<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".08" citation="COMAR 10.09.07.08" title_num="10" subtitle_num="09" chapter_num="07" heading="Payment Procedures.">
  <paragraph num="A.">
    <text>Requests for Payment.</text>
    <paragraph num="(1)">
      <text>All requests for payment of services rendered shall be submitted in accordance with COMAR 10.09.36.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Billing time limitations for claims submitted pursuant to this chapter are set forth in COMAR 10.09.36.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Payment to a provider shall be limited to the number of days each participant attends the medical day care center, as authorized by a participant’s home and community based services waiver service plan.</text>
  </paragraph>
  <paragraph num="C.">
    <text>Payment shall be made only to a qualified medical day care provider. Payment may not be made to a participant, or to individual nurses, physicians, social workers, activity coordinators, or aides for services rendered in connection with the provision of medical day care.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Per Diem Rate.</text>
    <paragraph num="(1)">
      <text>Payment to a medical day care services provider shall be as follows:</text>
      <paragraph num="(a)">
        <text>For dates of service from January 1, 2021 through October 31, 2021, $88.95 per diem;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>For dates of service from November 1, 2021 through June 30, 2022, $93.58 per diem;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>For dates of service [on or after] from July 1, 2022 through December 31, 2023, $104.81 per diem;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>For dates of service from January 1, 2024 through June 30, 2024, $113.19 per diem; and</text>
      </paragraph>
      <paragraph num="(e)">
        <text>For dates of service on or after July 1, 2024, $116.59 per diem.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Subject to the limitations of the State budget, the per diem rate shall increase on July 1 of each year by 4 percent.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Payment to a provider of medical day care services may not exceed the lesser of the:</text>
    <paragraph num="(1)">
      <text>Per diem rate established under §D of this regulation; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Provider's customary charge to the general public for services covered by the Program, unless the service is free to individuals not covered by Medicaid.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>If the service is free to individuals not covered by Medicaid:</text>
    <paragraph num="(1)">
      <text>The provider:</text>
      <paragraph num="(a)">
        <text>May charge the Program; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Shall be reimbursed in accordance with §D of this regulation; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>The provider’s reimbursement is not limited to the provider’s customary charge.</text>
    </paragraph>
  </paragraph>
</regulation>