Md. Code Regs. 10.09.76.03

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

Section 10.09.76.03 - Conditions for Participation

A. General requirements for participation in the Program are that a provider shall:

(1) Meet the conditions for participation as set forth in COMAR 10.09.36; and

(2) If delivering services via telehealth, comply with COMAR 10.09.49 and any subregulatory guidance issued by the Department.

B. To participate as a Maryland Medicaid SBHC, a provider shall:

(1) Be approved by the Maryland Department of Health as an SBHC;

(2) Meet conditions for participation as a:

(a) Free-standing clinic as set forth in COMAR 10.09.08.03B;

(b) Physician as set forth in COMAR 10.09.02.03; or

(c) Nurse practitioner as set forth in COMAR 10.09.01.03.

(3) Provide somatic health care services through health professionals who:

(a) Are trained and experienced in community health and providing health care services to school-aged children;

(b) Have knowledge of health promotion and illness prevention strategies for children and adolescents; and

(c) Are EPSDT certified;

(4) Ensure staff is assigned responsibilities consistent with the staff's education and experience and within the staff's scope of practice;

(5) Designate an individual to be responsible for overall management of the SBHC;

(6) Whenever comprehensive primary health services are being delivered, maintain a staffing pattern that includes at least one of the following on-site:

(a) A physician;

(b) A nurse practitioner; or

(c) A physician assistant;

(7) Maintain policies and procedures that ensure confidentiality of services and records which are practiced consistently, in accordance with Health-General Article, §4-301, Annotated Code of Maryland;

(8) Maintain data collection and storage capabilities adequate to maintain medical records and standard demographic data;

(9) Require any physician assistant employed by the provider to have a delegation agreement with the supervising physician in accordance with COMAR 10.09.55.02 and .03; and

(10) Transmit a health visit report:

(a) To the student's MCO and PCP within 3 business days of the health visit, as designated by the Department, for inclusion in the student-participant's medical record; and

(b) If follow-up care with the PCP within 1 week of the health visit is required and the health visit report is mailed, to the student's MCO and PCP by telephone, email, or fax on the day of the SBHC visit.

C. Specific requirements for participation in the Program as a dentist or dental hygienist in an SBHC are that a provider shall meet the conditions for participation as set forth in COMAR 10.09.05.03A-E.

Md. Code Regs. 10.09.76.03

Regulations .03 adopted as an emergency provision effective July 1, 2006 (33:15 Md. R. 1274); adopted permanently effective September 25, 2006 (33:19 Md. R. 1560)
Regulation .03B amended effective November 5, 2007 (34:22 Md. R. 1977)
Regulation .03E amended effective June 30, 2008 (35:13 Md. R. 1180)
Regulation .03E amended as an emergency provision effective November 1, 2008 (35:24 Md. R. 2069); amended permanently effective February 23, 2009 (36:4 Md. R. 353)
Regulations .03 repealed effective 41:13 Md. R. 752, eff.7/7/2014 ; adopted effective 44:7 Md. R. 355, eff. 4/10/2017; amended effective 48:12 Md. R. 473, eff. 6/14/2021; amended effective 50:22 Md. R. 973, eff. 11/13/2023