# COMAR Title 10 — Maryland Department of Health

## Subtitle 09 — Medical Care Programs

### Chapter 46 — Home and Community-Based Services Waiver for Individuals with Brain Injury

#### Regulation .11 Limitations.

*COMAR 10.09.46.11*

A. Reimbursement shall be made by the Program only if all of the requirements of this chapter are met.

B. Reimbursement may not be made by the Program for a waiver service furnished before:

  (1) Enrollment of the participant in the waiver;

  (2) Development of the participant's waiver plan of care; and

  (3) Inclusion of the specific service in the participant's approved waiver plan of care.

C. The Program shall reimburse for a participant not more than:

  (1) One unit of residential habilitation services for a date of service;

  (2) One unit of day habilitation per day;

  (3) One unit of supported employment per day;

  (4) A combined maximum of seven units of supported employment and day habilitation per week; or

  (5) 32 units of individual support services for a date of service.

D. The Program does not cover the following:

  (1) Room and board for the participant;

  (2) Room and board for an unrelated personal caregiver who lives with the participant;

  (3) Direct payments to the participant's family;

  (4) Respite care for a participant residing in an out-of-home facility;

  (5) Activities or supervision reimbursed by a source other than Medicaid;

  (6) Payment for day habilitation on the same date of service as medical day care under COMAR 10.09.07;

  (7) Payment for day habilitation on the same date of services as on-site psychiatric rehabilitation as defined in COMAR 10.21.21 and COMAR 10.21.25;

  (8) Payment for residential habilitation on the same date of service as personal care under COMAR 10.09.20;

  (9) Payment for residential habilitation on the same date of service as residential rehabilitation services as defined in COMAR 10.21.22;

  (10) Payment for supported employment on the same date of service as mental health vocational supported employment as defined in COMAR 10.21.28;

  (11) Payment for individual support services on the same day as residential habilitation services as defined in Regulation .01B of this chapter; or

  (12) Payment for individual support services on the same day as family and individual support services as defined in Regulation .01B of this chapter.