PROPOSAL
Maryland Register
Issue Date: December 9, 2016
Volume 43 • Issue 25• Pages 1406—1407
Title 10
DEPARTMENT OF HEALTH AND MENTAL HYGIENE
Subtitle 14 CANCER CONTROL
10.14.06 Cigarette Restitution Fund Program
Authority: Health-General Article, §§13-1001—13-1002, 13-1005—13-1012, 13-1014, 13-1101—13-1102, 13-1106—13-1116, and 13-1119, Annotated Code of Maryland
Notice of Proposed Action
[16-319-P]
The Secretary of Health and Mental Hygiene proposes to amend Regulations .02—.04, repeal existing Regulations .05 and .06, and adopt new Regulations .05 and .06 under COMAR 10.14.06 Cigarette Restitution Fund Program.
Statement of Purpose
The purpose of this action is to:
(1) Create a clear set of financial guidelines for local health departments and Statewide academic health centers to follow when determining an applicant’s eligibility for cancer treatment services;
(2) Remove a provision that local health departments or Statewide academic health centers may establish additional financial requirements for eligibility of cancer treatment services;
(3) Simplify the description of individuals who may receive tobacco treatment products; and
(4) Update the definition of “Statewide Academic Health Centers” to include organizations that meet the requirements of Health-General Article, §13-1115, Annotated Code of Maryland.
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 9, 2017. A public hearing has not been scheduled.
.02 Definitions.
A. (text unchanged)
B. Terms Defined.
[(1) “Annual gross income” means the total amount of income received each year from all sources before taxes are withheld or deductions are taken.
(2) “Annual net income” means the total amount of income received each year from all sources after taxes are withheld and deductions are taken.]
[(3)] (1)—[(8)] (6) (text unchanged)
(7) “Gross annual household income” means the total income of the applicant and any member of the applicant’s household received each year from all sources before taxes are withheld or deductions are taken.
[(9)] (8)—[(11)] (10) (text unchanged)
[(12)] (11) “Statewide academic health center” means [the]:
(a) The University of Maryland Medical Group [or the];
(b) The Johns Hopkins Institutions;
(c) The organization designated by the Department as stipulated by Health-General Article, §13-1115, Annotated Code of Maryland; or
(d) One or more of the organizations in §B(11)(a)—(c) of this regulation.
[(13)] (12) (text unchanged)
[(14)] (13) “Tobacco treatment product” means [a medication, including, but not limited to, nicotine patch, Zyban, nicotine gum and lozenge, and any other similar product to] all Food and Drug Administration-approved tobacco cessation medications, including both prescription and over-the-counter medications, that assist individuals to stop using tobacco products.
[(15)] (14)—[(17)] (16) (text unchanged)
.03 Responsibilities of the Department.
The Department shall:
A. Establish guidelines for defining financial eligibility of an uninsured individual for the purpose of receiving:
(1) (text unchanged)
(2) Tobacco treatment products under the Tobacco Use Prevention and Cessation Program; and
[B. Require each local health department and Statewide academic health center to develop written financial eligibility criteria for an uninsured individual in accordance with the requirements of Regulations .04—.06 of this chapter for:
(1) Cancer treatment services; and
(2) Tobacco treatment products;
C. Require each local health department and Statewide academic health center to submit the written financial eligibility criteria for cancer treatment services and tobacco treatment products to the Department when:
(1) The financial eligibility criteria is initially developed; and
(2) Any changes are made to the financial eligibility criteria; and]
[D.] B. Review the written [financial eligibility criteria] documentation submitted by a local health department or Statewide academic health center to assure that the [factors] criteria listed in Regulations .05 and .06 of this chapter [are included in the financial eligibility criteria] are followed.
.04 Responsibilities of Local Health Departments and Statewide Academic Health Centers.
A. (text unchanged)
B. If a local health department or a Statewide academic health center decides that grant funds under the Cigarette Restitution Fund Program will be used to pay for cancer treatment services or tobacco treatment products:
(1) (text unchanged)
(2) A local health department or a Statewide academic health center shall[:
(a) Develop written financial eligibility criteria for:
(i) Cancer treatment services in accordance with Regulation .05 of this chapter; and
(ii) Tobacco treatment products in accordance with Regulation .06 of this chapter;
(b) Update the written financial eligibility criteria when any changes are made; and
(c) Send the written financial eligibility criteria to the Department:
(i) When the written financial eligibility criteria are first developed; and
(ii) At any time the written financial eligibility criteria changes] adhere to the financial guidelines established by the Department as set forth in Regulations .05 and .06 of this chapter.
.05 Criteria for Eligibility for Cancer Treatment Services.
A. A local health department or a Statewide academic health center shall use the following financial eligibility criteria for cancer treatment services under the Cancer Prevention, Education, Screening and Treatment Program:
(1) The basis for determining financial eligibility shall be the gross annual household income;
(2) An applicant with a gross annual household income above 250 percent of the federal poverty level is not eligible to receive cancer treatment services;
(3) Written documentation required for determination of the gross annual household income shall include:
(a) The household’s most recent federal income tax return; or
(b) If a household income tax return was not filed, the following:
(i) The most recent W-2 statement;
(ii) Pay stubs from two consecutive pays;
(iii) A Social Security entitlement letter; or
(iv) A notarized letter from the applicant stating that the applicant is not working and does not have any income;
(4) The household income level for determining financial eligibility shall be based on the size of the family unit including the applicant and may include the following individuals as verified by the most recent tax return:
(a) The applicant’s spouse;
(b) Any financially dependent children; or
(c) Any financially dependent relative; and
(5) The type of written documentation that an applicant shall provide in order to document the size of the family unit includes the following:
(a) The most recent income tax return;
(b) A divorce decree, if applicable; or
(c) If a household income tax return was not filed, written documentation shall include the names, ages, and relationship to the applicant of individuals supported by the gross annual household income.
B. A local health department or a Statewide academic health center may establish requirements for eligibility of cancer treatment services in addition to those cited in §A of this regulation.
.06 Criteria for Eligibility for Tobacco Treatment Products.
A local health department shall make tobacco treatment products available free of charge to an individual participating in the Cigarette Restitution Fund Program.
VAN T. MITCHELL
Secretary of Health and Mental Hygiene
