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<regulation prefix="Regulation" num=".01" citation="COMAR 10.09.32.01" title_num="10" subtitle_num="09" chapter_num="32" heading="Definitions.">
  <paragraph num="A.">
    <text>The following terms have the meanings indicated.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Terms Defined.</text>
    <paragraph num="(1)">
      <text>“Case management” means services which will assist participants in gaining access to the full range of Medical Assistance services, as well as to any additional needed medical, social, housing, financial, counseling, and other support services.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Case manager” means a physician, nurse, or social worker (refer to Regulation .02 of this chapter) employed by the HIV ongoing case management provider and chosen by the participant or the participant’s legally authorized representative.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Department” means Department as defined in COMAR 10.09.36.01.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Entity” means a facility, agency, organization, department, office, corporation, partnership, group or individual.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>“HIV diagnostic evaluation services” means a bio-psychosocial assessment of a participant and development or revision of an individualized plan of care by a multidisciplinary team convened by an approved HIV diagnostic evaluation services provider.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“HIV diagnostic evaluation services provider” means an entity approved by the Department as a provider of HIV diagnostic evaluation services, as defined in Regulation .03 of this chapter.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“HIV-infected individual” means a person determined as positive for human immunodeficiency virus (HIV) infection by the enzyme-linked immunosorbent assay (ELISA) and confirmed by the Western Blot, or another generally accepted diagnostic testing algorithm for HIV infection.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“HIV ongoing case management” means the activities involved in developing, revising, implementing, and monitoring the plan of care, as performed by a case manager through an approved HIV ongoing case management provider.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“HIV ongoing case management provider” means an entity, as defined in Regulation .03 of this chapter, approved by the Department as a provider of ongoing case management services to participants.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>“HIV-targeted case management” means the provision of HIV diagnostic evaluation services and HIV ongoing case management.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“Medical Assistance Program” means the Medical Assistance Program as defined in COMAR 10.09.36.01.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>“Medically necessary” has the meaning stated in COMAR 10.09.36.01.</text>
    </paragraph>
    <paragraph num="(13)">
      <text>“Multidisciplinary team” means the members convened by the HIV diagnostic evaluation services provider to perform a bio-psychosocial assessment of the participant and develop or revise an individualized plan of care.</text>
    </paragraph>
    <paragraph num="(14)">
      <text>“Nurse” means a person who is licensed as a registered nurse in the jurisdiction in which services are provided.</text>
    </paragraph>
    <paragraph num="(15)">
      <text>“Ongoing case management” means the activities involved in developing, revising, implementing, and monitoring the plan of care, as performed by a case manager through an approved HIV ongoing case management provider.</text>
    </paragraph>
    <paragraph num="(16)">
      <text>“Participant” means a recipient who:</text>
      <paragraph num="(a)">
        <text>Has been diagnosed as HIV-infected or is a child less than 2 years old born to a woman diagnosed as HIV-infected;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Elects, or has a legally authorized representative elect in the recipient's behalf, to receive the services available under these regulations; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Is not receiving the same case management services under the Social Security Act, §1915(b), 1915(c), or 1915(g).</text>
      </paragraph>
    </paragraph>
    <paragraph num="(17)">
      <text>“Physician” means a doctor of medicine or osteopathy who is licensed to practice medicine in the jurisdiction in which services are rendered.</text>
    </paragraph>
    <paragraph num="(18)">
      <text>“Plan of Care” means a goal-directed treatment plan developed and revised by the HIV diagnostic evaluation service provider’s multidisciplinary team that is based on the bio-psychosocial assessment.</text>
    </paragraph>
    <paragraph num="(19)">
      <text>“Program” means the Program as defined in COMAR 10.09.36.01.</text>
    </paragraph>
    <paragraph num="(20)">
      <text>“Provider” means the HIV diagnostic evaluation services provider or HIV ongoing case management provider, which offers covered case management services to participants through a provider agreement signed with the Department and which is identified as a Program provider by issuance of an individual account number.</text>
    </paragraph>
    <paragraph num="(21)">
      <text>“Provider agreement” means a contract between the Department and the provider.</text>
    </paragraph>
    <paragraph num="(22)">
      <text>“Recipient” means recipient as defined in COMAR 10.09.36.01.</text>
    </paragraph>
    <paragraph num="(23)">
      <text>“Social worker” means a person who is in compliance with the social work licensing requirements of the jurisdiction in which services are provided.</text>
    </paragraph>
  </paragraph>
</regulation>