PROPOSAL
Maryland Register
Issue Date: December 23, 2016
Volume 43 • Issue 26 • Pages 1487—1488
Title 10
DEPARTMENT OF HEALTH AND MENTAL HYGIENE
Subtitle 09 MEDICAL CARE PROGRAMS
Notice of Proposed Action
[16-333-P]
The Secretary of Health and Mental Hygiene proposes to amend:
(1) Regulation .04 under COMAR 10.09.08 Freestanding Clinics; and
(2) Regulations .04 and .06 under COMAR 10.09.77 Urgent Care Centers.
Statement of Purpose
The purpose of this action is to clarify language regarding scope of practice for services rendered by physicians, nurses, psychologists, and social workers in freestanding clinics and by physicians and physician assistants in urgent care centers.
Comparison to Federal Standards
There is no corresponding federal standard to this proposed action.
Estimate of Economic Impact
The proposed action has no economic impact.
Economic Impact on Small Businesses
The proposed action has minimal or no economic impact on small businesses.
Impact on Individuals with Disabilities
The proposed action has no impact on individuals with disabilities.
Opportunity for Public Comment
Comments may be sent to Michele Phinney, Director, Office of Regulation and Policy Coordination, Department of Health and Mental Hygiene, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to dhmh.regs@maryland.gov, or fax to 410-767-6483. Comments will be accepted through January 23, 2017. A public hearing has not been scheduled.
10.09.08 Freestanding Clinics
Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland
.04 Covered Services.
A. (text unchanged)
B. Medically Necessary Services. The program covers medically necessary services as described in §§C, D, and E of this regulation and in Regulation .05 of this chapter, rendered to participants by a freestanding clinic, when these services are performed by a physician or by [one of the following]:
(1) A registered nurse, a psychologist, or a social worker, provided that the individual[:
(a) Performing the service is in the physician’s employ;
(b) Is under the physician’s direct supervision; and
(c) Performs] performs the service within the scope of the individual’s license or certification for the purpose of assisting in the provision of physicians’ services;
(2)—(3) (text unchanged)
C.—E. (text unchanged)
10.09.77 Urgent Care Centers
Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland
.04 Covered Services.
The Program covers the following medically necessary services rendered to recipients in a free-standing urgent care center:
A.—C. (text unchanged)
D. [Physician] Urgent care services [rendered in free-standing urgent care centers], when the services are performed by a physician or one of the following acting within the scope of their practice:
[(1) Another licensed physician in the physician’s employ;]
[(2)] (1) A certified registered [physician’s] physician assistant [or a];
(2) A licensed registered nurse [provided the individual performing the service:]; or
[(a) Is in the physician’s employ;
(b) Is under the physician’s direct supervision; and
(c) Performs the service within the scope of the individual’s license or certification for the purpose of assisting in the provision of physician’s services; or]
(3) A certified nurse practitioner [provided that the individual performing the service is in the physician’s employ and performs the services within the scope of the individual’s license or certification]; and
E. (text unchanged)
.06 Payment Procedures.
A. Payment for free-standing urgent care centers is as follows:
(1) (text unchanged)
(2) In addition to the facility fee, the Program shall reimburse for services rendered by the physician, nurse practitioner, or physician assistant during the visit at the free-standing urgent care center [when performed by a physician, or by other authorized personnel under that physician’s supervision]; and
(3) (text unchanged)
B.—J. (text unchanged)
VAN T. MITCHELL
Secretary of Health and Mental Hygiene