Sec. 10.09.07.06. Limitations  


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  • A. Medical day care services are not covered for:

    (1) Individuals who do not meet the definition of "participant" in Regulation .01B of this chapter; and

    (2) Individuals younger than 16 years old.

    B. Covered services do not include:

    (1) Days of service in excess of the frequency specified in the participant’s home and community based services waiver service plan;

    (2) Services which are not part of those services listed in Regulation .05 of this chapter;

    (3) Services for a number of participants that exceeds the provider’s licensed capacity on a given day;

    (4) More than one day of care, per participant, per day; and

    (5) A day of care provided on the same day that the following services are provided and billed to the Department:

    (a) Day habilitation services under COMAR 10.09.26;

    (b) Supported employment services under COMAR 10.09.26;

    (c) Programs of All-Inclusive Care for the Elderly under COMAR 10.09.44;

    (d) Senior center plus services under COMAR 10.09.54;

    (e) Adult day care reimbursed under the State of Maryland's human service contracts; or

    (f) On-site psychiatric rehabilitation services under COMAR 10.09.59.