<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".07" citation="COMAR 10.09.48.07" title_num="10" subtitle_num="09" chapter_num="48" heading="Limitations.">
  <paragraph num="A.">
    <text>Restrictions may not be placed on a participant’s option to receive coordination of community services.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Coordination of community services provided under this chapter does not restrict or otherwise affect eligibility for Title XIX benefits or other available benefits or programs.</text>
  </paragraph>
  <paragraph num="C.">
    <text>Coordination of community services may not be:</text>
    <paragraph num="(1)">
      <text>Provided as an integral and inseparable part of another covered Program service;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Provided as an administrative function;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Rendered in connection with the implementation of another service authorized under §1915(b) or 1915(c) of the Social Security Act; or</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Provided as a substitute or in duplication of another service or support.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Unless otherwise approved by the Department, reimbursement may not be made for coordination of community services if the participant is receiving comparable case management services under any other State program.</text>
  </paragraph>
  <paragraph num="E.">
    <text>A participant’s coordination of community services provider may not also provide DDA-funded direct services, including meaningful day, support, and residential services for the participant.</text>
  </paragraph>
  <paragraph num="F.">
    <text>Service Exclusions.</text>
    <paragraph num="(1)">
      <text>Unless an individual is transitioning into the community, coordination of community services may not be provided to:</text>
      <paragraph num="(a)">
        <text>Individuals between the ages of 22 and 64 who are served in institutions for mental disease; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Inmates or residents of public institutions.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Services of more than 180 consecutive days of a covered stay in a medical institution will not be reimbursed unless an individual is transitioning from another Medicaid program into a DDA waiver program as authorized by the DDA.</text>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>An applicant is ineligible to be a provider if, within the preceding 10 years, the entity, its owner, or any member of its board of directors has had a provider license or certification revoked or suspended for more than 30 days, pursuant to Maryland or another state’s regulations, or has been found by a court of law to have committed fraud, abuse, intentional or negligent tort, or a criminal act.</text>
  </paragraph>
</regulation>