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<chapter num="31" heading="Emergency Service Transporters" title_num="10" subtitle_num="09">
  <regulation prefix="Regulation" num=".01" 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>“Department” has the meaning stated in COMAR 10.09.36.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>“Emergency medical services (EMS) provider " has the meaning stated in Education Article, §13–516, Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Emergency service transporter” means a public entity or volunteer fire, rescue, or emergency medical service that provides emergency medical transportation services.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>“EMS Board” means the State Emergency Medical Services Board established by Education Article, §13-503, Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>“Facility” means a hospital or nursing facility including an intermediate care facility, skilled nursing facility, comprehensive care facility, or extended care facility.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>“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.</text>
      </paragraph>
      <paragraph num="(7)">
        <text>“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.</text>
      </paragraph>
      <paragraph num="(8)">
        <text>“Participant” has the meaning stated in COMAR 10.09.36.</text>
      </paragraph>
      <paragraph num="(9)">
        <text>“Program” has the meaning stated in COMAR 10.09.36.</text>
      </paragraph>
      <paragraph num="(10)">
        <text>“Provider” has the meaning stated in COMAR 10.09.36.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Licensing Requirements.">
    <text>A provider shall meet all licensing requirements:</text>
    <paragraph num="A.">
      <text>Set forth in COMAR 10.09.36; and</text>
    </paragraph>
    <paragraph num="B.">
      <text>In the jurisdiction where the service is provided.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Conditions for Participation.">
    <text>To participate in the Program, the provider shall:</text>
    <paragraph num="A.">
      <text>Comply with the conditions for participation set forth in COMAR 10.09.36;</text>
    </paragraph>
    <paragraph num="B.">
      <text>Certify that all third-party payers are routinely billed for services;</text>
    </paragraph>
    <paragraph num="C.">
      <text>Retain all documentation, including but not limited to run sheets, for 6 years; and</text>
    </paragraph>
    <paragraph num="D.">
      <text>When delivering mobile integrated health, render services in accordance with the MIH services medical protocols adopted by the EMS Board.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Covered Services.">
    <paragraph num="A.">
      <text>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:</text>
      <paragraph num="(1)">
        <text>Medical services delivered at the scene of a 911 response consistent with EMS Board protocols, with or without subsequent transportation;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Medical services provided while transporting the participant to a facility, free-standing urgent care center, or other Department-approved destination; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Transportation to a facility, free-standing urgent care center, or other Department-approved destination.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>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:</text>
      <paragraph num="(1)">
        <text>Health assessments;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Remote medical diagnostics;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Chronic disease monitoring and education;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Medication compliance;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Immunizations and vaccinations;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Laboratory specimen collection;</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Hospital discharge follow-up care; and</text>
      </paragraph>
      <paragraph num="(8)">
        <text>Minor medical procedures.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Limitations.">
    <text>Under this chapter, the Program does not cover:</text>
    <paragraph num="A.">
      <text>Services not rendered in response to a 911 call unless delivered as part of a mobile integrated health visit;</text>
    </paragraph>
    <paragraph num="B.">
      <text>Services performed or billed by an emergency services transporter that is not enrolled in the Program;</text>
    </paragraph>
    <paragraph num="C.">
      <text>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;</text>
    </paragraph>
    <paragraph num="D.">
      <text>Services rendered to anyone other than an eligible participant;</text>
    </paragraph>
    <paragraph num="E.">
      <text>Services for which proper documentation, including but not limited to run sheets, cannot be provided on request of the Department or its designee;</text>
    </paragraph>
    <paragraph num="F.">
      <text>Services not indicated by the medical protocols adopted by the EMS Board;</text>
    </paragraph>
    <paragraph num="G.">
      <text>Mobile integrated health services delivered to participants younger than 18 years old; and</text>
    </paragraph>
    <paragraph num="H.">
      <text>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.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Payment Procedures.">
    <paragraph num="A.">
      <text>Payment procedures for this chapter are set forth in COMAR 10.09.36.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Emergency Medical Transportation Services Reimbursement.</text>
      <paragraph num="(1)">
        <text>Payment for covered services provided in response to each 911 call incident is the lesser of:</text>
        <paragraph num="(a)">
          <text>The amount billed; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Effective July 1, 2022, $150.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>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:</text>
        <paragraph num="(a)">
          <text>The amount billed; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>$150.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Mobile Integrated Health Reimbursement.</text>
      <paragraph num="(1)">
        <text>Payment for a mobile integrated health visit is the lesser of:</text>
        <paragraph num="(a)">
          <text>The amount billed; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Effective January 1, 2023, $150.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>The provider shall bill one mobile integrated health service, regardless of the number of clinical services rendered to a participant during the visit.</text>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>Billing time limitations for claims submitted pursuant to this chapter are set forth in COMAR 10.09.36.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".07" heading="Recovery and Reimbursement.">
    <text>Recovery and reimbursement under this chapter are set forth in COMAR 10.09.36.</text>
  </regulation>
  <regulation prefix="Regulation" num=".08" heading="Cause for Suspension or Removal and Imposition of Sanctions.">
    <text>Cause for suspension or removal and imposition of sanctions under this chapter are set forth in COMAR 10.09.36.</text>
  </regulation>
  <regulation prefix="Regulation" num=".09" heading="Appeal Procedures.">
    <text>Appeal procedures under this chapter are set forth in COMAR 10.09.36.</text>
  </regulation>
  <annotations>
    <annotation type="Authority">Health-General Article, §§2-104(b), 15-103, 15-105, and 15-114.1, Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: June 14, 1999 (26:12 Md. R. 925)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .01B amended effective May 1, 2023 (50:8 Md. R. 337)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .03B, C amended effective May 1, 2023 (50:8 Md. R. 337)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .03D adopted effective May 1, 2023 (50:8 Md. R. 337)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .04 amended effective May 1, 2023 (50:8 Md. R. 337)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .05 amended effective May 1, 2023 (50:8 Md. R. 337)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .06 amended effective May 1, 2023 (50:8 Md. R. 337)</annotation>
  </annotations>
</chapter>