Code of Maryland Regulations (Last Updated: April 6, 2021) |
Title 10. Maryland Department of Health |
Part 3. |
Subtitle 11. MATERNAL AND CHILD HEALTH |
Chapter 10.11.03. Children's Medical Services Program |
Sec. 10.11.03.11. General Conditions of Provider Participation
-
A. A provider of services which are covered by the CMS Program shall comply with the following general requirements:
(1) For fee for service reimbursement, be approved by Medical Assistance in writing as a Medical Assistance provider;
(2) For copay and deductible reimbursement, be a participating provider with the insurance plan purchased by the CMS Program for the family;
(3) Request preauthorization on the forms designated by the CMS Program;
(4) Adhere to administrative procedures that are established by the CMS Program for the specific treatment services; and
(5) Maintain adequate records, including prescriptions, for a minimum of 6 years, and make them available upon request to the Department or the Department's designee.
B. The approval referenced in §A(1) of this regulation shall specify, at a minimum, the following:
(1) Approved services which may be provided; and
(2) Duration of approval status.