<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".04" citation="COMAR 10.09.22.04" title_num="10" subtitle_num="09" chapter_num="22" heading="Covered Services.">
  <paragraph num="A.">
    <text>The Program covers medically necessary services described in §B of this regulation, rendered to participants in a free-standing dialysis facility, when these services are:</text>
    <paragraph num="(1)">
      <text>Performed by a physician or by one of the following:</text>
      <paragraph num="(a)">
        <text>A physician assistant;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A nurse practitioner;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>An RN;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>An LPN;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>A social worker; or</text>
      </paragraph>
      <paragraph num="(f)">
        <text>A dietitian-nutritionist;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Provided by a non-physician listed in §A(1) of this regulation, when the following conditions are met:</text>
      <paragraph num="(a)">
        <text>The individual performing the service is in the employ of, or under contract with, the free-standing dialysis facility;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The individual performing the service is under a physician's direct supervision or written direction;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The individual performs the service within the scope of the individual's license or certification for the purpose of assisting in the provision of the physician's services; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The services are provided according to the free-standing dialysis facility physician's written plan of care;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Curative or rehabilitative services, when clearly related to the participant’s individual needs;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Adequately described in the participant’s medical record and consistent with the physician’s written plan of care.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Covered services include:</text>
    <paragraph num="(1)">
      <text>Dialysis services furnished on an outpatient basis and provided by a free-standing dialysis facility, to include hemodialysis, peritoneal dialysis, CAPD, CCPD, and home dialysis training; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Laboratory tests, supplies, and prescription drugs as related to dialysis services.</text>
    </paragraph>
  </paragraph>
</regulation>