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regulation prefix="Regulation" num=".06" heading="Repealed."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