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Subtitle 1 - Medical and Pharmacy Assistance Programs
Section 15-101 - Definitions - (a) In this title the following words have the meanings...
Section 15-101.1 - Applicability of Other Provisions to a Managed Care Organization - (a) Except as otherwise provided in this subtitle, a managed...
Section 15-102 - Indigent and Medically Indigent -- Preventive and Home Care Services; Educational Opportunities - (a) Subject to the limitations of the State budget, the...
Section 15-102.1 - Indigent and Medically Indigent -- Comprehensive System of Health Care - (a) The General Assembly finds that it is a goal...
Section 15-102.2 - Applicability of Certain Provisions -- Claims of Subrogation - (a) Except as otherwise provided in this section, the provisions...
Section 15-102.3 - Applicability of Certain Provisions -- Examination of Financial Affairs and Status - (a) The provisions of § 15–112(b)(1)(ii) and (2), (f) through...
Section 15-102.4 - Surplus Requirements - (a) (1) Each managed care organization shall be actuarially sound....
Section 15-102.5 - Mechanism to Provide for Equitable Distribution of Enrollees - (a) Subject to § 15-103(f) of this subtitle, a health...
Section 15-102.6 - Applicability of Other Provisions; Regulations - (a) (1) Subject to paragraph (2) of this subsection, the...
Section 15-102.7 - Applicability of Certain Premium Tax Provisions - The premium tax imposed under § 6-102 of the Insurance...
Section 15-102.8 - Claims Processing Charge for Medicaid Claims Paid by Department to District of Columbia Hospitals - (a) The Department may impose a claims processing charge on...
Section 15-103 - Medical Assistance Program - (a) (1) The Secretary shall administer the Maryland Medical Assistance...
Section 15-103.1 - Promotion of Cost Effectiveness of State Health Care System - The Program shall use its leverage as a high volume...
Section 15-103.2 - Rfps for Comparing Performance and Cost of Different Managed Care Dental Programs - (a) The Department shall issue a request for proposals for...
Section 15-103.3 - Healthchoice Performance Incentive Fund - (a) There is a HealthChoice Performance Incentive Fund established in...
Section 15-103.4 - Credentialing of Health Care Providers - (a) A managed care organization may deem a health care...
Section 15-103.5 - Rate Review and Comparison; Reports - (a) For the calendar year prior to the report date...
Section 15-103.6 - Regulations to Ensure Parity of Specialty Mental Health and Substance Use Disorder Services With Federal Acts - (a) (1) Subject to paragraph (2) of this subsection, on...
Section 15-103.7 - Valued-Based Purchasing Program -- Collection of Penalties -- Total Amount of Incentives -- Distribution of Funding - (a) In this section, “Program” means the program established by...
Section 15-104 - Contracts With Department of Human Services - The Secretary may contract with the Department of Human Services...
Section 15-105 - Reimbursement Procedures Under Program - (a) In this section, “dual eligibility” means simultaneous eligibility for...
Section 15-105.1 - Reimbursement Procedures Under Program -- Electronic Reimbursement - (a) This section does not apply to a person providing...
Section 15-105.2 - Reimbursement to Health Care Providers - The Program shall reimburse health care providers in accordance with...
Section 15-106 - Review of Health Care Under Program - (a) (1) In cooperation with the professional organizations whose members...
Section 15-107 - Cost Reports of Program Participants - (a) The Department may require facilities that participate in the...
Section 15-108 - Field Verification of Program Participants - (a) In this section, “board” means an appeal board established...
Section 15-109 - Eligibility; Admissibility of Long-Term Care Transaction Forms - (a) An individual is not ineligible under the Program solely...
Section 15-109.1 - Plan for Dissemination of Advance Directive Information - (a) The Department, in consultation with the Office of the...
Section 15-109.2 - Benefits and Services for Incarcerated or Institutionalized Individuals. - ** CONTINGENCY – NOT IN EFFECT – CHAPTER 82 OF...
Section 15-110 - Reimbursement -- Acute General and Chronic Care Hospitals - The Department shall reimburse acute general and chronic care hospitals...
Section 15-111 - Reimbursement -- Day Care for the Elderly and Medically Handicapped Adults - (a) The Department may authorize reimbursement of a licensed day...
Section 15-112 - Reimbursement -- Physicians - After consultation with the State Board of Pharmacy, the Secretary...
Section 15-113 - Reimbursement -- Public Institutions - (a) In this section, “inmate of a public institution” has...
Section 15-114 - Reimbursement -- Related Institutions - (a) In this section, “related institution” includes any of the...
Section 15-114.1 - Emergency Service Transporters - (a) In this section, “emergency service transporter” means a public...
Section 15-115 - Placement in Skilled or Intermediate Nursing Facility - (a) The Department may not place a Program recipient in...
Section 15-116 - Reimbursement -- Skilled Nursing Facilities - The Department shall reimburse skilled nursing facilities for services provided...
Section 15-117 - Reimbursement -- Reserved Beds - (a) In this section, “leave of absence” includes: (1) A...
Section 15-118 - Drugs - (a) (1) Unless the prescriber directs otherwise on the form...
Section 15-118.1 - Certain Prescribed Drugs Not Specialty Drugs - The Secretary may not consider drugs prescribed to treat diabetes,...
Section 15-120 - Subrogation Claims - (a) If a Program recipient has a cause of action...
Section 15-121 - Claims Against Estates - (a) In accordance with applicable federal law and rules and...
Section 15-121.1 - Subrogation of Department to Program Recipient's Claim Under 19-505 and 19-506 of the Insurance Article - (a) If a Program recipient has a claim for any...
Section 15-121.2 - Subrogation of Department to Program Recipient's Claim Under 19-509 and 19-510 of the Insurance Article - (a) If a Program recipient has a claim for any...
Section 15-121.3 - Assignment of Subrogation Right - The Department may assign its right of subrogation under §§...
Section 15-122 - Responsibility of Spouse Under Program - (a) (1) The spouse of a Program recipient is responsible...
Section 15-122.1 - Certain Providers Excluded From Repaying Depreciation Allowance - (a) In this section, “participating provider” means any facility that...
Section 15-122.2 - Intercepting State Tax Refund for Converted Funds - (a) In this section, “converted funds” means the amount received...
Section 15-122.3 - Personal Needs Allowance -- Disabled Person With Guardian - (a) (1) In this section the following words have the...
Section 15-123 - Fraud - (a) (1) In this section the following words have the...
Section 15-124.2 - Maryland Medbank Program - (a) In this section, “Program” means the Maryland Medbank Program...
Section 15-124.3 - Medicare Option Prescription Drug Program - (a) (1) In this section the following words have the...
Section 15-125 - Program for Children With Special Health Care Needs - (a) (1) In this section the following words have the...
Section 15-126 - Educational Programs for Handicapped Children - The Secretary shall provide educational programs to meet the needs...
Section 15-128 - Reimbursement for Services Provided by Hospice Care Program - The Department may provide reimbursement, under the Maryland Medical Assistance...
Section 15-129 - Durable Medical Equipment - (a) In this section, “durable medical equipment” means durable medical...
Section 15-130 - Application for Home- or Community-Based Services Waiver for Seriously Emotionally Disturbed Youth or Autistic or Developmentally Disabled Youth in Order to Receive Federal Matching Funds - (a) In this section, “seriously emotionally disturbed” means a condition...
Section 15-130.1 - Psychiatric Residential Treatment Demonstration Waiver Application - (a) The Department shall apply to the Centers for Medicare...
Section 15-131 - Application for Home- or Community-Based Services Waiver for Federal Matching Funds for Services to Adults - (a) The Department shall investigate development of integrated care systems...
Section 15-132 - Home and Community Based Services for Impaired Individuals; Medicaid Waiver - (a) (1) In this section the following terms have the...
Section 15-132.1 - Voluntary Tax Withholding - (a) In this section, “self-employed provider” means an individual who:...
Section 15-133 - Grants to Improve Home- and Community-Based Service Systems - (a) The State shall apply to the Health Care Financing...
Section 15-134 - Maryland Medical Assistance Program Waiver - (a) If the Department applies for a Medical Assistance Program...
Section 15-134.1 - Military Families - (a) In this section, “legal resident” means an individual who...
Section 15-135 - Home-Based and Community Services for Residents of Nursing Facilities - (a) (1) In this section the following words have the...
Section 15-136 - Maryland Pharmacy Access Hotline - (a) The Department shall use existing resources to establish a...
Section 15-137 - Home-Based and Community Services for Residents of Nursing Facilities -- Denial of Access Prohibited - (a) The Department may not deny an individual access to...
Section 15-138 - Employed Persons With Disabilities Program - (a) To the extent that funding is available in the...
Section 15-139 - Amendment of State Medical Assistance Program to Receive Federal Matching Funds - (a) On or before December 1, 2003, the Department shall...
Section 15-140 - State Plan Amendment to the Family Planning Program - The Department shall apply to the Centers for Medicare and...
Section 15-141 - Pilot Program to Provide Limited Dental Coverage to Adult Maryland Medical Assistance Program Recipients - (a) On or before September 1, 2018, the Department shall...
Section 15-141.1 - Collaborative Care Pilot Program - // EFFECTIVE UNTIL JUNE 30, 2024 PER CHAPTERS 683 AND...
Section 15-141.2 - Telehealth Defined -- Pilot Program -- Outcome Data -- Reports Required - (a) (1) In this section the following words have the...
Section 15-142 - Fair Share Health Care Fund - (a) In this section, “Fund” means the Fair Share Health...
Section 15-143 - Legal Immigrants -- Pregnant Women and Children - The Governor shall include in the budget bill for fiscal...
Section 15-145 - Information From and Liability of Health Insurance Carriers - (a) In this section, “carrier” means: (1) A health insurer;...
Section 15-146 - Report -- Change to Medical Eligibility for Nursing Facility Level of Care - (a) In this section, “home– and community–based waiver services” includes...
Section 15-147 - Former Officials or Employees -- Participation in Contracts - Notwithstanding § 5–504 of the General Provisions Article, a former...
Section 15-148 - Prior Authorization Not Required for Contraceptive Drug or Devices - (a) Except for a drug or device for which the...
Section 15-149 - Application to Epsdt Services for Program Recipients -- Prohibition on Conditioning Reimbursement for Services on Presence or Availability of Parent or Caregiver -- Adoption of Regulations - (a) (1) In this section the following words have the...
Subtitle 3 - Maryland Children's Health Program
Section 15-301 - Established; Purpose; Administration; Eligible Participants - (a) There is a Maryland Children’s Health Program. (b) The...
Section 15-301.1 - Premium Plans - (a) (1) In this section the following words have the...
Section 15-302 - Review, Monitoring, and Disapproval of Applications; Termination of Coverage - (a) (1) The Department shall monitor applications to determine whether...
Section 15-303 - Enrollment of Program Recipients Into Managed Care Organizations; Expedited Eligibility - (a) (1) The Department shall be responsible for enrolling program...
Section 15-304 - School-Based Outreach Program; Outreach Mechanisms - (a) (1) For purposes of increasing the number of eligible...
Subtitle 4 - Qualified State Long-Term Care Insurance Partnership
Section 15-401 - Definitions - (a) In this subtitle the following words have the meanings...
Section 15-402 - Program Established; Purposes; Administration - (a) There is a Qualified State Long–Term Care Insurance Partnership....
Section 15-403 - Eligibility - (a) To be eligible for the Program, an individual must:...
Section 15-404 - Qualifying Policy - To qualify under the Program, a long–term care policy shall:...
Section 15-405 - Calculation of Resources - In determining eligibility for medical assistance, an amount of resources...
Section 15-406 - Public Education - The Commissioner, through the Consumer Education and Advocacy Program, shall...
Section 15-407 - Regulations; Report to General Assembly - The Department and the Commissioner shall jointly: (1) Adopt regulations...
Subtitle 5 - Evaluation and Planning Services
Section 15-501 - Evaluation and Planning Services - (a) An individual who is eligible for medical assistance at...
Subtitle 6 - Prescription Drug Repository Program
Section 15-601 - Definitions - (a) In this subtitle the following words have the meanings...
Section 15-602 - Establishment; Purpose - (a) There is a Prescription Drug Repository Program regulated by...
Section 15-603 - Acceptance of Prescription Drugs and Medical Supplies - (a) Except as provided in subsection (b) of this section,...
Section 15-604 - Donation of Prescription Drugs and Medical Supplies - (a) Any person may donate prescription drugs or medical supplies...
Section 15-605 - Repository - (a) The Board may approve Medbank of Maryland, Inc., or...
Section 15-606 - Eligibility Requirements - To be eligible to receive donated prescription drugs or medical...
Section 15-607 - Immunity - (a) This section applies to: (1) A person that donates...
Section 15-608 - Regulations - (a) On or before January 1, 2007, and in consideration...
Section 15-609 - Records and Reports; Inspections - (a) A repository shall: (1) Maintain records of donated prescription...
Subtitle 7 - Health Care Coverage Fund
Section 15-701 - General Consideration - (a) In this subtitle, “Fund” means the Health Care Coverage...
Section 15-702 - Assessments for Publicly Owned Specialty Hospitals; Use of Revenues - (a) The Department shall ensure that publicly owned specialty hospitals...
Subtitle 9 - Collective Bargaining by Independent Home Care Providers
Section 15-901 - Definitions - (a) In this subtitle the following words have the meanings...
Section 15-902 - Legislative Intent - In according independent home care providers and their representatives rights...
Section 15-903 - Bargaining Unit - (a) There shall be only one appropriate bargaining unit of...
Section 15-904 - Collective Bargaining - (a) The Department and the departments of Human Services and...
Section 15-905 - Communication With State Officials on Matters of Interest - The certification of an exclusive representative of independent home care...
Section 15-906 - Strikes Prohibited - (a) A provider organization may not call or direct a...
Section 15-907 - Construction of Subtitle - (a) This subtitle may not be construed to make independent...
Subtitle 10 - Senior Prescription Drug Assistance Program
Section 15-1001 - Definitions [Subtitle Subject to Abrogation] - // EFFECTIVE UNTIL DECEMBER 31, 2024 PER CHAPTERS 462 AND...
Section 15-1002 - Program Established [Subtitle Subject to Abrogation] - // EFFECTIVE UNTIL DECEMBER 31, 2024 PER CHAPTERS 462 AND...
Section 15-1003 - General Consideration - // EFFECTIVE UNTIL DECEMBER 31, 2024 PER CHAPTERS 462 AND...
Section 15-1004 - Senior Prescription Drug Assistance Program Fund - // EFFECTIVE UNTIL DECEMBER 31, 2024 PER CHAPTERS 462 AND...
Section 15-1005 - Report; Regulations [Subtitle Subject to Abrogation] - // EFFECTIVE UNTIL DECEMBER 31, 2024 PER CHAPTERS 462 AND...
Section 15-1006 - Outreach Materials; Publication; Application Assistance [Subtitle Subject to Abrogation] - // EFFECTIVE UNTIL DECEMBER 31, 2024 PER CHAPTERS 462 AND...