Md. Code Regs. 10.09.80.03

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

Section 10.09.80.03 - Conditions for Provider Participation

A. A provider shall be in compliance with COMAR 10.09.36.03 and 10.63.01.05.

B. A provider of community-based substance use disorder services shall include:

(1) Community-based substance use disorder providers that:

(a) Are licensed by the Department as community-based substance use disorder providers pursuant to the requirements listed in Regulation .05 of this chapter;

(b) Maintain verification of licenses and credentials of all professionals employed by or under contract with the provider in their respective personnel files; and

(c) Require any physician assistant employed by the provider to have a delegation agreement with the supervising physician in accordance with COMAR 10.09.55.02 and .03;

(2) Federally qualified health centers in compliance with COMAR 10.09.08; or

(3) Opioid treatment programs that:

(a) Are licensed by the Department's Behavioral Health Administration;

(b) Are approval by the U.S. Drug Enforcement Administration; and

(c) Comply with 42 CFR Part 8.

C. A provider of substance use disorder services shall maintain adequate documentation of each contact with a participant as part of the medical record, which, at a minimum, includes:

(1) The date of service with start and end times;

(2) Documents all services received by the participant;

(3) The participant's primary reason for the substance use disorder visit;

(4) A description of the service provided;

(5) Progress notes; and

(6) An official e-Signature, or a legible signature, along with the printed or typed name of the individual providing care, with the appropriate degree or title.

D. The providers shall make the documentations required under Regulation .05C available, as requested to carry out required activities, to:

(1) The Department;

(2) The ASO;

(3) The Core Service Agency;

(4) The Local Addictions Authority;

(5) The Local Behavioral Health Authority;

(6) The Office of Inspector General of the Department; and

(7) The Office of the Attorney General Medicaid Fraud Control Unit.

E. A provider shall comply with all federal statutes and regulations, including the Health Insurance Portability and Accountability Act, 42 U.S.C. § 1320D et seq., and implementing regulations at 45 CFR Parts 160 and 164.

F. If delivering services via telehealth, a provider shall comply with COMAR 10.09.49 and any subregulatory guidance issued by the Department.

Md. Code Regs. 10.09.80.03

Regulations .03 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 .03 amended effective 42:21 Md. R. 1302, eff.10/26/2015; amended effective 44:19 Md. R. 897, eff. 9/25/2017; amended effective 49:23 Md. R. 996, eff. 11/14/2022