• English

    Google Translate Disclaimer

    The Maryland Department of Information Technology (“DoIT”) offers translations of the content through Google Translate. Because Google Translate is an external website, DoIT does not control the quality or accuracy of translated content. All DoIT content is filtered through Google Translate which may result in unexpected and unpredictable degradation of portions of text, images and the general appearance on translated pages. Google Translate may maintain unique privacy and use policies. These policies are not controlled by DoIT and are not associated with DoIT’s privacy and use policies. After selecting a translation option, users will be notified that they are leaving DoIT’s website. Users should consult the original English content on DoIT’s website if there are any questions about the translated content.

    DoIT uses Google Translate to provide language translations of its content. Google Translate is a free, automated service that relies on data and technology to provide its translations. The Google Translate feature is provided for informational purposes only. Translations cannot be guaranteed as exact or without the inclusion of incorrect or inappropriate language. Google Translate is a third-party service and site users will be leaving DoIT to utilize translated content. As such, DoIT does not guarantee and does not accept responsibility for, the accuracy, reliability, or performance of this service nor the limitations provided by this service, such as the inability to translate specific files like PDFs and graphics (e.g. .jpgs, .gifs, etc.).

    DoIT provides Google Translate as an online tool for its users, but DoIT does not directly endorse the website or imply that it is the only solution available to users. All site visitors may choose to use alternate tools for their translation needs. Any individuals or parties that use DoIT content in translated form, whether by Google Translate or by any other translation services, do so at their own risk. DoIT is not liable for any loss or damages arising out of, or issues related to, the use of or reliance on translated content. DoIT assumes no liability for any site visitor’s activities in connection with use of the Google Translate functionality or content.

    The Google Translate service is a means by which DoIT offers translations of content and is meant solely for the convenience of non-English speaking users of the website. The translated content is provided directly and dynamically by Google; DoIT has no direct control over the translated content as it appears using this tool. Therefore, in all contexts, the English content, as directly provided by DoIT is to be held authoritative.

    Maryland Register
    Issue Date:  September 2, 2016
    Volume 43 • Issue 18 • Pages 1025—1027
    Title 10
    Notice of Proposed Action
    The Secretary of Health and Mental Hygiene proposes to amend:
    (1) Regulations .02, .03, and .23 under COMAR 10.09.65 Maryland Medicaid Managed Care Program: Managed Care Organizations;
    (2) Regulation .01 under COMAR 10.09.66 Maryland Medicaid Managed Care Program: Access; and
    (3) Regulation .15 under COMAR 10.09.67 Maryland Medicaid Managed Care Program: Benefits.
    Statement of Purpose
    The purpose of this action is to:
    (1) Include sexual orientation and gender as basis for nondiscrimination;
    (2) Add section 1157 of the Affordable Care Act to the list of provisions that MCOs must comply with;
    (3) Remove the requirement that a full SPR review must be conducted annually;
    (4) Replace the current asthma HEDIS measure with asthma medication ratio effective January 1, 2017;
    (5) Include texts and emails as prohibited cold-call marketing activities; and
    (6) Clarify that medically necessary podiatry services are covered for all members.
    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 October 3, 2016. A public hearing has not been scheduled.
    10.09.65 Maryland Medicaid Managed Care Program: Managed Care Organizations
    Authority: Health-General Article, §§2-104 and 15-103, Annotated Code of Maryland
    .02 Conditions for Participation.
    A.—F. (text unchanged)
    G. An MCO:
    (1) (text unchanged)
    (2) May not discriminate against an enrollee on any basis, including, but not limited to, age, sex, race, creed, color, marital status, sexual orientation, gender identity, national origin, physical or mental handicap, health status, or need for health care services;
    (3)—(4) (text unchanged)
    H.—I. (text unchanged)
    J. MCO Local Access Area Participation.
    (1)—(3) (text unchanged)
    (4) Unless the Department approves a shorter time frame, an MCO that exits the Program during the calendar year shall submit their exit transition plan to the Department 120 days prior to the effective date of the exit.
    [(4)] (5)[(7)] (8) (text unchanged)
    K.—W. (text unchanged)
    X. An MCO shall meet all other requirements of applicable State and federal law including but not limited to:
    (1)—(5) (text unchanged)
    (6) Any laws that pertain to enrollee rights; [and]
    (7) 45 CFR Part 74, as amended, including particular attention to requirements at 45 CFR §§74.42, 74.43, 74.44, 74.48, and 74. 53(a) and (b), and Appendix A; and
    (8) Section 1557 of the Affordable Care Act.
    Y.—EE. (text unchanged)
    .03 Quality Assessment and Improvement.
    A. (text unchanged)
    B. An MCO shall participate in all quality assessment activities required by the Department in order to determine if the MCO is providing medically necessary enrollee health care. These activities include, but are not limited to:
    (1) [An annual] A Systems Performance Review (SPR) performed by an external quality review organization hired by the Department to assess an MCO’s structure and operations in order to determine its ability to provide health care to its enrollees as follows:
    (a)—(d) (text unchanged)
    (2) (text unchanged)
    (3) The annual collection and evaluation of a set of performance measures with targets as determined by the Department as follows:
    (a) The composition of the core performance measures are listed in [§B(3)(d)] §B(3)(d) and (e) of this regulation;
    (b)—(d) (text unchanged)
    (e) Effective January 1, 2017, the core performance measures are:
    (i) Adolescent well care visits;
    (ii) Adult Body Mass Index (BMI) assessment;
    (iii) Ambulatory care for Supplemental Security Income (SSI) adults;
    (iv) Ambulatory care for Supplemental Security Income (SSI) children;
    (v) Breast cancer screening;
    (vi) Childhood immunizations—Combo 3;
    (vii) Comprehensive diabetes care—HbA1c testing;
    (viii) Controlling high blood pressure;
    (ix) Immunization for adolescents;
    (x) Lead screening for children 12—23 months old;
    (xi) Asthma medication ratio;
    (xii) Postpartum care; and
    (xiii) Well child visits, 3—6 years old;
    [(e)] (f)—[(g)] (h) (text unchanged)
    (4)—(6) (text unchanged)
    C. (text unchanged)
    .23 Marketing.
    A.—B. (text unchanged)
    C. An MCO may not engage in any cold call marketing, including activities using or involving any of the following mechanisms:
    (1)—(3) (text unchanged)
    (4) Email;
    (5) Texting;
    [(4)] (6)[(5)] (7) (text unchanged)
    D. (text unchanged)
    10.09.66 Maryland Medicaid Managed Care Program: Access
    Authority: Health-General Article, §§15-102.1(b)(10) and 15-103(b), Annotated Code of Maryland
    .01 Access Standards: Addressing Enrollees’ Individualized Needs.
    A. An MCO shall provide access to health care services and information in a manner that addresses the individualized needs of its enrollees, regardless of gender, sexual orientation, or gender identity, including, but not limited to, the delivery of services and information to enrollees:
    (1)—(4) (text unchanged)
    B. (text unchanged)
    10.09.67 Maryland Medicaid Managed Care Program: Benefits
    Authority: Health-General Article, Title 15, Subtitle 1, Annotated Code of Maryland
    .15 Benefits — Podiatry Services.
    A. An MCO shall provide for its enrollees medically necessary podiatry services [as follows:].
    [A. Medically necessary services for enrollees younger than 21 years old;]
    B. In addition to the services described in §A of this regulation, an MCO shall provide:
    [B.] (1)—[C.] (2) (text unchanged)
    Secretary of Health and Mental Hygiene