Chapter 13. Ambulance and Wheelchair Van Services
Regulation .01 Definitions.LinkCopy Citation
A.
In this chapter, the following terms have the meanings indicated.
B.
Terms Defined.
(1)
“Department” has the meaning stated in COMAR 10.09.36.
(2)
“Medical Assistance Program” has the meaning stated in COMAR 10.09.36.
(3)
“Medical Care Programs” has the meaning stated in COMAR 10.09.36.
(4)
“Medicare” has the meaning stated in COMAR 10.09.36.
(5)
“Program” has the meaning stated in COMAR 10.09.36.
(6)
“Provider” has the meaning stated in COMAR 10.09.36.
(7)
“Recipient” has the meaning stated in COMAR 10.09.36.
Regulation .02 Licensing Requirements.LinkCopy Citation
Providers shall meet all licensing requirements as set forth in COMAR 10.09.36.
Regulation .03 Conditions for Participation.LinkCopy Citation
To participate in the Program, the provider shall:
A.
Comply with the conditions for participation as set forth in COMAR 10.09.36;
B.
Be approved as a provider of ambulance services by Medicare.
Regulation .04 Covered Services.LinkCopy Citation
The program covers copayment and deductible payments for Medicare-approved services to Maryland Medical Assistance recipients.
Regulation .05 Limitations.LinkCopy Citation
The Program does not cover any payment for service other than coinsurance and deductible as approved by Medicare.
Regulation .06 Repealed.LinkCopy Citation
Regulation .07 Payment Procedures.LinkCopy Citation
A.
Payment procedures for this chapter are set forth in COMAR 10.09.36.
B.
The Department will authorize payment on Medicare ambulance claims if:
(1)
The provider accepts Medicare assignments;
(2)
Medicare makes direct payment to the provider;
(3)
The services are covered by the Program;
(4)
Initial billing is made directly to Medicare according to Medicare guidelines;
(5)
Medicare has determined that services were medically justified.
C.
The Department will make supplemental payment on Medicare ambulance claims, subject to the following conditions:
(1)
Deductible insurance will be paid in full;
(2)
Coinsurance will be paid in full.
D.
Billing time limitations for claims submitted pursuant to this chapter are set forth in COMAR 10.09.36.
Regulation .08 Recovery and Reimbursement.LinkCopy Citation
Recovery and reimbursement for this chapter are set forth in COMAR 10.09.36.
Regulation .09 Cause for Suspension or Removal and Imposition of Sanctions.LinkCopy Citation
Cause for suspension or removal and imposition of sanctions for this chapter are set forth in COMAR 10.09.36.
Regulation .10 Appeal Procedures.LinkCopy Citation
Appeal procedures for this chapter are set forth in COMAR 10.09.36.
Regulation .11 Interpretive Regulation.LinkCopy Citation
The interpretive regulation for this chapter is set forth in COMAR 10.09.36.
Chapter annotations
Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland
History: Effective date: January 1, 1976 (2:29 Md. R. 1740)
History: Chapter revised September 23, 1977 (4:20 Md. R. 1545)
History: Regulation .01 amended effective January 23, 1989 (16:1 Md. R. 70)
History: Regulation .01B and .05I amended, and .05J adopted as an emergency provision effective July 17, 1990 (17:16 Md. R. 1984); adopted permanently effective November 1, 1990 (17:20 Md. R. 2427)
History: Regulation .01C-1 adopted and D amended effective July 1, 1986 (13:13 Md. R. 1492)
History: Regulation .03B amended effective January 6, 1983 (9:26 Md. R. 2572); January 30, 1984 (11:2 Md. R. 113); January 23, 1989 (16:1 Md. R. 70)
History: Regulation .04A amended effective July 1, 1986 (13:13 Md. R. 1492)
History: Regulation .05 amended effective July 1, 1986 (13:13 Md. R. 1492)
History: Regulation .06A amended effective July 1, 1986 (13:13 Md. R. 1492)
History: Regulation .06E adopted effective April 4, 1980 (7:7 Md. R. 708)
History: Regulation .07 amended effective January 23, 1989 (16:1 Md. R. 70)
History: Regulation .07A-1 adopted, E and G amended effective July 1, 1986 (13:13 Md. R. 1492)
History: Regulation .07A-1 amended effective February 22, 1988 (15:4 Md. R. 473)
History: Regulation .07D amended effective July 1, 1978 (5:12 Md. R. 968); January 1, 1980 (6:26 Md. R. 2075); July 1, 1980 (7:13 Md. R. 1279)
History: Regulation .07D amended as an emergency provision effective July 1, 1982 (9:11 Md. R. 1123); adopted permanently effective November 1, 1982 (9:19 Md. R. 1894)
History: Regulation .07E amended as an emergency provision effective July 1, 1990 (17:15 Md. R. 1850); amended permanently effective November 1, 1990 (17:20 Md. R. 2427)
History: Regulation .07F amended effective April 9, 1984 (11:7 Md. R. 625)
History: Regulation .07H amended as an emergency provision effective January 8, 1979 (6:2 Md. R. 72); emergency status extended until June 1, 1979 (6:12 Md. R. 1045); adopted permanently effective June 1, 1979 (6:11 Md. R. 979)
History: Regulation .07J amended as an emergency provision effective July 1, 1978 (5:14 Md. R. 1131); adopted permanently effective November 3, 1978 (5:22 Md. R. 1673)
History: Regulation .07J amended effective January 30, 1984 (11:2 Md. R. 113); September 10, 1984 (11:18 Md. R. 1584)
History: Regulation .07K amended as an emergency provision effective January 28, 1991 (18:3 Md. R. 301); emergency status expired April 8, 1991 (18:9 Md. R. 1004)
History: Regulation .07K amended as an emergency provision effective April 9, 1991 (18:9 Md. R. 1005); amended permanently effective October 7, 1991 (18:18 Md. R. 2004)
History: Regulation .08A amended effective May 12, 1986 (13:9 Md. R. 1029)
History: Regulation .09A, B amended effective August 17, 1981 (8:16 Md. R. 1365)
History: Regulation .10 amended effective June 6, 1983 (10:11 Md. R. 974)
History: Regulation .11 adopted effective October 25, 1982 (9:21 Md. R. 2106)
History: Chapter revised effective September 16, 1991 (18:18 Md. R. 2005)
History: Regulation .01B amended effective July 18, 1994 (21:14 Md. R. 1229)
History: Regulation .03 amended effective July 18, 1994 (21:14 Md. R. 1229)
History: Regulation .04 repealed and new Regulation .04 adopted effective July 18, 1994 (21:14 Md. R. 1229)
History: Regulation .05 amended effective July 18, 1994 (21:14 Md. R. 1229)
History: Regulation .06 repealed effective July 18, 1994 (21:14 Md. R. 1229)
History: Regulation .07 amended effective July 18, 1994 (21:14 Md. R. 1229)