Chapter 31. Emergency Service Transporters
Regulation .01 Definitions.LinkCopy Citation
A.
In this chapter, the following terms have the meanings indicated.
B.
Terms Defined.
(1)
“Department” has the meaning stated in COMAR 10.09.36.
(2)
“Emergency medical services (EMS) provider " has the meaning stated in Education Article, §13–516, Annotated Code of Maryland.
(3)
“Emergency service transporter” means a public entity or volunteer fire, rescue, or emergency medical service that provides emergency medical transportation services.
(4)
“EMS Board” means the State Emergency Medical Services Board established by Education Article, §13-503, Annotated Code of Maryland.
(5)
“Facility” means a hospital or nursing facility including an intermediate care facility, skilled nursing facility, comprehensive care facility, or extended care facility.
(6)
“Free-standing urgent care center” means a location, distinct from a hospital emergency room, a physician's office, or a free-standing clinic, whose purpose is to diagnose and treat illness or injury for unscheduled, ambulatory patients seeking immediate medical attention.
(7)
“Mobile integrated health” means a community-based preventive, primary, chronic, pre-admission, or post-admission health care service provided by an emergency medical services provider to a participant.
(8)
“Participant” has the meaning stated in COMAR 10.09.36.
(9)
“Program” has the meaning stated in COMAR 10.09.36.
(10)
“Provider” has the meaning stated in COMAR 10.09.36.
Regulation .02 Licensing Requirements.LinkCopy Citation
A provider shall meet all licensing requirements:
A.
Set forth in COMAR 10.09.36; and
B.
In the jurisdiction where the service is provided.
Regulation .03 Conditions for Participation.LinkCopy Citation
To participate in the Program, the provider shall:
A.
Comply with the conditions for participation set forth in COMAR 10.09.36;
B.
Certify that all third-party payers are routinely billed for services;
C.
Retain all documentation, including but not limited to run sheets, for 6 years; and
D.
When delivering mobile integrated health, render services in accordance with the MIH services medical protocols adopted by the EMS Board.
Regulation .04 Covered Services.LinkCopy Citation
A.
Emergency Medical Transportation Services. The Program covers the following services when provided by an enrolled emergency service transporter to an eligible participant in response to a 911 call:
(1)
Medical services delivered at the scene of a 911 response consistent with EMS Board protocols, with or without subsequent transportation;
(2)
Medical services provided while transporting the participant to a facility, free-standing urgent care center, or other Department-approved destination; and
(3)
Transportation to a facility, free-standing urgent care center, or other Department-approved destination.
B.
Mobile Integrated Health Services. The Program covers the following medically necessary mobile integrated health services when delivered by an EMS provider or any team member in the participant’s home or another community-based setting permitted by the EMS Board’s medical protocols:
(1)
Health assessments;
(2)
Remote medical diagnostics;
(3)
Chronic disease monitoring and education;
(4)
Medication compliance;
(5)
Immunizations and vaccinations;
(6)
Laboratory specimen collection;
(7)
Hospital discharge follow-up care; and
(8)
Minor medical procedures.
Regulation .05 Limitations.LinkCopy Citation
Under this chapter, the Program does not cover:
A.
Services not rendered in response to a 911 call unless delivered as part of a mobile integrated health visit;
B.
Services performed or billed by an emergency services transporter that is not enrolled in the Program;
C.
Services rendered by an emergency services transporter in response to a 911 call when the participant refuses medical services and transport of the participant does not occur;
D.
Services rendered to anyone other than an eligible participant;
E.
Services for which proper documentation, including but not limited to run sheets, cannot be provided on request of the Department or its designee;
F.
Services not indicated by the medical protocols adopted by the EMS Board;
G.
Mobile integrated health services delivered to participants younger than 18 years old; and
H.
Services delivered in any setting other than the eligible participant’s home or any community-based site permitted under the medical protocols adopted by the EMS Board.
Regulation .06 Payment Procedures.LinkCopy Citation
A.
Payment procedures for this chapter are set forth in COMAR 10.09.36.
B.
Emergency Medical Transportation Services Reimbursement.
(1)
Payment for covered services provided in response to each 911 call incident is the lesser of:
(a)
The amount billed; or
(b)
Effective July 1, 2022, $150.
(2)
Effective January 1, 2023, payment for covered services provided in response to each 911 call incident that does not result in a transport is the lesser of:
(a)
The amount billed; or
(b)
$150.
C.
Mobile Integrated Health Reimbursement.
(1)
Payment for a mobile integrated health visit is the lesser of:
(a)
The amount billed; or
(b)
Effective January 1, 2023, $150.
(2)
The provider shall bill one mobile integrated health service, regardless of the number of clinical services rendered to a participant during the visit.
D.
Billing time limitations for claims submitted pursuant to this chapter are set forth in COMAR 10.09.36.
Regulation .07 Recovery and Reimbursement.LinkCopy Citation
Recovery and reimbursement under this chapter are set forth in COMAR 10.09.36.
Regulation .08 Cause for Suspension or Removal and Imposition of Sanctions.LinkCopy Citation
Cause for suspension or removal and imposition of sanctions under this chapter are set forth in COMAR 10.09.36.
Regulation .09 Appeal Procedures.LinkCopy Citation
Appeal procedures under this chapter are set forth in COMAR 10.09.36.
Chapter annotations
Authority: Health-General Article, §§2-104(b), 15-103, 15-105, and 15-114.1, Annotated Code of Maryland
History: Effective date: June 14, 1999 (26:12 Md. R. 925)
History: Regulation .01B amended effective May 1, 2023 (50:8 Md. R. 337)
History: Regulation .03B, C amended effective May 1, 2023 (50:8 Md. R. 337)
History: Regulation .03D adopted effective May 1, 2023 (50:8 Md. R. 337)
History: Regulation .04 amended effective May 1, 2023 (50:8 Md. R. 337)
History: Regulation .05 amended effective May 1, 2023 (50:8 Md. R. 337)
History: Regulation .06 amended effective May 1, 2023 (50:8 Md. R. 337)