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<regulation prefix="Regulation" num=".01" citation="COMAR 10.09.22.01" title_num="10" subtitle_num="09" chapter_num="22" 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>“CMS” means Centers for Medicare and Medicaid Services.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Continuous ambulatory peritoneal dialysis (CAPD)” means a dialysis treatment method performed manually during the day by patient in which the patient’s peritoneal membrane is used as a dialyzer.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Continuous cycling peritoneal dialysis (CCPD)” means a dialysis treatment method performed automatically during the night with a peritoneal dialysis cycler in which the patient’s peritoneal membrane is used as a dialyzer.</text>
    </paragraph>
    <paragraph num="(4)">
      <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="(5)">
      <text>“Dialysis” means a treatment method in which waste products are removed from the body by diffusion from one fluid compartment to another across a semi-permeable membrane.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“Dietitian-nutritionist” means an individual who is licensed as a dietitian-nutritionist by the Board of Dietetic Practice to practice dietetics in Maryland.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Free-standing dialysis facility” means a dialysis unit capable of providing staff-assisted dialysis, which is not located in an acute hospital setting.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Hemodialysis” means a dialysis treatment method in which blood passes through an artificial kidney machine and the waste products diffuse across a manmade membrane into a bath solution known as dialysate after which the cleansed blood is returned to the patient’s body.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“Home dialysis” means hemodialysis or peritoneal dialysis performed regularly in the home with the assistance of a family member or the patient’s caregiver.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>"Home dialysis training” means instructions on how to perform dialysis services in a home setting.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“Licensed practical nurse (LPN)” means an individual licensed to practice licensed practical nursing as defined in Health Occupations Article, §8-301, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(12)">
      <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="(13)">
      <text>“Medically necessary” means that the service or benefit is:</text>
      <paragraph num="(a)">
        <text>Directly related to diagnostic, preventive, curative, palliative, rehabilitative, or ameliorative treatment of an illness, injury, disability, or health condition;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Consistent with currently accepted standards of good medical practice;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The most cost efficient service that can be provided without sacrificing effectiveness or access to care; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Not primarily for the convenience of the consumer, family or provider.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(14)">
      <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="(15)">
      <text>“Nurse practitioner” means an individual who is licensed and certified to practice as a nurse practitioner as defined in Health Occupations Article, §8-301, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(16)">
      <text>“Participant” means a person who is certified as eligible for, and is receiving, Medical Assistance benefits.</text>
    </paragraph>
    <paragraph num="(17)">
      <text>“Patient care policies” means written policies and protocols describing patient care practices and procedures established by a group of professional personnel (including one or more physicians affiliated with the free-standing dialysis facility) and approved in writing by the facility's medical director.</text>
    </paragraph>
    <paragraph num="(18)">
      <text>“Peritoneal dialysis” means a dialysis treatment method in which waste products pass from the patient’s body through the peritoneal membrane into the peritoneal cavity where the bath solution (dialysate) is introduced and removed periodically.</text>
    </paragraph>
    <paragraph num="(19)">
      <text>“Physician” means an individual who is authorized under the Maryland Medical Practice Act to practice medicine in this State as stated in Health-General Article §1-101, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(20)">
      <text>“Physician assistant” means an individual who is licensed to practice medicine with physician supervision as stated in Health Occupations Article, §§15-301(d) and (e) and 15-302, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(21)">
      <text>“Plan of care” means a written plan for evaluation, treatment, and follow-up of each participant documented in the participant’s medical record that should include, at a minimum, the following information:</text>
      <paragraph num="(a)">
        <text>Patient identification data;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Date of service;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Reason for visit;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Medical history;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Plan for treatment;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Results of all laboratory tests ordered and performed; and</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Interpretation of all diagnostic radiology procedures ordered and performed.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(22)">
      <text>“Program” means the Maryland Medical Assistance Program.</text>
    </paragraph>
    <paragraph num="(23)">
      <text>“Registered nurse (RN)” means an individual licensed to practice registered nursing as defined in Health Occupations Article, §8-301, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(24)">
      <text>“Social worker” means a person who is licensed as a social worker in accordance with COMAR 10.42.01.05.</text>
    </paragraph>
  </paragraph>
</regulation>