<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".22" citation="COMAR 10.09.84.22" title_num="10" subtitle_num="09" chapter_num="84" heading="Conditions for Reimbursement.">
  <text>The Program shall reimburse for the services specified in Regulations .14—.21 of this chapter, if provided in accordance with the requirements of this chapter and if the service:</text>
  <paragraph num="A.">
    <text>Is recommended on the participant’s plan of service as necessary in order to:</text>
    <paragraph num="(1)">
      <text>Prevent the applicant’s or participant’s admission to an institution;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Safely transition the applicant or participant from an institution, such as a nursing facility, into the community; or</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Assure the health and safety of an applicant or participant in the community;</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Has been preauthorized by the Department in the participant’s plan of service;</text>
  </paragraph>
  <paragraph num="C.">
    <text>Is provided to an enrolled participant;</text>
  </paragraph>
  <paragraph num="D.">
    <text>Is medically necessary; and</text>
  </paragraph>
  <paragraph num="E.">
    <text>Is provided by a Medicaid provider who meets the conditions for participation under this chapter.</text>
  </paragraph>
</regulation>