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<regulation prefix="Regulation" num=".01" citation="COMAR 10.09.15.01" title_num="10" subtitle_num="09" chapter_num="15" 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>“Ambulatory surgical center” means any distinct, Medicare-certified entity that operates exclusively for the purpose of providing surgical services to patients not requiring hospitalization.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Board” means the State Board of Podiatric Medical Examiners.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Department” means the Maryland Department of Health, the single State agency designated to administer the Maryland Medical Assistance Program under Title XIX of the Social Security Act, 42 U.S.C. 1396 et seq.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Emergency services” means treatment for traumatic injury or infection other than athlete's foot or chronic mycotic infection of the nail bed.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>“Hospital” means an institution which falls within the jurisdiction of Health-General Article, Title 19, Subtitle 3, Annotated Code of Maryland, and is licensed pursuant to COMAR 10.07.01, or other applicable standards established by the state in which the service is provided.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“Medical Assistance Program” means a program of comprehensive medical and other health-related care for indigent and medically indigent persons.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Medically necessary” has the meaning stated in COMAR 10.09.36.01.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Medicare” means the insurance program administered by the Federal Government under Title XVIII of the Social Security Act, 42 U.S.C. 1395 et seq.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“Nursing facility” means a skilled nursing facility certified for participation pursuant to Title XVIII or Title XIX of the Social Security Act, or an intermediate care facility certified for participation pursuant to Title XIX of the Social Security Act, which has entered into a provider agreement with the Department.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>“Participant” means an individual who is certified as eligible for, and is receiving, Medical Assistance benefits.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“Personal hygiene care” means routine hygienic care in the absence of pathology.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>“Podiatrist” means a Doctor of Podiatry (D.P.M.) who is licensed to practice podiatry by the Board or by the state in which the service is rendered.</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Practice Podiatry.</text>
      <paragraph num="(a)">
        <text>“Practice podiatry” means to diagnose or surgically, medically, or mechanically treat any ailment of the:</text>
        <paragraph num="(i)">
          <text>Human foot or ankle;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Anatomical structures that attach to the human foot; or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Soft tissue below the midcalf.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>“Practice podiatry” does not include:</text>
        <paragraph num="(i)">
          <text>Surgical treatment of acute ankle fracture; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Administration of an anesthetic, other than a local anesthetic.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(14)">
      <text>“Preauthorization” means an approval required from the Department or its designee before rendering services.</text>
    </paragraph>
    <paragraph num="(15)">
      <text>“Program” means the Maryland Medical Assistance Program.</text>
    </paragraph>
    <paragraph num="(16)">
      <text>“Provider” means an individual, association, partnership, or an incorporated or unincorporated group of podiatrists, duly licensed to provide services for participants, and who, through appropriate agreement with the Department, has been identified as a Program provider by the issuance of an individual account number.</text>
    </paragraph>
    <paragraph num="(17)">
      <text>“Routine care” means the cutting or removing of corns and calluses, and the trimming, cutting, clipping, or debriding of toenails.</text>
    </paragraph>
    <paragraph num="(18)">
      <text>“Utilization control agent” means the organization responsible for reviewing the use of medical services to determine medical necessity and lengths of stay according to professional standards.</text>
    </paragraph>
  </paragraph>
</regulation>