Md. Code Regs. 10.09.80.01

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.09.80.01 - Definitions

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) Administrative Service Organization (ASO)" means the contractor procured by the State to provide the Department with administrative support services to operate the Maryland Public Behavioral Health System.

(2) "Behavioral Health Administration (BHA)" means the administration within the Department that establishes regulatory requirements that behavioral health programs are to maintain in order to become licensed by the Department.

(3) "Community-based substance use disorder program" means a program that provides services in community settings not regulated by the Health Services Cost Review Commission.

(4) "DATA 2000 waived provider" means a provider who has received a waiver under the Drug Addiction and Treatment Act of 2000 which expands the clinical context of medication assisted opioid dependency treatment and permits qualified physicians, nurse practitioners, and physician assistants to dispense or prescribe certain narcotic medications that have a lower risk of abuse, like buprenorphine, in settings other than an opioid treatment program

(5) "DEA" means the Drug Enforcement Administration of the U.S. Department of Justice.

(6) "Department" means the Department of Health and Mental Hygiene, as defined in COMAR 10.09.36.01, or its authorized agents acting on behalf of the Department

(7) "Discharge plan" means a written description of specific goals and objectives to assist the participant upon leaving treatment.

(8) "Documentation" means the written medical record.

(9) "Individualized treatment plan" means a written plan of action that is developed and periodically updated and revised to address a participant's specific service needs.

(10) "License" means the approval issued to a program by the BHA or its designee that permits a behavioral health provider to operate in Maryland.

(11) "Medical Assistance" has the meaning stated in COMAR 10.09.24.02.

(12) "Medically necessary" means 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 current 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.

(13) "Medication management" means a visit with a physician, nurse practitioner, or physician assistant for the purpose of evaluation, prescribing, and providing medications for substance use disorder symptom reduction, withdrawal management, or medication assisted treatment.

(14) "Participant" means an individual who is certified as eligible for, and is receiving, Medical Assistance benefits.

(15) "Peer recovery support services" means a set of nonclinical activities provided by individuals in recovery from behavioral health concerns, including substance use or addictive disorders or mental health concerns, who use their personal, lived experiences and training to support other individuals with substance use or addictive disorders.

(16) "Program" means the Maryland Medical Assistance Program.

(17) "Progress note" means an objective documentation of the recipient's progress in relation to specific treatment goals and objectives.

(18) "Recovery support services" means community-based services provided to people and their families during the initiation, on-going, and post-acute stages of their recovery from substance abuse.

(19) Substance use disorder" means a maladaptive pattern of substance use leading to clinically significant impairment or distress and manifested by recurrent and significant adverse consequences related to the repeated use of substances.

(20) "Substance use disorder services" means the services for which a participant's diagnosis and treatment provider meet the criteria specified in COMAR 10.09.70 and this chapter.

(21) "Telehealth" has the meaning stated in COMAR 10.09.49.02.

(22) "Treatment plan" means a written plan that addresses the individual's biopsychosocial needs through goals and objectives and is updated as needed according to the treatment modality.

Md. Code Regs. 10.09.80.01

Regulations .01 adopted as an emergency provision effective January 1, 2010 (37:6 Md. R. 474); adopted permanently effective May 31, 2010 (37:11 Md. R. 765)
Regulation .01 amended effective 42:21 Md. R. 1302, eff.10/26/2015; amended effective 44:7 Md. R. 356, eff. 4/10/2017; amended effective 49:23 Md. R. 996, eff. 11/14/2022; amended effective 50:9 Md. R. 379, eff. 5/15/2023; amended effective 51:15 Md. R. 708, eff. 8/5/2024.