Md. Code Regs. 10.09.59.08

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.09.59.08 - Authorization Requirements

A. The ASO shall establish a process, through a utilization review system, for authorization of specialty mental health services.

B. The ASO shall authorize services that are:

(1) Medically necessary;

(2) Of a type, frequency, and duration that are consistent with expected results and cost-effective; and

(3) Delivered in a manner consistent with this chapter.

C. Preauthorization is not required before a provider renders services in an emergency department.

D. Except as provided in Regulation .08C of this chapter, no payment shall be rendered for services that have not been authorized.

Md. Code Regs. 10.09.59.08

Regulations .08 adopted as an emergency provision effective February 3, 1995 (22:4 Md. R. 232); adopted permanently effective June 5, 1995 (22:11 Md. R. 821)
Regulations .08 under, Rehabilitation and Other Mental Health Services, repealed and new Regulations .08 under, Specialty Mental Health Services, adopted effective December 22, 2014 (41:25 Md. R. 1479)
Regulation .08 amended effective 42:21 Md. R. 1300, eff.10/26/2015