Sec. 10.09.33.03. Participant Eligibility  


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  • A. An individual is eligible for health home services if the individual:

    (1) Is a recipient of Maryland Medical Assistance; and

    (2) Meets the following criteria:

    (a) Receives outpatient mental health rehabilitation or treatment services with a PRP or MTS program for a serious and persistent mental illness or serious emotional disturbance, and is not currently receiving:

    (i) 1915(i) waiver services; or

    (ii) Mental health case management; or

    (b) Receives treatment with an OTP for an opioid substance use disorder and is at risk for additional chronic conditions based on:

    (i) Current alcohol use, tobacco use, or other non-opioid use; or

    (ii) A history of alcohol, tobacco, or other non-opioid substance dependence.

    B. A health home participant that is no longer receiving services from their PRP, MTS program, or OTP provider may continue to receive health home services for up to 6 months for the purposes of reengagement or transition to another level of care.