Sec. 10.09.46.10. Conditions for Reimbursement

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The Department shall reimburse for services covered under this chapter if the services are:

A. Provided to a participant who meets the qualifications for eligibility specified in Regulations .02 and .03 of this chapter;

B. Preauthorized in the participant's waiver plan of care by the BHA, as being reasonable and medically necessary to prevent institutionalization;

C. Provided by an approved provider which meets the conditions for participation in Regulations .05 and .06 of this chapter; and

D. Rendered pursuant to:

(1) The relevant definition of covered services in Regulation .01 of this chapter;

(2) All other requirements specified in this chapter and COMAR 10.09.36; and

(3) The waiver proposal and any amendments to it approved by the Secretary of the U.S. Department of Health and Human Services.

                    
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