<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".03" citation="COMAR 10.09.05.03" title_num="10" subtitle_num="09" chapter_num="05" heading="Provider Qualifications and Conditions for Participation.">
  <paragraph num="A.">
    <text>General requirements for participation in the Program are that a provider shall:</text>
    <paragraph num="(1)">
      <text>Comply with requirements set forth in COMAR 10.09.36; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If delivering services via telehealth, comply with COMAR 10.09.49 and any subregulatory guidance issued by the Department.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>To participate in the Program as a dental provider, a provider shall meet the licensure requirements established in Regulation .02 of this chapter.</text>
  </paragraph>
  <paragraph num="C.">
    <text>To participate in the Program as an EPSDT certified provider of fluoride varnish services, the provider shall:</text>
    <paragraph num="(1)">
      <text>Have MDH Certification for the Application of Fluoride Varnish; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Meet the following requirements:</text>
      <paragraph num="(a)">
        <text>Be board-certified in one of the following:</text>
        <paragraph num="(i)">
          <text>Pediatrics;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Family practice; or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Internal medicine;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Be a licensed physician, physician assistant, or licensed and certified nurse practitioner, delivering primary health care to children and adolescents; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Be a local health department or a federally qualified health center.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>The provider shall:</text>
    <paragraph num="(1)">
      <text>Complete the Dental Provider Application; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Submit verification of the National Provider Identifier (NPI) Number.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Mobile Dental Unit and Mobile Dental Practice.</text>
    <paragraph num="(1)">
      <text>The mobile dental unit shall provide or arrange for comprehensive dental services with a participating Maryland Healthy Smiles Dental Program provider.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The mobile dental unit and mobile dental practice shall be linked through either ownership or a legally binding contract to a brick and mortar dental office that has a permanent and fixed location.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The brick and mortar dental office shall participate in the Maryland Healthy Smiles Dental Program.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>The mobile dental unit and mobile dental practice shall have and utilize the electronic technology that enables the same day exchange of patient records with:</text>
      <paragraph num="(a)">
        <text>The brick and mortar dental office; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>If requested, the dental office of the parent or legal guardian's choice.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>The mobile dental unit and mobile dental practice service area shall be limited to 30 miles in a rural setting and 10 miles in an urban setting from the brick and mortar dental office that the mobile dental unit and mobile dental practice is either owned by or with which the dental office holds a legally binding contract.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>A mobile dental unit and mobile dental practice shall:</text>
      <paragraph num="(a)">
        <text>Maintain dental records for the patient;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Observe all patient rights;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Obtain written, informed consent from a parent or legal guardian, which shall:</text>
        <paragraph num="(i)">
          <text>Be renewed each school year before treating a minor; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Allow the parent or legal guardian to request that the dental records be sent to a provider of their choice;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(d)">
        <text>Comply with all applicable federal, State, and local laws, regulations, and ordinances regulating:</text>
        <paragraph num="(i)">
          <text>Equipment;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Flammability;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Construction;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Infection control;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Sanitation procedures; and</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Zoning;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(e)">
        <text>Comply with the statutes and regulations of the Maryland Department of the Environment for all dental radiographic and imaging equipment;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Obtain, keep current, and make readily available all applicable county and city licenses or permits necessary to operate the mobile dental unit or mobile dental practice which would include the active dentist, hygienist and dental assistant licenses and the dental radiographic and imaging equipment permits;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Provide an update to the Department regarding any mobile dental unit or mobile dental practice provider changes within 72 hours;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Provide access to a ramp or a lift if services are provided to disabled individuals;</text>
      </paragraph>
      <paragraph num="(i)">
        <text>Have ready access to a properly functioning sterilization system;</text>
      </paragraph>
      <paragraph num="(j)">
        <text>Have ready access to an adequate supply of potable water, including hot water;</text>
      </paragraph>
      <paragraph num="(k)">
        <text>Have immediate access to toilet facilities;</text>
      </paragraph>
      <paragraph num="(l)">
        <text>Have an appropriately covered noncorrosive metal container for refuse and waste materials;</text>
      </paragraph>
      <paragraph num="(m)">
        <text>Have carbon monoxide and smoke detection devices or systems installed and in proper working condition;</text>
      </paragraph>
      <paragraph num="(n)">
        <text>Have a chair designed and purposed exclusively for the provision of dental services;</text>
      </paragraph>
      <paragraph num="(o)">
        <text>Have a dental treatment light;</text>
      </paragraph>
      <paragraph num="(p)">
        <text>Have a radiograph unit with appropriate processing equipment;</text>
      </paragraph>
      <paragraph num="(q)">
        <text>Have an evacuation unit suitable for dental surgical use;</text>
      </paragraph>
      <paragraph num="(r)">
        <text>Have written procedures for medical emergencies;</text>
      </paragraph>
      <paragraph num="(s)">
        <text>Have appropriate equipment to treat medical emergencies;</text>
      </paragraph>
      <paragraph num="(t)">
        <text>Have appropriate and sufficient dental instruments and infection control supplies; and</text>
      </paragraph>
      <paragraph num="(u)">
        <text>Have any other equipment or system that is necessary to provide the services being rendered by the mobile dental unit or mobile dental practice.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(7)">
      <text>Dental hygienists or dental assistants may not solely operate a mobile dental unit or mobile dental practice.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>The owner or owners of a mobile dental unit or mobile dental practice shall submit a business plan to the dental administrative service organization for the mobile unit or mobile dental practice that includes:</text>
      <paragraph num="(a)">
        <text>The mission of the mobile dental unit and mobile dental practice;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Verification of ownership of the mobile dental unit and mobile dental practice;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>A list of the clinical practitioners that will render services in the mobile dental unit or mobile dental practice; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The targeted population.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>