Sec. 10.09.42.03. Conditions for Participation

A. General requirements for participation in the Program are that a provider shall meet all conditions for participation as set forth in COMAR 10.09.36.03 and 42 CFR, Part 416, Subpart B.

B. Specific requirements for participation in the Program are that the provider shall meet all specific conditions for participation as set forth in 42 CFR, Part 416, Subpart C, to include the following:

(1) Be approved by Medicare to furnish ambulatory surgical services to patients and maintain documentation of certification by the Department of Health and Human Services and the Centers for Medicare and Medicaid Services;

(2) Have clearly defined, written, patient care policies;

(3) Maintain adequate documentation of each recipient visit as part of the plan of care, which at a minimum, shall include:

(a) Date of service;

(b) Recipient's reason for visit;

(c) A brief description of service provided, and

(d) A legible signature and printed or typed name of the professional providing care, with the appropriate title;

(4) Have written, effective procedures for infection control which are known to all levels of staff as specified in COMAR 10.06.01;

(5) Be approved by the state in which the service is provided, except where a Certificate of Need is not required;

(6) Provide for in-house Program evaluation and clinical record review which assess use of services for appropriateness in meeting a recipient's needs;

(7) Refer laboratory testing only to independent medical laboratory providers.