<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".06" citation="COMAR 10.09.38.06" title_num="10" subtitle_num="09" chapter_num="38" heading="Payment Procedures.">
  <paragraph num="A.">
    <text>Request for Payment.</text>
    <paragraph num="(1)">
      <text>Requests for payment of Healthy Start Program services rendered and completed shall be submitted by an approved provider according to procedures established by the Department. Payment requests which are not properly prepared or submitted may not be processed, but shall be returned unpaid to the provider.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Requests for payment shall be submitted on the invoice form specified by the Department. A separate invoice shall be submitted for each participant. The completed form shall indicate the:</text>
      <paragraph num="(a)">
        <text>Date or dates of service;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Participant's name and Medical Assistance number;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Provider's name, location, and provider number; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Nature, unit or units, and procedure code or codes of covered services provided.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Providers shall bill the Program for the appropriate fee specified in §C of this regulation.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Billing time limitations for claims submitted pursuant to this chapter are set forth in COMAR 10.09.36.</text>
  </paragraph>
  <paragraph num="C.">
    <text>Payments shall be made:</text>
    <paragraph num="(1)">
      <text>Only to a qualified provider for covered services rendered to a participant, as specified in these regulations;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>According to the applicable rate under COMAR 10.09.02 or 10.09.21 for risk assessment—plan of care, and enriched maternity service;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>According to methodology described in the memorandum of understanding between the Program and each local health department for risk assessment—plan of care;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>For high-risk nutrition counseling as follows:</text>
      <paragraph num="(a)">
        <text>To federally qualified health centers, according to COMAR 10.09.08.05;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>To each local health department, according to the methodology described in the memorandum of understanding between the Program and each local health department;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>To Maryland qualified health centers, according to COMAR 10.09.08.06; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>To all other eligible providers, according to COMAR 10.09.02.07D.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>