the reimbursement
				  rate approved by the insurer plus the difference between the reimbursement rate
				  approved by the insurer, and the Medical Assistance approved rate in the State
				  plus the payment of the deductible by the Department;
(3) Agree to abide by the provisions set
				  forth in this section by signing and sending to the Department the designated
				  Departmental form; and
(4) Agree to
				  the medical, financial, and reporting requirements of the Program pursuant to
				  Regulation .04A(5), (6), (7)(a)-(e), and (8)-(10) of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.05 - Nurse Practitioner Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. To be considered a participating nurse
				  practitioner in the Program, the provider shall:
(1) Be a certified nurse practitioner in
				  Maryland or a jurisdiction bordering Maryland;
(2) Have a current written attestation with a
				  physician who is licensed to practice medicine in Maryland or a jurisdiction
				  bordering Maryland, if required by that jurisdiction;
(3) Agree to accept, for each reimbursed
				  medical procedure performed or service provided, the following reimbursement
				  including, if applicable, a medical management fee as described in Regulation
				  .15 of this chapter:
(a) The current Medical
				  Assistance approved rate in the State for an eligible patient who is uninsured
				  or has insurance that does not provide coverage for a certain procedure or
				  service;
(b) The reimbursement
				  rate approved by the insurer plus the payment of the deductible and patient
				  contribution amount by the Department for an eligible patient who has
				  insurance, other than Medicare, that provides coverage for a certain procedure
				  or service;
(c) The reimbursement
				  rate approved by Medicare plus the payment of the deductible and patient
				  contribution amount by the Department for an eligible patient who is covered by
				  Medicare only; or
(d) For an
				  eligible patient who has insurance that provides coverage for a reimbursed
				  procedure or service that is less than the current Medical Assistance approved
				  rate, the reimbursement rate approved by the insurer plus the difference
				  between the reimbursement rate approved by the insurer and the Medical
				  Assistance approved rate in the State plus the payment of the deductible by the
				  Department;
(4) Agree to
				  abide by the provisions set forth in this section by signing and sending to the
				  Department the designated Departmental form; and
(5) Agree to the medical, financial, and reporting
				  requirements of the Program pursuant to Regulation .04A(5)-(6), (7)(a)-(e), and
				  (8)-(10) of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.06 - Nurse Anesthetist Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. To be considered a participating nurse
				  anesthetist in the Program, the provider shall:
(1) Be a certified nurse anesthetist in
				  Maryland or a jurisdiction bordering Maryland;
(2) Be currently collaborating with an
				  anesthesiologist or other physician who is licensed to practice medicine in
				  Maryland or a jurisdiction bordering Maryland in the manner prescribed by COMAR
				  10.27.06 or by the jurisdiction in which the service is provided;
(3) Agree to accept, for each covered medical
				  procedure performed or service provided, the following reimbursement including,
				  if applicable, a medical management fee as described in Regulation .15 of this
				  chapter:
(a) The current Medical Assistance
				  approved rate in the State for an eligible patient who is uninsured or who has
				  insurance that does not provide coverage for a reimbursed procedure or
				  service;
(b) The reimbursement rate
				  approved by the insurer plus the payment of the deductible and the patient
				  contribution amount by the Department for an eligible patient who has
				  insurance, other than Medicare, that provides coverage for a certain procedure
				  or service;
(c) The reimbursement
				  rate approved by Medicare plus the payment of the deductible and patient
				  contribution amount by the Department for an eligible patient who is covered by
				  Medicare only; or
(d) For an
				  eligible patient who has insurance that provides reimbursement for a covered
				  procedure or service that is less than the current Medical Assistance approved
				  rate, the reimbursement rate approved by the insurer plus the difference
				  between the reimbursement rate approved by the insurer and the Medical
				  Assistance approved rate in the State plus the payment of the deductible by the
				  Department;
(4) Agree to
				  abide by the provisions set forth in this section by signing and sending to the
				  Department the designated Departmental form; and
(5) Agree to the medical, financial, and reporting
				  requirements of the Program pursuant to Regulation .04A(5)-(6), (9), and (10)
				  of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.07 - Physical Therapy Services

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  To be considered a participating physical therapist in the Program, the
				  provider shall:
(1) Be a physical therapist
				  licensed to practice physical therapy in Maryland or a jurisdiction bordering
				  Maryland;
(2) Agree to abide by the
				  provisions set forth in this regulation by signing and sending to the
				  Department the designated Departmental form;
(3) Follow standard health and safety
				  procedures to protect an eligible patient from potential hazards;
(4) Agree to the medical and reporting
				  requirements of the Program pursuant to Regulation .04A(5), (9), and (10) of
				  this chapter;
(5) Agree to accept,
				  as payment in full, the amount paid by the Program pursuant to §E of this
				  regulation plus the amount paid by the eligible patient's health insurer, if
				  applicable; and
(6) Agree not to
				  bill an eligible patient an additional charge for the covered
				  service.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.08 - Pharmacy Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. To be
				  considered a participating pharmacy in the Program, the provider shall:
(1) Obtain a permit from the Department
				  pursuant to Health Occupations Article, Title 12, Annotated Code of
				  Maryland;
(2) Agree to abide by the
				  provisions set forth in this regulation by signing and sending to the
				  Department the designated Departmental form;
(3) Agree to accept, as payment in full, the
				  amount paid by the Program pursuant to §E of this regulation plus the
				  amount paid by the eligible patient's health insurer, if applicable;
(4) Agree not to bill an eligible patient for
				  an additional charge for the reimbursed pharmacy services provided;
				  and
(5) Maintain adequate
				  prescription and administrative records for a minimum of 5 years and, upon
				  request, allow the Department access to the records.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.09 - Hospital Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. To be
				  considered a participating hospital in the Program, the provider shall:
(1) Be licensed as a hospital in Maryland or
				  a jurisdiction bordering Maryland;
(2) Agree to abide by the provisions set
				  forth in this regulation by signing and sending to the Department the
				  designated Departmental form;
(3)
				  Agree to accept, as payment in full, the amount paid by the Program pursuant to
				  §E of this regulation;
(4)
				  Agree not to bill an eligible patient for an additional charge for the
				  reimbursed hospital services provided; and
(5) Maintain adequate records for a minimum
				  of 5 years and, upon request, allow the Department access to the
				  records.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.10 - Disposable Medical Supplies and Durable Medical Equipment

Current through Register Vol. 51, No. 14, July 12, 2024
A. To be considered a participating medical
				  supply company in the Program, the provider of disposable medical supplies and
				  durable medical equipment shall:
(1) To the
				  extent required by law, be licensed and legally authorized to practice or
				  deliver services in Maryland or a jurisdiction bordering Maryland;
(2) Agree to abide by the provisions set
				  forth in this regulation by signing and sending to the Department the
				  designated Departmental form;
(3)
				  Agree to accept, as payment in full, the amount paid by the Department pursuant
				  to §F of this regulation plus, if applicable, the amount paid by the
				  eligible patient's health insurer and the patient contribution
				  amount;
(4) Agree not to bill an
				  eligible patient for an additional charge for the eligible disposable medical
				  supplies and eligible durable medical equipment other than the patient
				  contribution amount, excluding the deductible; and
(5) Maintain adequate records for a minimum
				  of 6 years and, upon request, allow the Department access to the
				  records.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.11 - Home Health Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. To be
				  considered a participating home health services provider in the Program, the
				  provider of home health services shall:
(1)
				  Be a home health services provider licensed in Maryland or a jurisdiction
				  bordering Maryland;
(2) Agree to
				  abide by the provisions set forth in this regulation and apply for
				  participation in the Program by signing and sending to the Department the
				  designated Departmental form;
(3)
				  Comply with COMAR
				  10.09.04.03A,
				  B(2)-(3), C(4), and D, if offering skilled nursing care;
(4) Accept, as payment in full for covered
				  services rendered, the amount paid by the Program pursuant to §D of this
				  regulation plus, if applicable, the amount paid by the eligible patient's
				  health insurer and the patient contribution amount, and agree not to bill an
				  eligible patient an additional charge for the covered services; and
(5) Maintain the patient care, medical
				  supply, billing, and the patient contribution amount records for a minimum of 6
				  years and, upon request, allow the Department access to the records.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.12 - Medical Laboratory Services

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  To be considered a participating medical laboratory in the Program, the
				  provider shall:
(1) Be in compliance with the
				  applicable license requirements for a medical laboratory providing services for
				  Maryland residents including, but not limited to:
(a) Requirements for Medicare certification;
(b) Compliance with the
				  requirements pursuant to COMAR
				  10.10.03.01 if operating in
				  Maryland; and
(c) Requirements for
				  the Federal Clinical Laboratory Improvement Act of 1988,
				  42 U.S.C. §
													263a;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.13 - Freestanding Ambulatory Surgical Center Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. To be considered a participating
				  freestanding ambulatory surgical center in the Program, the provider shall:
(1) Be Medicare certified to provide
				  ambulatory surgical services in Maryland or a jurisdiction bordering
				  Maryland;
(2) Comply with COMAR
				  10.09.42.02 and .03B;
(3) Agree to abide by the provisions set
				  forth in this regulation by signing and sending to the Department the
				  designated Departmental form;
(4)
				  Agree to accept, as payment in full for the reimbursed service, the amount paid
				  by the Program as specified in §E of this regulation plus, if applicable,
				  the amount paid by the eligible patient's health insurer and the patient
				  contribution amount;
(5) Agree not
				  to bill an eligible patient, who is either uninsured or who is insured with
				  Medicare only, for the reimbursed service;
(6) Agree not to bill an eligible patient,
				  who has insurance coverage other than Medicare only, for an additional charge
				  for the reimbursed service other than the patient contribution
				  amount;
(7) Maintain adequate
				  records for a minimum of 6 years and, upon request, allow the Department access
				  to the records; and
(8) Agree to
				  the medical requirements of the Program pursuant to Regulation .04A(8)-(10) of
				  this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.14 - Occupational Therapy Services

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  To be considered a participating occupational therapist in the Program, the
				  provider shall:
(1) Be an occupational
				  therapist licensed to practice occupational therapy in Maryland or a
				  jurisdiction bordering Maryland;
(2) Agree to abide by the provisions set
				  forth in this regulation by signing and sending to the Department the
				  designated departmental form;
(3)
				  Follow standard health and safety procedures to protect an eligible patient
				  from potential hazards;
(4) Agree
				  to requirements of the Program set forth in Regulation .04A(5), (9), and (10)
				  of this chapter;
(5) Agree to
				  accept as payment in full the amount paid by the Program under §E of this
				  regulation, plus the amount paid by the eligible patient's health insurer, if
				  applicable; and
(6) Agree not to
				  bill an eligible patient an additional charge for the service.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.15 - Medical Management Fee

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  participating health care provider eligible to receive a medical management fee
				  may be one of the following:
(1)
				  Anesthesiologist;
(2) Certified
				  nurse midwife;
(3) Family
				  practitioner;
(4)
				  Gynecologist;
(5) Medical
				  internist;
(6) Medical
				  oncologist;
(7) Nurse
				  anesthetist;
(8) Nurse
				  practitioner;
(9)
				  Pathologist;
(10) Radiation
				  oncologist;
(11) Radiation
				  oncologist;
(12)
				  Radiologist;
(13) Surgeon;
				  and
(14) Participating health care
				  provider who renders services pursuant to §B of this regulation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.16 - Department, Local Health Department, Hospital, and Health Care Provider Responsibilities

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Department is responsible for the following:
(1) Developing the necessary administrative
				  forms needed for the Program including, but not limited to, a:
(a) Standard application form to determine
				  eligibility of patients;
(b)
				  Release of patient information form; and
(c) Participating health care provider
				  agreement form;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.17 - Reimbursement

Current through Register Vol. 51, No. 14, July 12, 2024
A. The Department
				  shall reimburse a participating health care provider only for a medical service
				  or procedure related to the diagnosis and treatment of breast cancer, cervical
				  cancer, or a precancerous cervical lesion for an eligible patient.
B. The Department shall reimburse a
				  participating health care provider a medical management fee pursuant to
				  Regulation .15 of this chapter.
C.
				  The participating health care provider shall reimburse the Department for an
				  overpayment.
D. Insurance or Other
				  Coverage.
(1) If the patient has insurance or
				  other coverage, the participating health care provider shall first seek payment
				  from that source.
(2) The provider
				  shall submit a copy of the insurance carrier's notice or remittance advice with
				  the invoice.
(3) If the insurance
				  carrier provides coverage for a reimbursable procedure or service, the
				  Department shall pay the deductible and patient contribution amount.
(4) If an insurance carrier rejects the
				  claim or pays less than the amount of the allowed Medical Assistance Program
				  rate, the provider may submit a claim to the Department.
(5) The Department shall pay the difference
				  between what was paid by the insurance carrier and the maximum allowable
				  Medical Assistance Program rate.
(6) If payment is made by both the Department
				  and the insurance carrier or other source for the same service, the provider
				  shall refund to the Department within 60 days of receipt the amount paid by the
				  Department, or the Department may recoup those funds.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.18 - Liability

Current through Register Vol. 51, No. 14, July 12, 2024
Responsibility for liability for services provided, and for
					 the availability of appropriate insurance coverage, rests with the
					 participating health care provider.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.19 - Termination from the Program

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  If the Department determines that a participating health care provider has
				  failed to comply with the applicable regulations of this chapter, the
				  Department may terminate the written agreement with the provider by giving 30
				  days notice in writing to the participating health care provider.
B. The participating health care provider may
				  terminate the provider agreement with the Department by:
(1) Giving 30 days notice in writing to the
				  Department; and
(2) Notifying
				  eligible patients, for whom services have not been provided, of the provider's
				  withdrawal from the Program.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.20 - Appeal Procedures

Current through Register Vol. 51, No. 14, July 12, 2024
A. provider
				  filing an appeal of the Department's decision to terminate the provider's
				  agreement with the Program shall do so according to State Government Article,
				  Title 10, Subtitle 2, Annotated Code of Maryland.
B. A provider shall file an appeal within 30
				  days of receipt of written notice of termination.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.21 - Billing and Reimbursement Time Limitations

Current through Register Vol. 51, No. 14, July 12, 2024
A. The Program may not reimburse claims
				  received for payment more than 12 months after the date of service except as
				  specified in §§B-D of this regulation.
B. To obtain reimbursement from the Program,
				  a health care provider that originally submits a claim to Medicare or another
				  health insurer shall also submit the claim to the Program within a period
				  whereby the Program receives the claim within the latter of:
(1) 12 months after the date of service;
				  or
(2) 6 months from the Medicare
				  or other health insurer remittance date as shown on the explanation of
				  benefits.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.22 - Maryland Health Insurance Plan Coverage

Current through Register Vol. 51, No. 14, July 12, 2024
A. In lieu of providing direct reimbursement
				  to participating health care providers, the Program may pay MHIP, if available,
				  to provide health coverage for individuals enrolled in the Program who are also
				  eligible for MHIP.
B. The Program
				  may pay MHIP, if available, for health coverage for eligible patients,
				  including:
(1) MHIP premiums;
(2) Pre-existing condition buy-downs;
				  and
(3) Any MHIP fees.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment › Section 10.14.02.23 - Funding Availability

Current through Register Vol. 51, No. 14, July 12, 2024
Payment under 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 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.03 - Breast Cancer Treatment Methods › Section 10.14.03.01 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. The following
				  terms have the meanings indicated.
B. Terms Defined.
(1) "Department" means the Maryland
				  Department of Health and Mental Hygiene.
(2) "Diagnosis" means a histopathologic
				  finding of breast cancer in a biopsy specimen.
(3) "Treating physician" means an individual
				  authorized under the Medical Practice Act to practice medicine in Maryland who,
				  in Maryland, treats a patient for breast cancer.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.03 - Breast Cancer Treatment Methods › Section 10.14.03.02 - Requirements for the Department of Health and Mental Hygiene

Current through Register Vol. 51, No. 14, July 12, 2024
A. The Department
				  shall provide a standardized written summary in layman's language that:
(1) Lists effective methods of treating
				  breast cancer that may be medically practicable including all types of surgical
				  treatment and radiological, hormonal, and chemotherapeutic treatment and
				  combinations of these treatments; and
(2) Describes the advantages, disadvantages,
				  risks, and procedures associated with each method of treatment.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.03 - Breast Cancer Treatment Methods › Section 10.14.03.03 - Requirements of Treating Physicians

Current through Register Vol. 51, No. 14, July 12, 2024
A. At any time before, but not more than 5
				  days after, a treating physician informs a patient of a diagnosis of breast
				  cancer, and before treatment, the treating physician shall give the patient:
(1) The standardized written summary provided
				  by the Department; or
(2) An
				  equivalent summary including the requirements under Regulation .02A written in
				  language that the patient understands.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.04 - Breast Cancer Program › Section 10.14.04.01 - Purpose and Scope

Current through Register Vol. 51, No. 14, July 12, 2024
A. This
				  chapter:
(1) Establishes the requirements for
				  participating medical providers;
(2) Sets criteria for applicant
				  eligibility;
(3) Outlines services
				  covered; and
(4) Delineates the
				  responsibilities of the Department and local health departments for breast
				  cancer screening, diagnosis, and treatment services under the Breast Cancer
				  Program created by Health-General Article, §20-116, Annotated Code of
				  Maryland.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.04 - Breast Cancer Program › Section 10.14.04.03 - Overview of Funding and Delivery of Services

Current through Register Vol. 51, No. 14, July 12, 2024
A. The Breast Cancer Program created by
				  Health-General Article, §20-116, Annotated Code of Maryland, provides
				  State funding for breast cancer screening, diagnosis, and treatment for
				  eligible individuals under this chapter.
B. Services funded under the Breast Cancer
				  Program shall be delivered through two previously existing programs as follows:
(1) Breast cancer screening and diagnostic
				  services shall be provided to an enrollee through local health departments and
				  private entities that contract with the Department to render services in
				  Baltimore City and Calvert County under the Breast and Cervical Cancer Program;
				  and
(2) Breast cancer diagnostic
				  and treatment services shall be provided to an enrollee through the
				  Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment
				  Program.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.04 - Breast Cancer Program › Section 10.14.04.04 - Eligibility-Breast and Cervical Cancer Program

Current through Register Vol. 51, No. 14, July 12, 2024
A. To be eligible to receive breast cancer
				  services under this chapter through the Breast and Cervical Cancer Program, an
				  applicant shall:
(1) Be a resident of
				  Maryland;
(2) Be 40 years old or
				  older;
(3) Meet the financial
				  eligibility criteria specified in §B of this regulation;
(4) Meet the health insurance criteria
				  specified in §C of this regulation; and
(5) Be determined to be eligible to receive
				  covered services by a:
(a) Local health
				  department or an agency or organization designated by the local health
				  department; or
(b) Private entity
				  that contracts with the Department to render services in Baltimore City or
				  Calvert County.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 14 - CANCER CONTROL › Chapter 10.14.04 - Breast Cancer Program › Section 10.14.04.05 - Eligibility - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment Program

Current through Register Vol. 51, No. 14, July 12, 2024
To be eligible to receive breast cancer services under this
					 chapter through the Reimbursement for Breast and Cervical Cancer Diagnosis and
					 Treatment Program, an applicant shall meet the eligibility requirements
					 specified in COMAR
					 10.14.02.03A.