Md. Code Regs. 10.09.84.22

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

Section 10.09.84.22 - Conditions for Reimbursement

The Program shall reimburse for the services specified in Regulations .14-.21 of this chapter, if provided in accordance with the requirements of this chapter and if the service:

A. Is recommended on the participant's plan of service as necessary in order to:

(1) Prevent the applicant's or participant's admission to an institution;

(2) Safely transition the applicant or participant from an institution, such as a nursing facility, into the community; or

(3) Assure the health and safety of an applicant or participant in the community;

B. Has been preauthorized by the Department in the participant's plan of service;

C. Is provided to an enrolled participant;

D. Is medically necessary; and

E. Is provided by a Medicaid provider who meets the conditions for participation under this chapter.

Md. Code Regs. 10.09.84.22

Effective date: 41:5 Md. R. 343, eff.3/17/2014 ; amended effective 43:7 Md. R. 449, eff.4/11/2016