# COMAR Title 10 — Maryland Department of Health

## Subtitle 09 — Medical Care Programs

### Chapter 13 — Ambulance and Wheelchair Van Services

**Authority:** Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

**Administrative History:** Effective date: January 1, 1976 (2:29 Md. R. 1740)

**Administrative History:** Chapter revised September 23, 1977 (4:20 Md. R. 1545)

**Administrative History:** Regulation .01 amended effective January 23, 1989 (16:1 Md. R. 70)

**Administrative 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)

**Administrative History:** Regulation .01C-1 adopted and D amended effective July 1, 1986 (13:13 Md. R. 1492)

**Administrative 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)

**Administrative History:** Regulation .04A amended effective July 1, 1986 (13:13 Md. R. 1492)

**Administrative History:** Regulation .05 amended effective July 1, 1986 (13:13 Md. R. 1492)

**Administrative History:** Regulation .06A amended effective July 1, 1986 (13:13 Md. R. 1492)

**Administrative History:** Regulation .06E adopted effective April 4, 1980 (7:7 Md. R. 708)

**Administrative History:** Regulation .07 amended effective January 23, 1989 (16:1 Md. R. 70)

**Administrative History:** Regulation .07A-1 adopted, E and G amended effective July 1, 1986 (13:13 Md. R. 1492)

**Administrative History:** Regulation .07A-1 amended effective February 22, 1988 (15:4 Md. R. 473)

**Administrative 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)

**Administrative 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)

**Administrative 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)

**Administrative History:** Regulation .07F amended effective April 9, 1984 (11:7 Md. R. 625)

**Administrative 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)

**Administrative 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)

**Administrative History:** Regulation .07J amended effective January 30, 1984 (11:2 Md. R. 113); September 10, 1984 (11:18 Md. R. 1584)

**Administrative 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)

**Administrative 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)

**Administrative History:** Regulation .08A amended effective May 12, 1986 (13:9 Md. R. 1029)

**Administrative History:** Regulation .09A, B amended effective August 17, 1981 (8:16 Md. R. 1365)

**Administrative History:** Regulation .10 amended effective June 6, 1983 (10:11 Md. R. 974)

**Administrative History:** Regulation .11 adopted effective October 25, 1982 (9:21 Md. R. 2106)

**Administrative History:** Chapter revised effective September 16, 1991 (18:18 Md. R. 2005)

**Administrative History:** Regulation .01B amended effective July 18, 1994 (21:14 Md. R. 1229)

**Administrative History:** Regulation .03 amended effective July 18, 1994 (21:14 Md. R. 1229)

**Administrative History:** Regulation .04 repealed and new Regulation .04 adopted effective July 18, 1994 (21:14 Md. R. 1229)

**Administrative History:** Regulation .05 amended effective July 18, 1994 (21:14 Md. R. 1229)

**Administrative History:** Regulation .06 repealed effective July 18, 1994 (21:14 Md. R. 1229)

**Administrative History:** Regulation .07 amended effective July 18, 1994 (21:14 Md. R. 1229)

#### Regulation .01 Definitions.

*COMAR 10.09.13.01*

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.

*COMAR 10.09.13.02*

Providers shall meet all licensing requirements as set forth in COMAR 10.09.36.

#### Regulation .03 Conditions for Participation.

*COMAR 10.09.13.03*

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.

*COMAR 10.09.13.04*

The program covers copayment and deductible payments for Medicare-approved services to Maryland Medical Assistance recipients.

#### Regulation .05 Limitations.

*COMAR 10.09.13.05*

The Program does not cover any payment for service other than coinsurance and deductible as approved by Medicare.

#### Regulation .06 Repealed.

*COMAR 10.09.13.06*

#### Regulation .07 Payment Procedures.

*COMAR 10.09.13.07*

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.

*COMAR 10.09.13.08*

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.

*COMAR 10.09.13.09*

Cause for suspension or removal and imposition of sanctions for this chapter are set forth in COMAR 10.09.36.

#### Regulation .10 Appeal Procedures.

*COMAR 10.09.13.10*

Appeal procedures for this chapter are set forth in COMAR 10.09.36.

#### Regulation .11 Interpretive Regulation.

*COMAR 10.09.13.11*

The interpretive regulation for this chapter is set forth in COMAR 10.09.36.