PROPOSAL
Maryland Register
Issue Date: August 19, 2016
Volume 43 • Issue 17 • Page 979
Title 10
DEPARTMENT OF HEALTH AND MENTAL HYGIENE
Subtitle 09 MEDICAL CARE PROGRAMS
10.09.53 Early and Periodic Screening, Diagnosis, and Treatment: Nursing Services for Individuals Younger than 21 Years Old
Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland
Notice of Proposed Action
[16-208-P]
The Secretary of Health and Mental Hygiene proposes to amend Regulation .07 under COMAR 10.09.53 Early and Periodic Screening, Diagnosis, and Treatment: Nursing Services for Individuals Younger than 21 Years Old.
Statement of Purpose
The purpose of this action is to modify the indexing of rates in order to ensure that the amount of the applicable index will be known during the time that the annual budget is developed. Language is also proposed to align with federal policy allowing Medicaid payment for services provided free of charge to other patients.
Comparison to Federal Standards
There is a corresponding federal standard to this proposed action, but the proposed action is not more restrictive or stringent.
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 September 19, 2016. A public hearing has not been scheduled.
.07 Payment Procedures.
A. (text unchanged)
B. [Payment to a provider of nursing services may not exceed the following fee schedule] The following rates are effective July 1, 2016:
(1) (text unchanged)
(2) [$12.50] $12.91 for 15 minutes of services provided by a registered nurse to one participant;
(3) [$8.63] $8.91 for 15 minutes of services provided by a registered nurse to each of two or more participants in the same residence;
(4) [$8.11] $8.37 for 15 minutes of services provided by a licensed practical nurse to one participant;
(5) [$5.60] $5.78 for 15 minutes of services provided by a licensed practical nurse to each of two or more participants in the same residence;
(6) [$4.28] $4.42 for 15 minutes of services provided by a CNA or HHA to one participant;
(7) [$2.95] $3.05 for 15 minutes of services provided by a CNA or HHA to each of two or more participants in the same residence; and
(8) A flat rate of [$50] $51.64 per visit for a registered nurse supervisory visit of a nurse, CNA, or HHA.
C. Payment to a provider of nursing services may not exceed the lesser of:
(1) (text unchanged)
(2) The provider’s customary charge to the general public [for nursing services] unless the service is free to individuals not covered by Medicaid.
D. If the service is free to individuals not covered by Medicaid:
(1) The provider:
(a) May charge the Program; and
(b) Shall be reimbursed in accordance with §B of this regulation; and
(2) The provider’s reimbursement is not limited to the provider’s customary charge.
[D.] E. Effective July 1, [2014] 2017, subject to the limitations of the State budget, the fee schedule rates in §B(2)—(8) of this regulation shall be adjusted annually by [adjusting the fee by] the percentage of the annual increase in the [March] previous July Consumer Price Index for All Urban Consumers, medical care component, Washington-Baltimore, from the U.S. Department of Labor, Bureau of Labor Statistics.
VAN T. MITCHELL
Secretary of Health and Mental Hygiene
