Md. Code Regs. 10.09.69.09 : MARYLAND DEPARTMENT OF HEALTH —Part 2 — MEDICAL CARE PROGRAMS — Maryland Medicaid Managed Care Program: Rare and Expensive Case Management — Covered Services - General Requirements

For participants in the REM program, the Program covers and shall reimburse for services specified in Regulations .10 and .11 of this chapter when these services are:

A. Medically necessary;
B. Prescribed by a:
(1) Physician;
(2) Physician assistant; or
(3) Nurse practitioner;
C. Preauthorized, when required, by the Department;
D. Rendered in accordance with accepted health professional standards;
E. Rendered in accordance with the treatment plan or physician's, physician assistant's, or nurse practitioner's order, or both; and
F. Delivered by an enrolled Medical Assistance provider.

Md. Code Regs. 10.09.69.09

Regulations .09 adopted as an emergency provision effective November 8, 1996 (23:25 Md. R. 1730)
Regulations .09 adopted effective March 10, 1997 (24:5 Md. R. 408)
Regulations .09 amended as an emergency provision effective July 1, 1997 (24:16 Md. R. 1151); emergency status expired December 31, 1997
Regulations .09, amended effective January 1, 1999 (25:26 Md. R. 1925)
Regulation .09B amended effective February 9, 1998 (25:3 Md. R. 144)
Regulations .09 adopted effective February 2, 2004 (31:2 Md. R. 84)
Regulation .09 amended effective November 6, 2006 (33:22 Md. R. 1732); amended and recodified from .08 effective 45:13 Md. R. 665, eff. 7/2/2018