Regulation .10 Conditions for Reimbursement.

The Department shall reimburse for services covered under this chapter if the services are:

Provided to a participant who meets the qualifications for eligibility specified in Regulations .02 and .03 of this chapter;

Preauthorized in the participant's waiver plan of care by the BHA, as being reasonable and medically necessary to prevent institutionalization;

Provided by an approved provider which meets the conditions for participation in Regulations .05 and .06 of this chapter; and

Rendered pursuant to:

(1)

The relevant definition of covered services in Regulation .01 of this chapter;

(2)

All other requirements specified in this chapter and COMAR 10.09.36; and

(3)

The waiver proposal and any amendments to it approved by the Secretary of the U.S. Department of Health and Human Services.