Md. Code Regs. 14.17.04.06

Current through Register Vol. 51, No. 24, December 2, 2024

Section 14.17.04.06 - Compassionate Use Fund

A. The purpose of the Compassionate Use Fund is to reduce the cost of obtaining a medical assessment to determine the appropriateness of treatment with cannabis or reduce the cost of medical cannabis for individuals enrolled in the Maryland Medical Assistance Program or in the Veterans Affairs Maryland Health Care System.

B. Eligibility for Compassionate Use Fund.

(1) A patient enrolled in the Maryland Medical Assistance Program or in the Veterans Affairs Maryland Health Care System may attest to a certifying provider eligibility for the Compassionate Use Fund due to their coverage status.

(2) A certifying provider shall verify the individual's eligibility for the Compassionate Use Fund due to their coverage status and provide documentation of eligibility status to the Administration.

(3) A certifying provider shall reverify patient enrollment in the Maryland Medical Assistance Program or in the Veterans Affairs Maryland Health Care System annually.

C. Reimbursement of Written Certification.

(1) A certifying provider may submit to the Administration for reimbursement of the written certification for individuals enrolled in the Maryland Medical Assistance Program or in the Veterans Affairs Maryland Health Care System.

(2) In order to submit for reimbursement under this section, a certifying provider shall:

(a) Verify a patient's active enrollment in the Maryland Medical Assistance Program or the Veterans Affairs Maryland Health Care System at the time the written certification is given;

(b) Conspicuously display a standard assessment and evaluation fee to be paid by the patient to obtain a written certification;

(c) Offer a discount of $50 off the provider's fee to provide written certifications to patients eligible under §B of this regulation; and

(d) Charge an assessment and evaluation fee not to exceed the amount conspicuously displayed in §C(2)(b) of this regulation to obtain a written certification to all patients, regardless of eligibility under §B of this regulation.

(3) Nothing in this section prohibits a certifying provider from offering a discount above $50 off the provider's fee to provide written certifications to patients eligible under §B of this regulation.

D. Reimbursement.

(1) On a monthly basis, a certifying provider may request reimbursement from the Administration for the discounted prices offered to eligible patients under this regulation.

(2) A certifying provider may submit a request for reimbursement by the 15^th of the following month, in the manner specified by the Administration.

(3) To request reimbursement, a certifying provider shall provide the Administration with detailed records of the discounts provided, including:

(a) A list of qualifying patients who obtained discounts in the past month, and whether the patient was enrolled in the Maryland Medical Assistance Program or the Veterans Affairs Maryland Health Care System;

(b) An itemized account of the discounts provided to eligible patients in the past month, indicating:

(i) The full price of the written certification; and

(ii) Reduced cost paid by the eligible patient; and

(c) Any additional information requested by the Administration.

(4) To the extent funds are available within the Compassionate Use Fund, the Administration shall reimburse a certifying provider for eligible expenses.

(5) If the Compassionate Use Fund lacks sufficient funds to reimburse a certifying provider:

(a) The Administration shall cease providing reimbursements; and

(b) A certifying provider is no longer required to provide discounts pursuant to this regulation.

Md. Code Regs. 14.17.04.06

Regulation .06 adopted effective 50:14 Md. R. 559, eff. 7/1/2023 (EMERGENCY); adopted effective 51:14 Md. R. 676, eff. 6/7/2024, exp. 8/31/2024 (Emergency); adopted effective 51:14 Md. R. 678, eff. 7/22/2024.