Md. Code Regs. 10.09.85.01

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

Section 10.09.85.01 - Definitions

A. The following terms have the meanings indicated.

B. Terms Defined.

(1) "Certified nurse midwife (CNM)" means a registered nurse who is certified by the American College of Nurse-Midwives, and is licensed in the state in which the service is provided.

(2) "Commission for the Accreditation of Birth Centers (CABC)" means the independent authority that accredits developing and existing birth centers in the United States of America, according to established national standards.

(3) "Department" means the Department of Health and Mental Hygiene.

(4) "Free-standing Birth Center" means a free-standing facility not associated with a hospital that provides physician or certified nurse midwifery services.

(5) "Medical Assistance Program" means the program, financed by federal, state, and local funds, for the comprehensive medical care for persons of all ages within certain income limits.

(6) "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.

(7) "Newborn" means an infant who is not more than 48 hours old.

(8) "Participant" means an individual who is eligible for Program benefits.

(9) "Physician" means an individual legally licensed to practice medicine by the Board or in the state in which the physician's practice is located.

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

(11) "Provider" means a free-standing birth center.

Md. Code Regs. 10.09.85.01

Effective date: 41:8 Md. R. 471, eff.5/1/2014