<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".14" citation="COMAR 10.09.20.14" title_num="10" subtitle_num="09" chapter_num="20" heading="Payment Procedures.">
  <paragraph num="A.">
    <text>Request for Payment — Personal Assistance. To receive payment as a personal assistance provider agency under Regulation .09 of this chapter, a provider and its workers shall use the telephonic time-keeping system approved by the Department to:</text>
    <paragraph num="(1)">
      <text>Document time; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Submit claims.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Request for Payment — All Other Covered Services. To receive payment as a provider of services covered under Regulations .10 and .11 of this chapter, a provider shall submit claims in accordance with procedures outlined in the Department’s billing manual.</text>
  </paragraph>
  <paragraph num="C.">
    <text>Billing time limitations are set forth in COMAR 10.09.36.06.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Payments.</text>
    <paragraph num="(1)">
      <text>Payments for services rendered to a participant shall be made directly to a qualified provider.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>A provider shall be paid the lesser of:</text>
      <paragraph num="(a)">
        <text>The provider’s usual and customary charge to the general public unless the service is free to individuals not covered by Medicaid; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The rate established according to the fee schedule published by the Department.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Effective July 1, 2018, for personal assistance services up to 12 hours per day, payment will be made in 15-minute units of service. For individuals who are determined to need more than 12 hours of personal assistance per day, a daily rate for the service will be paid.</text>
  </paragraph>
  <paragraph num="F.">
    <text>Rates.</text>
    <paragraph num="(1)">
      <text>The Department shall publish a fee schedule for services covered under this chapter which shall be publicly available and updated at least annually or upon any changes made by the Department.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Effective July 1, 2018, the Program’s rates as specified in the Department’s fee schedule shall increase on July 1 of each year by 3 percent, subject to the limitations of the State budget.</text>
    </paragraph>
  </paragraph>
</regulation>