<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".06" citation="COMAR 10.11.03.06" title_num="10" subtitle_num="11" chapter_num="03" heading="Medical Eligibility.">
  <paragraph num="A.">
    <text>Children with special health care needs may be eligible for services covered by the CMS Program.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Chronic medical conditions which may render an applicant medically eligible include, but are not limited to, the following:</text>
    <paragraph num="(1)">
      <text>Chronic asthma;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Chronic renal disease;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Cystic fibrosis;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Diabetes and other endocrine disorders;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Hemophilia;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Immune deficiencies;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Juvenile rheumatoid arthritis;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Leukemia and other childhood cancers;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Phenylketonuria and other inborn errors of metabolism; and</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Sickle cell anemia and other chronic anemia.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Other medical and surgical conditions which may render an applicant medically eligible include, but are not limited to, the following:</text>
    <paragraph num="(1)">
      <text>Biliary atresia;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Bronchopulmonary dysplasia;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Tracheal esophogeal fistula; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Ulcerative colitis.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Neurodevelopmental conditions which may render an applicant medically eligible include, but are not limited to, the following:</text>
    <paragraph num="(1)">
      <text>Brain tumors;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Cerebral palsy and other central nervous system disorders;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Certain high risk neonates;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Closed head injury with residual defects;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Down's syndrome and other genetic and chromosomal anomalies;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Hydrocephalus;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Medical aspects of learning disabilities and attention deficit disorders;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Medical aspects of intellectual disability and developmental delay;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Muscular atrophies and dystrophies;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Spina bifida, myelomeningocele, and the spinal cord dysfunctions;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Other neurologic damage;</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Peripheral neuromuscular disease; and</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Seizure disorder.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Orthopedic conditions which may render an applicant medically eligible include, but are not limited to, the following:</text>
    <paragraph num="(1)">
      <text>Chronic conditions resulting from trauma;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Chronic infections of bones and joints;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Club foot and other foot deformities;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Congenital developmental hip conditions such as congenital hip dislocation;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Limb deficiencies and length discrepancies;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Skeletal dysplasias and other forms of dwarfism; and</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Spinal column defects and deformities.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>Cardiac conditions which may render an applicant medically eligible include, but are not limited to, the following:</text>
    <paragraph num="(1)">
      <text>Arrhythmias;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Congenital heart defects;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Hypertension; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Rheumatic heart disease.</text>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>Craniofacial and dental conditions which may render an applicant medically eligible include, but are not limited to, the following:</text>
    <paragraph num="(1)">
      <text>Cleft lip and palate, orofacial defects;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Handicapping malocclusions; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Medically necessary dental care related to eligible medical conditions.</text>
    </paragraph>
  </paragraph>
  <paragraph num="H.">
    <text>Vision, hearing and speech-language conditions, which may render an applicant medically eligible include, but are not limited to, the following:</text>
    <paragraph num="(1)">
      <text>Amblyopia;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Cataract;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Cholesteatoma;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Chronic otitis media;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Conductive and sensory-neural hearing loss;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Otosclerosis;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Speech-language disorders;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Strabismus; and</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Velopharyngeal incompetence.</text>
    </paragraph>
  </paragraph>
  <paragraph num="I.">
    <text>The following are excluded from CMS Program medically eligible services:</text>
    <paragraph num="(1)">
      <text>Well child care;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Mental health;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Emergency care; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Urgent care.</text>
    </paragraph>
  </paragraph>
  <paragraph num="J.">
    <text>Care excluded from CMS Program medically eligible conditions unless the services are medically necessary due to the underlying chronic condition includes:</text>
    <paragraph num="(1)">
      <text>Dermatology;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Gynecology; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Dental services.</text>
    </paragraph>
  </paragraph>
</regulation>