<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".04-1" citation="COMAR 10.14.02.04-1" title_num="10" subtitle_num="14" chapter_num="02" heading="Physician Assistant Services.">
  <paragraph num="A.">
    <text>To be considered a participating physician assistant in the Program, the provider shall:</text>
    <paragraph num="(1)">
      <text>Be licensed to practice as a physician assistant in Maryland or a jurisdiction bordering Maryland;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Have a current written executed delegation agreement with a licensed supervising physician who is licensed to practice medicine in Maryland or a jurisdiction bordering on Maryland, if required by that jurisdiction;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Agree to accept, for each reimbursed medical procedure performed or service provided, the following reimbursement including, if applicable, a medical management fee as described in Regulation .15 of this chapter:</text>
      <paragraph num="(a)">
        <text>The current Medical Assistance approved rate in the State of an eligible patient who is uninsured or has insurance that does not provide coverage for a certain procedure or services;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The reimbursement rate approved by the insurer plus the payment of the deductible and patient contribution amount by the Department for an eligible patient who has insurance, other than Medicare, that provides coverage for a certain procedure or service;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The reimbursement rate approved by Medicare plus the payment of the deductible and patient contribution amount by the Department for an eligible patient who is covered by Medicare only; or</text>
      </paragraph>
      <paragraph num="(d)">
        <text>For an eligible patient who has insurance that provides coverage for a reimbursed procedure or service that is less than the current Medical Assistance approved rate, the reimbursement rate approved by the insurer plus the difference between the reimbursement rate approved by the insurer, and the Medical Assistance approved rate in the State plus the payment of the deductible and patient contribution amount by the Department;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Agree to abide by the provisions set forth in this section by signing and sending to the Department the designated Departmental form; and</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Agree to the medical, financial, and reporting requirements of the Program pursuant to Regulation .04A(5), (6), (7)(a)—(e), and (8)—(10) of this chapter.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>An eligible health care provider may be a physician assistant.</text>
  </paragraph>
  <paragraph num="C.">
    <text>The reimbursed medical services include services related to breast and cervical cancer rendered to participants in accordance with:</text>
    <paragraph num="(1)">
      <text>The functions allowed under:</text>
      <paragraph num="(a)">
        <text>The Physician Assistant’s Practice Act;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>COMAR 10.32.03; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The physician assistant’s written delegation agreement with a physician; or</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>If out-of-State, the functions authorized in the state in which the services are provided.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Non-reimbursed medical procedures and services include a procedure or service not related to the diagnosis and treatment of breast and cervical cancer.</text>
  </paragraph>
  <paragraph num="E.">
    <text>The participating physician assistant shall accept the responsibilities pursuant to Regulation .04E—G of this chapter.</text>
  </paragraph>
</regulation>