Sec. 10.09.76.05. Limitations

The Program does not cover the following:

A. Services not specified in Regulation .04 of this chapter;

B. Services not medically necessary;

C. Investigational and experimental drugs and procedures;

D. Basic school health services as defined in COMAR 13A.05.05.05-.15;

E. Services to individuals who are not enrolled in the school system;

F. Nursing or other health services provided as part of a participant’s individualized educational program (IEP) as defined in COMAR 10.09.50.01B or individualized family service plan (IFSP) as defined in COMAR 10.09.50.01B;

G. Skilled nursing services provided to enable a participant to be safely maintained in the school setting such as:

(1) Nasogastric tube feedings;

(2) Catheterization;

(3) Oral, nasotracheal, or tracheal suctioning; and

(4) Nebulizer treatments;

H. School health services which are required in all school settings such as:

(1) Hearing and vision screening unless completed as part of an EPSDT well-child check-up;

(2) Routine assessment of minor injuries;

(3) First aid;

(4) Administration of medications including supervision of self-administered medications;

(5) General health promotion counseling; and

(6) Review of health records;

I. Routine sports physicals;

J. Vaccines supplied by Vaccines for Children (VFC);

K. Visits for the sole purpose of:

(1) Administering medication;

(2) Checking blood pressure;

(3) Measuring weight;

(4) Interpreting lab results; or

(5) Group or individual health education; and

L. Services provided outside of the physical location of the approved SBHC.