<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".11" citation="COMAR 10.09.46.11" title_num="10" subtitle_num="09" chapter_num="46" heading="Limitations.">
  <paragraph num="A.">
    <text>Reimbursement shall be made by the Program only if all of the requirements of this chapter are met.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Reimbursement may not be made by the Program for a waiver service furnished before:</text>
    <paragraph num="(1)">
      <text>Enrollment of the participant in the waiver;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Development of the participant's waiver plan of care; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Inclusion of the specific service in the participant's approved waiver plan of care.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The Program shall reimburse for a participant not more than:</text>
    <paragraph num="(1)">
      <text>One unit of residential habilitation services for a date of service;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>One unit of day habilitation per day;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>One unit of supported employment per day;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>A combined maximum of seven units of supported employment and day habilitation per week; or</text>
    </paragraph>
    <paragraph num="(5)">
      <text>32 units of individual support services for a date of service.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>The Program does not cover the following:</text>
    <paragraph num="(1)">
      <text>Room and board for the participant;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Room and board for an unrelated personal caregiver who lives with the participant;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Direct payments to the participant's family;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Respite care for a participant residing in an out-of-home facility;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Activities or supervision reimbursed by a source other than Medicaid;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Payment for day habilitation on the same date of service as medical day care under COMAR 10.09.07;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>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;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Payment for residential habilitation on the same date of service as personal care under COMAR 10.09.20;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Payment for residential habilitation on the same date of service as residential rehabilitation services as defined in COMAR 10.21.22;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Payment for supported employment on the same date of service as mental health vocational supported employment as defined in COMAR 10.21.28;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Payment for individual support services on the same day as residential habilitation services as defined in Regulation .01B of this chapter; or</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Payment for individual support services on the same day as family and individual support services as defined in Regulation .01B of this chapter.</text>
    </paragraph>
  </paragraph>
</regulation>