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<regulation prefix="Regulation" num=".05" citation="COMAR 10.09.46.05" title_num="10" subtitle_num="09" chapter_num="46" heading="Conditions for Provider Participation — General.">
  <text>General requirements for participation in the Medical Assistance Program as a provider of BI waiver services are that the provider, with the exception of a medical day care provider, shall:</text>
  <paragraph num="A.">
    <text>Be approved by the BHA as meeting the requirements and able to provide the services specified in this chapter;</text>
  </paragraph>
  <paragraph num="B.">
    <text>Have a provider agreement in effect;</text>
  </paragraph>
  <paragraph num="C.">
    <text>Meet all the conditions for participation in COMAR 10.09.36, except as otherwise specified in this chapter;</text>
  </paragraph>
  <paragraph num="D.">
    <text>Have demonstrated experience in the provision of services to individuals with BI as evidenced by:</text>
    <paragraph num="(1)">
      <text>Having:</text>
      <paragraph num="(a)">
        <text>A history of serving individuals with brain injury for at least the past 2 years;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A program of specialized services appropriate for the needs of individuals with brain injury; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Availability of licensed healthcare professionals with experiences in the provision of services to individuals with brain injury to supervise, train, or consult with program staff regarding the needs of waiver participants; or</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Accreditation by CARF for the provision of brain injury services;</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Verify the licenses or credentials of all agencies and individuals who render services on the provider's behalf under this chapter, and have a copy of the licenses or credentials available for inspection;</text>
  </paragraph>
  <paragraph num="F.">
    <text>Assure that direct care workers who render services under this chapter:</text>
    <paragraph num="(1)">
      <text>Receive oversight from an appropriately licensed or certified health care professional; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Are determined by the provider as qualified to meet the participants' needs;</text>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>Provide an annual continuing education program approved by BHA for all staff working with waiver participants on the needs of individuals with BI that may include:</text>
    <paragraph num="(1)">
      <text>Types of brain injury;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Behavioral, emotional, cognitive, and physical changes after brain injury; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Strategies for compensation and remediation of deficits caused by a brain injury;</text>
    </paragraph>
  </paragraph>
  <paragraph num="H.">
    <text>Provide services in accordance with the requirements of Regulation .04 of this chapter and all applicable federal, State, and local laws and regulations;</text>
  </paragraph>
  <paragraph num="I.">
    <text>Agree to provide and bill BHA or its authorized representative for only those services covered under this chapter which have been preauthorized in the participant's waiver plan of care;</text>
  </paragraph>
  <paragraph num="J.">
    <text>Be ineligible to participate in the BI Waiver if the provider or any of its current or previous principals  have overpayments that remain due and owing to the Department;</text>
  </paragraph>
  <paragraph num="K.">
    <text>Provide services in person, except as authorized by the Department; and</text>
  </paragraph>
  <paragraph num="L.">
    <text>If providing services via virtual supports, comply with the requirements established in Regulation .09-1 of this chapter.</text>
  </paragraph>
</regulation>