Sec. 10.09.69.08. Specific Conditions for Provider Participation

A. Case Management Providers. To participate in the Program, a case management provider shall meet the conditions set forth in Regulations .06 and .07 of this chapter.

B. Chiropractic Service Providers. To participate in the Program, the chiropractic service provider shall:

(1) Meet the:

(a) Conditions set forth in Regulation .07 of this chapter; and

(b) Requirements for chiropractic providers specified in COMAR 10.43.04;

(2) Develop a goal-directed treatment plan that is based on an evaluation conducted during the initial assessment, which requires:

(a) A review or evaluation of the treatment plan 30 days after the initial assessment; and

(b) A review and update of the treatment plan every 90 days; and

(3) Render services in accordance with orders written by a physician, physician assistant, or nurse practitioner.

C. Dental Service Providers. To participate in the Program, the dental service provider shall meet the:

(1) Conditions set forth in Regulation .07 of this chapter; and

(2) Requirements for dental providers specified in COMAR 10.09.05.

D. Nutritional Supplement Providers. To participate as a provider of nutritional supplements, a provider shall meet the:

(1) Conditions of participation as set forth in Regulation .07 of this chapter; and

(2) Criteria of the conditions for participation for pharmacy providers set forth in COMAR 10.09.03.

E. Shift Private Duty Nursing/CNA/CNA-CMT/HHA/HHA-CMT Providers. To participate as a provider agency for shift private duty nursing, CNA, CNA-CMT, HHA, or HHA-CMT services, a provider shall:

(1) Meet the conditions set forth in Regulation .07 of this chapter;

(2) Meet all requirements of conditions for participation set forth in COMAR 10.09.53.03;

(3) Participate in interdisciplinary team meetings, when requested by the Department or its designee;

(4) Develop a goal-directed written nursing care plan that is based on an evaluation conducted during the initial assessment, which requires:

(a) A review or evaluation of the nursing care plan 30 days after the initial assessment; and

(b) A review and update of the nursing care plan every 90 days;

(5) Ensure timesheets are signed by the individual rendering services;

(6) Ensure a nurse's, CNA’s, CNA-CMT’s, HHA’s, or HHA-CMT’s shift to be not more than a total of 60 hours per week or 16 consecutive hours and that the individual is off 8 or more hours before starting another shift unless otherwise authorized by the Department;

(7) Obtain the participant's signature or the signature of the participant's witness on the provider's official forms to verify receipt of service; and

(8) Be licensed as a:

(a) Residential service agency in accordance with COMAR 10.07.05; or

(b) Home health agency in accordance with COMAR 10.07.10 which meets the conditions of participation specified by the Medicare program in 42 CFR §484.36.

F. Occupational Therapy Providers. To participate in the Program as a provider of occupational therapy services, a provider shall:

(1) Meet the conditions set forth in Regulation .07 of this chapter;

(2) Be a self-employed occupational therapist licensed according to COMAR 10.46.01;

(3) Be an agency or clinic which employs occupational therapists or be a Program provider of home health services under COMAR 10.09.04; and

(4) Develop a goal-directed written treatment plan that is based on an evaluation conducted during the initial assessment which requires:

(a) A review or evaluation of the treatment plan 30 days after the initial assessment; and

(b) A review and update of the treatment plan every 90 days.

G. Speech-Language Pathology Providers. To participate in the Program, a speech-language pathology provider shall:

(1) Meet the conditions set forth in Regulation .07 of this chapter;

(2) Be a self-employed speech-language pathologist according to COMAR 10.41.03 or be a Program provider of home health services under COMAR 10.09.04;

(3) Be an agency or clinic that employs speech-language pathologists; and

(4) Develop a goal-directed written treatment plan that is based on an initial assessment, which requires:

(a) A review or evaluation of the treatment plan 30 days after the initial assessment; and

(b) A review and update of the treatment plan every 90 days.