<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".06" citation="COMAR 10.09.85.06" title_num="10" subtitle_num="09" chapter_num="85" heading="Payment Procedures.">
  <paragraph num="A.">
    <text>The Program will reimburse free-standing birth centers for:</text>
    <paragraph num="(1)">
      <text>A facility fee of $2,000 for the care of the delivering mother and delivery of the newborn, if the delivery takes place at the facility; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>A facility fee of $500 for the care of the newborn.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>If the mother is transferred to a hospital prior to delivering the newborn, the Department will reimburse as follows:</text>
    <paragraph num="(1)">
      <text>If the mother was at the birth center for less than 2 hours, before the delivery of the newborn, the reimbursement will be at 25 percent of the Medicaid rate;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If the mother was at the birth center for 2 to 5 hours, before the delivery of the newborn, the reimbursement will be at 50 percent of the Medicaid rate;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>If the mother was at the birth center for 5 to 8 hours, before to the delivery of the newborn, the reimbursement will be at 70 percent of the Medicaid rate; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>If the mother was at the birth center for more than 8 hours, before the delivery of the newborn, the reimbursement will be at the full Medicaid rate.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The Program shall pay for covered services at the lower of the:</text>
    <paragraph num="(1)">
      <text>Provider's customary charge to the general public; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The Program’s fee.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>The provider shall submit a request for payment as set forth in COMAR 10.09.36.04A.</text>
  </paragraph>
  <paragraph num="E.">
    <text>The Program reserves the right to return to the provider, before payment, all invoices that are not properly completed.</text>
  </paragraph>
  <paragraph num="F.">
    <text>The Program may not make a direct payment to a recipient.</text>
  </paragraph>
  <paragraph num="G.">
    <text>Billing time limitations for claims submitted under this chapter are set forth in COMAR 10.09.36.06.</text>
  </paragraph>
</regulation>