Sec. 10.67.03.10. Special Needs Populations  


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  • An MCO applicant shall include in its application the following information or descriptions:

    A. A narrative description of the clinical expertise and experience of the MCO's network for special needs populations in a format specified by the Department;

    B. Written evidence of the applicant's ability to comply with specific quality access, data, and performance measurements to satisfy the general requirements for all special needs populations specified in COMAR 10.67.04.04;

    C. Written evidence, including treatment protocols, of the applicant’s ability to provide the range of clinical and support services specified in COMAR 10.67.04.05-.10 and .13, to ensure appropriate and coordinated services to the following special populations:

    (1) Children with special health care needs;

    (2) Individuals with a physical disability;

    (3) Individuals with a developmental disability;

    (4) Pregnant and postpartum women;

    (5) Individuals who are homeless; and

    (6) Individuals with HIV/AIDS; and

    D. Referral protocols that demonstrate the conditions under which PCPs will make the arrangements for children with special health care needs to be referred to MCO specialty care networks and when appropriate the behavioral health ASO for services as described in COMAR 10.09.59 or 10.09.80.