Sec. 10.09.32.05. Limitations  


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  • A. HIV-targeted case management shall be advisory in nature.

    B. A restriction may not be placed on qualified recipients' option to receive HIV case management services.

    C. HIV-targeted case management does not restrict or otherwise affect:

    (1) Eligibility for Title XIX benefits or other available benefits or programs;

    (2) The freedom of a recipient to select from all available services for which the individual is found to be eligible; or

    (3) The participant's free choice of qualified providers.

    D. HIV-targeted case management may not be:

    (1) Provided as an integral and inseparable part of another covered Program service;

    (2) Provided as an administrative function;

    (3) Rendered in connection with the implementation of the Social Security Act, §1915(b) or 1915(c); or

    (4) Part of institutional discharge planning.

    E. Reimbursement may not be made for HIV-targeted case management services if the participant is:

    (1) Eligible to receive services under the Maryland Medicaid Managed Care Program, as defined in COMAR 10.67.01; or

    (2) Receiving comparable case management services under:

    (a) The Rare and Expensive Case Management Program, as defined in COMAR 10.09.69; or

    (b) Under another Program authority.

    F. A participant's case manager may not be a direct services provider for the participant.