<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".03" citation="COMAR 10.09.18.03" title_num="10" subtitle_num="09" chapter_num="18" heading="Conditions for Participation.">
  <text>To participate in the Program, the provider shall:</text>
  <paragraph num="A.">
    <text>Unless exempt from Medicare accreditation requirements:</text>
    <paragraph num="(1)">
      <text>Be accredited by a Medicare-approved accreditation organization;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Effective November 1, 2011, provide documentation of:</text>
      <paragraph num="(a)">
        <text>Accreditation; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Having submitted an application for accreditation; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Effective April 1, 2012, be accredited or terminated from the Program;</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Apply for participation in the Program using the application form designated by the Department;</text>
  </paragraph>
  <paragraph num="C.">
    <text>If located more than 25 miles from the border of Maryland, shall provide to the Program documentation demonstrating that the enrollment and screening requirements of 42 CFR Part 455, Subpart E have been performed within the 12 months preceding the application for initial enrollment or revalidation of enrollment by:</text>
    <paragraph num="(1)">
      <text>A Medicare contractor; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The Medicaid agency or the Children’s Health Insurance Program of another state;</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Be approved for participation by the Department;</text>
  </paragraph>
  <paragraph num="E.">
    <text>Verify the recipient's eligibility;</text>
  </paragraph>
  <paragraph num="F.">
    <text>Maintain for a minimum of 6 years adequate records which are sufficient in detail to support the invoices submitted for payment, and make these records available upon request to the Department or its designee;</text>
  </paragraph>
  <paragraph num="G.">
    <text>Provide service without discrimination as to race, creed, color, age, sex, national origin, marital status, or physical or mental handicap;</text>
  </paragraph>
  <paragraph num="H.">
    <text>Not knowingly employ a former Medicaid provider, or a former employee of a Medicaid provider, to provide service to Medical Assistance patients after that provider or employee has been disqualified from the Program, unless prior approval has been received from the Department;</text>
  </paragraph>
  <paragraph num="I.">
    <text>Accept payment by the Department as payment in full for services rendered, and make no additional charge to any person for covered services;</text>
  </paragraph>
  <paragraph num="J.">
    <text>Agree that if the Program denies payment or requests repayment on the basis that an otherwise covered service was not medically necessary or preauthorized, the provider may not seek payment for that service from the recipient;</text>
  </paragraph>
  <paragraph num="K.">
    <text>Agree that if the Program denies payment due to late billing, he may not seek payment from the recipient;</text>
  </paragraph>
  <paragraph num="L.">
    <text>Place no restriction on a recipient's right to select providers of the recipient's choice;</text>
  </paragraph>
  <paragraph num="M.">
    <text>Have emergency services available on a 24 hour-a-day basis;</text>
  </paragraph>
  <paragraph num="N.">
    <text>Be prepared to furnish necessary maintenance and repairs to oxygen and related respiratory equipment;</text>
  </paragraph>
  <paragraph num="O.">
    <text>Insure on every visit to the patient that all oxygen and related respiratory equipment functions properly;</text>
  </paragraph>
  <paragraph num="P.">
    <text>Provide suitable identification, including a recent photograph, which employees who visit patients at home will carry on their person and display on request;</text>
  </paragraph>
  <paragraph num="Q.">
    <text>Agree to discontinue billing or remove equipment promptly, if the patient dies, is institutionalized, or otherwise ceases to require the oxygen;</text>
  </paragraph>
  <paragraph num="R.">
    <text>Provide an ancillary source of oxygen to last at least 24 hours when the primary source is a concentrator.</text>
  </paragraph>
</regulation>