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<regulation prefix="Regulation" num=".01" citation="COMAR 10.09.64.01" title_num="10" subtitle_num="09" chapter_num="64" heading="Definitions.">
  <paragraph num="A.">
    <text>In this chapter, the following terms have the meanings indicated.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Terms Defined.</text>
    <paragraph num="(1)">
      <text>“Behavioral health care manager” means a nurse, clinical social worker, or psychologist working under the oversight and direction of the physician or other primary care provider with formal education or specialized training to provide coordination and intervention in behavioral health.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Collaborative Care Model” means the Psychiatric Collaborative Care Model, a patient-centered, evidence-based approach for integrating physical and behavioral health services in primary care settings that includes:</text>
      <paragraph num="(a)">
        <text>Care coordination and management;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Regular, systematic monitoring and treatment using a validated clinical rating scale;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Regular, systematic psychiatric or substance use disorder caseload reviews, or both; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Regular, systematic consultation for patients who do not show clinical improvement.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>“Federally qualified health center (FQHC)" means an entity as defined by Health-General Article, §24-1301, Annotated Code of Maryland, and §1905(l)(2)(B) of the Social Security Act.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Participant” means an individual who:</text>
      <paragraph num="(a)">
        <text>Has been determined to meet the qualifications for services under the Collaborative Care Model as specified in Regulation .04 of this chapter; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Is enrolled with the Department to receive Medicaid services.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>“Primary care provider (PCP)” means a physician, or other provider type as defined in COMAR 10.67.05.05, who is the primary coordinator of care for the enrollee, and whose responsibility is to provide accessible, continuous, comprehensive, and coordinated health services covering the full range of benefits required by the Maryland Medical Assistance Program.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“Program” means the Maryland Medical Assistance Program.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Psychiatric consultant” means a licensed psychiatrist, psychiatric nurse practitioner, addiction medicine specialist, or any other behavioral health medicine specialist as allowed under federal regulations governing the model who is trained in psychiatry and qualified to prescribe medication.</text>
    </paragraph>
  </paragraph>
</regulation>