• 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:  February 1, 2019

    Volume 46 • Issue 3 • Page 111-112

    Title 10 


    10.09.93 Chronic Hospitals

    Authority: Health-General Article, §§2-104(b), 15-102.8, 15-103, and 15-105, Annotated Code of Maryland

    Notice of Proposed Action


    The Secretary of Health proposes to amend Regulations .01.05.07, and .08 under COMAR 10.09.93 Chronic Hospitals.

    Statement of Purpose

    The purpose of this action is to:

    (1) Clarify that the definition of “chronic hospital” does not mean “long-term care facility” for purposes of Medicaid reimbursement;

    (2) Clarify the nature and frequency of rehabilitation services provided by a chronic hospital; and

    (3) Establish a new period for concurrent review of the continued medical necessity of a participant’s chronic hospital services.

    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 Jake Whitaker, Acting Director, Office of Regulation and Policy Coordination, Maryland Department of Health, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to mdh.regs@maryland.gov, or fax to 410-767-6483. Comments will be accepted through March 4, 2019. A public hearing has not been scheduled.

    .01 Definitions.

    A. (text unchanged)

    B. Terms Defined.

    (1)—(7) (text unchanged)

    (8) Chronic Hospital.

    (a) (text unchanged)

    (b) “Chronic hospital” does not mean a:

    (i) [long-term] Long-term care hospital, as defined at 42 CFR §412.23(e); or

    (ii) Long-term care facility, as defined at 42 CFR §483.5(a).

    (9)—(15) (text unchanged)

    [(16) “Level of care” means an assessment that an individual needs the level of services provided in a special psychiatric hospital.

    [(17)(16)[(25)] (24) (text unchanged)

    .05 Covered Services.

    A. Chronic hospitals shall provide the following services:

    (1)—(3) (text unchanged)

    (4) For participants admitted for [intensivemedically necessary rehabilitation services, [at least two sessions, 5 days per week, of] physical therapy, occupational therapy, or speech therapy [focused on language pathology], directed by an interdisciplinary team; and

    (5) (text unchanged)

    B.—E. (text unchanged)

    .07 Medical Eligibility.

    A. General Requirements.

    (1) (text unchanged)

    (2) An admission to a chronic hospital is medically necessary for a participant who [needs intensive]:

    (a) Requires rehabilitation services [otherof a lesser intensity or frequency than [thosethe acute inpatient rehabilitation services provided in a special rehabilitation hospital; and

    (b) May have comorbidities or a level of medical complexity that preclude admission to a special rehabilitation hospital.

    (3) (text unchanged)

    B. (text unchanged)

    .08 Utilization Review.

    A. Admission and Prior Approval.

    (1) (text unchanged)

    (2) For a participant to be preauthorized for services in a brain injury community integration program, [theprovider that meets the requirements of Regulation .04 of this chapter shall request a determination from the Department or its designee that the participant meets the criteria set forth in Regulation .07B of this chapter.

    (3) (text unchanged)

    B. Concurrent Review.

    (1) (text unchanged)

    (2) Concurrent review shall be conducted every 14 days as long as the participant remains hospitalized[, based on the participant’s diagnosis and condition,] to ensure the medical necessity of the participant’s inpatient stay[, at the following intervals:

    (a) After an initially authorized 30-day stay, or at the end of the expected length of stay identified at admission, whichever comes first; and

    (b) Every 14 days following the initial concurrent review, including clinical updates, on a form determined by the Department or its designee].

    (3) (text unchanged)

    C. (text unchanged)

    Secretary of Health