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<regulation prefix="Regulation" num=".06" citation="COMAR 10.09.27.06" title_num="10" subtitle_num="09" chapter_num="27" heading="Payment Procedures.">
  <paragraph num="A.">
    <text>Payment procedures as set forth in COMAR 10.09.36 apply.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Payments.</text>
    <paragraph num="(1)">
      <text>Payments shall be made directly to a qualified provider.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Providers shall be paid the lesser of:</text>
      <paragraph num="(a)">
        <text>The provider's 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="C.">
    <text>Rates.</text>
    <paragraph num="(1)">
      <text>The Department shall publish a fee schedule for services covered under this chapter that 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, 2022, rates for services governed by this chapter are as follows:</text>
      <paragraph num="(a)">
        <text>For home health aide or certified nursing assistant services provided to one participant:</text>
        <paragraph num="(i)">
          <text>$5.0809 per 15 minutes of services; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>If the services are rendered by a home health aide or certified nursing assistant who is also a certified medical technician, $6.1208 per 15 minutes of services;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>For home health aide or certified nursing assistant services provided to two or more participants in the same residence:</text>
        <paragraph num="(i)">
          <text>$3.5044 per 15 minutes of services per participant; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>If the services are rendered by a home health aide or certified nursing assistant who is also a certified medical technician, $4.2232 per 15 minutes of service per participant; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>Payments for home care case management services shall be made as follows:</text>
        <paragraph num="(i)">
          <text>Waiver enrollment process — $1,181.61;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>First month of home care case management — $1,181.61; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The second and any subsequent month of home care case management — $590.80.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Effective January 1, 2024 through June 30, 2024, rates for services governed by this chapter are as follows:</text>
      <paragraph num="(a)">
        <text>For home health aide or certified nursing assistant services provided to one participant:</text>
        <paragraph num="(i)">
          <text>$5.4874 per 15 minutes of services; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>$6.6105 per 15 minutes of service if the services are rendered by a home health aide or certified nursing assistant who is also a certified medical technician;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>For home health aide or certified nursing assistant services provided to two or more participants in the same residence:</text>
        <paragraph num="(i)">
          <text>$3.7848 per 15 minutes of services per participant; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>$4.5611 per 15 minutes of service per participant if the services are rendered by a home health aide or certified nursing assistant who is also a certified medical technician; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>Payments for home care case management services shall be made as follows:</text>
        <paragraph num="(i)">
          <text>Waiver enrollment process — $1,276.14;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>First month of home care case management — $1,276.14; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The second and any subsequent month of home care case management — $638.06.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Effective July 1, 2024, rates for services governed by this chapter are as follows:</text>
      <paragraph num="(a)">
        <text>For home health aide or certified nursing assistant services provided to one participant:</text>
        <paragraph num="(i)">
          <text>$5.6520 per 15 minutes of services; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>If the services are rendered by a home health aide or certified nursing assistant who is also a certified medical technician, $6.8088 per 15 minutes of services;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>For home health aide or certified nursing assistant services provided to two or more participants in the same residence:</text>
        <paragraph num="(i)">
          <text>$3.8983 per 15 minutes of services per participant; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>If the services are rendered by a home health aide or certified nursing assistant who is also a certified medical technician, $4.6979 per 15 minutes of service per participant; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>Payments for home care case management services shall be made as follows:</text>
        <paragraph num="(i)">
          <text>Waiver enrollment process — $1,314.42;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>First month of home care case management — $1,314.42; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The second and any subsequent month of home care case management — $657.21.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>Subject to the limitations of the State budget, the Program’s rates as specified in this regulation shall increase by 4 percent each year through Fiscal Year 2026.</text>
    </paragraph>
  </paragraph>
</regulation>