Regulation .05 Limitations.

HIV-targeted case management shall be advisory in nature.

A restriction may not be placed on qualified recipients' option to receive HIV case management services.

HIV-targeted case management does not restrict or otherwise affect:

(1)

Eligibility for Title XIX benefits or other available benefits or programs;

(2)

The freedom of a recipient to select from all available services for which the individual is found to be eligible; or

(3)

The participant's free choice of qualified providers.

HIV-targeted case management may not be:

(1)

Provided as an integral and inseparable part of another covered Program service;

(2)

Provided as an administrative function;

(3)

Rendered in connection with the implementation of the Social Security Act, §1915(b) or 1915(c); or

(4)

Part of institutional discharge planning.

Reimbursement may not be made for HIV-targeted case management services if the participant is:

(1)

Eligible to receive services under the Maryland Medicaid Managed Care Program, as defined in COMAR 10.09.62; or

(2)

Receiving comparable case management services under:

(a)

The Rare and Expensive Case Management Program, as defined in COMAR 10.09.69; or

(b)

Under another Program authority.

A participant's case manager may not be a direct services provider for the participant.