Md. Code Regs. 10.09.52.05

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.09.52.05 - Limitations

A. Service Coordination for Children with an IEP or enrolled in the Autism Waiver is advisory in nature except for Autism Waiver Service Coordination, covered under Regulations .03-1, .04-1, and .04-2 of this chapter.

B. A restriction may not be placed on a qualified participant's option to receive the services covered under this chapter except that Autism Waiver Service Coordination, as defined by Regulations .03-1, .04-1, and .04-2 of this chapter, is required for waiver eligible persons who choose to enroll in the Autism Waiver.

C. The services covered under this chapter may not restrict or otherwise affect the:

(1) Participant's eligibility for Title XIX benefits or other available benefits or programs except as limited by §E of this regulation;

(2) Freedom of the participant's parent to select from all available services for which the participant is found to be eligible;

(3) Participant's parent's free choice among qualified providers of services covered under this chapter, as well as among service providers of other services for which the participant qualifies; or

(4) Provider's right to bill the Program for other covered Program services.

D. Service Coordination for Children with an IEP or enrolled in the Autism Waiver may not be:

(1) Provided as an integral and inseparable part of another covered Program service;

(2) Provided as an administrative function necessary for the proper and efficient operation of the State's Medical Assistance plan; or

(3) Delivered as part of institutional discharge planning.

E. Reimbursement may not be made for the services covered under this chapter if the participant is receiving a similar case management service under another Program authority.

F. Reimbursement may not be made to providers that participate on, but do not convene, an IEP team or teams, for ongoing service coordination for residential students who reside in facilities that receive Medical Assistance reimbursement for residential services.

G. Only waiver participants may receive Autism Waiver Service Coordination, covered under Regulations .04-1 and .04-2 of this chapter.

Md. Code Regs. 10.09.52.05

Regulations .05 adopted as an emergency provision effective June 17, 1993 (20:14 Md. R. 1165); adopted permanently effective September 27, 1993 (20:19 Md. R. 1472)
Regulations .05 amended as an emergency provision effective March 23, 1998 (25:8 Md. R. 595); amended permanently effective June 29, 1998 (25:13 Md. R. 993):
Regulations .05 amended effective July 1, 2001(28:12 Md. R. 1107); amended effective 50:22 Md. R. 973, eff. 11/13/2023