In this chapter, the following terms have the meanings indicated. Terms Defined. “Assistance in Community Integration Services (ACIS)” means the ACIS program, a health related social needs benefit for qualified individuals, which is implemented in accordance with the HealthChoice Section 1115 Waiver approved by the Centers for Medicare and Medicaid Services. “Compliance activities” means tasks undertaken to ensure that ACIS is delivered in accordance with the HealthChoice Section 1115 Waiver approved by the Centers for Medicare and Medicaid Services. “Continuum of Care Program” means the regional or local planning body that coordinates housing and services funding for families and individuals experiencing homelessness. “Homelessness” has the meaning stated in 24 CFR §578.3. “Lead entity” means a local health department or local governmental agency, which: Has been awarded participant spaces in the ACIS program; Is an enrolled provider with the Maryland Medical Assistance Program; Is responsible for leadership, coordination, oversight, and monitoring of ACIS; Shall serve as the organizing hub and contact point for ACIS with all collaborators, including the participant’s MCO; and Shall facilitate the financial arrangement and payments with designated subcontractors. “Managed care organization (MCO)” has the meaning stated in Health-General Article, §15-101, Annotated Code of Maryland. “Participant” has the meaning stated in COMAR 10.09.36.01. “Program” means the Maryland Medical Assistance Program. A provider shall meet all conditions for participation as set forth in COMAR 10.09.36.03. A lead entity shall: Have been awarded participant spaces for ACIS by the Program; and Be a member of its local Continuum of Care Program. Eligibility for ACIS services under this chapter is limited to individuals who meet the following health and housing criteria: The individual is a participant that uses Maryland Medical Assistance; The individual meets at least one of the following health criteria: Repeated emergency department visits; Repeated hospital admissions in the past year; or Two or more chronic conditions as defined in §1945(h)(2) of the Social Security Act; and The individual meets at least one of the following housing criteria: Is homeless, chronically homeless, or at risk of homelessness as defined in 24 CFR §578.3; or Is at risk of institutional placement. The Program shall cover the following ACIS services: Compliance activities; and Housing and tenancy-based case management services when three or more services, as specified in §B of this regulation, are delivered per month per participant. Housing and tenancy-based case management services include the following: Community integration assessments to identify the participant’s: Housing preferences; Needs for support to maintain community integration; Budgeting needs; Needs for assistance applying for social services; and Needs for support regarding understanding and meeting obligations of tenancy; The development of a person-centered community integration plan with enumerated measurable goals inclusive of review and modification of the plan when necessary; Participation in meetings related to: Housing support; Crisis management; and Person-centered planning; Assistance in connecting individuals with social services defined in the integration plan such as: Housing required to meet the participant’s medical care needs; Independent living services; Counseling services; Employment support services; Services required to meet the participant’s medical needs; Transportation for services; and Entitlement programs; Assistance in communication with property managers or landlord for accommodation needs; and Connecting the participant to training and resource support related to being housed and household management. Under this chapter, the Program does not cover the following: Services provided to or for the primary benefit of individuals other than the participant; Services rendered but not appropriately documented; and Room and board. Providers may not bill for monthly ACIS case-management services if less than three housing and tenancy-based case management services were rendered to the participant for the month. Providers may not bill for compliance activities more than once per participant per calendar year. General policies governing payment procedures that are applicable to all providers are set forth in COMAR 10.09.36.04. Billing time limitations for claims submitted pursuant to this chapter are set forth in COMAR 10.09.36.06. Payments for services rendered to a participant shall be made directly to the qualified lead entity. Effective January 1, 2025, rates for the services outlined in this chapter shall be as follows: $725 per member per month for ACIS housing and tenancy-based case management; and $100 per member per year for compliance activities. Recovery and reimbursement regulations are as set forth in COMAR 10.09.36.07. Cause for suspension or removal and imposition of sanctions are as set forth in COMAR 10.09.36.08 Providers filing appeals from administrative decisions made in connection with these regulations shall do so according to COMAR 10.09.36.09. Interpretive regulatory requirements shall be as set forth in COMAR 10.09.36.10. Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland Effective date: May 12, 2025 (52:9 Md. R. 405)