Regulation .03 General Conditions for Provider Participation.
Regulation .03 General Conditions for Provider Participation.LinkCopy Citation
To participate in the Program, a provider shall:
A.
Meet the conditions for provider participation in the Medical Assistance Program as set forth in COMAR 10.09.36.03;
B.
Meet the conditions for licensure and practice as set forth in COMAR 10.63.01, 10.63.02, and 10.63.06;
C.
Have clearly defined and written patient care policies; and
D.
Maintain, either manually or electronically, adequate documentation of each contact with a participant as part of the medical record, which, at a minimum, meets the following requirements:
(1)
Includes the date of service with service start and end times;
(2)
Includes the participant’s primary behavioral health complaint or reason for the visit;
(3)
Includes a brief description of the service provided, including progress notes;
(4)
Includes an official e-Signature, or a legible signature, along with the printed or typed name of the individual providing care, with the appropriate title;
(5)
Is made available to the following as requested:
(a)
The Department;
(b)
The ASO;
(c)
The Core Service Agency;
(d)
The Office of Inspector General; and
(e)
The Office of the Attorney General Medicaid Fraud Control Unit; and
(6)
Is consistent with the medical records confidentiality and disclosure requirements of:
(a)
Maryland Confidentiality of Medical Records Act, Health-General Article, Title 4, Subtitle 3, Annotated Code of Maryland; and
(b)
Relevant federal statutes and regulations, including the Health Insurance Portability and Accountability Act, 42 U.S.C. §1320D et seq., and implementing regulations at 45 CFR Parts 160 and 164.