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<chapter num="01" heading="Maryland AIDS Drug Assistance Program: Temporary Assistance Program" title_num="10" subtitle_num="18">
  <regulation prefix="Regulation" num=".01" heading="Purpose.">
    <text>The purpose of the Maryland AIDS Drug Assistance Program’s Temporary Assistance Program is to provide short term assistance to individuals with Human Immunodeficiency Virus (HIV) who:</text>
    <paragraph num="A.">
      <text>Need HIV drugs and other products;</text>
    </paragraph>
    <paragraph num="B.">
      <text>Have an application for Medical Assistance or Low-Income Subsidy pending; and</text>
    </paragraph>
    <paragraph num="C.">
      <text>Are considered likely to have their application approved.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Definitions.">
    <paragraph num="A.">
      <text>In this chapter, the following terms have the meanings indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>“Acquired immunodeficiency syndrome (AIDS)” means the medical condition caused by the Human Immunodeficiency Virus.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>“Agent” means a case manager, licensed social worker, registered nurse, or any other related professional that assists an individual in submitting an application to the Temporary Assistance Program.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Applicant” means an individual on whose behalf an application has been submitted to the Temporary Assistance Program and whose eligibility status for the Temporary Assistance Program has not yet been determined.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>“Department” means the Maryland Department of Health.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>“Drug” means an article intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease licensed by the U.S. Food and Drug Administration, and covered by the Maryland AIDS Drug Assistance Program as specified in COMAR 10.18.06.04.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>“Enrollment period” means the period of time a recipient may receive Temporary Assistance Program benefits.</text>
      </paragraph>
      <paragraph num="(7)">
        <text>“Health care practitioner” means any individual licensed to prescribe U.S. Food and Drug Administration-approved drugs or other products in the state in which they practice.</text>
      </paragraph>
      <paragraph num="(8)">
        <text>“Human immunodeficiency virus (HIV)” means the virus that causes AIDS.</text>
      </paragraph>
      <paragraph num="(9)">
        <text>“Low-Income Subsidy (LIS)” means the federal program available under the Medicare Part D prescription drug program and Medicare advantage plans that assists persons who have limited income to pay for the cost of premiums, deductibles, and copayments.</text>
      </paragraph>
      <paragraph num="(10)">
        <text>“Maryland AIDS Drug Assistance Program (MADAP)” means the program administered by the Department that provides services specified in COMAR 10.18.06.04 for enrolled recipients.</text>
      </paragraph>
      <paragraph num="(11)">
        <text>“Medical Assistance” has the meaning specified in COMAR 10.09.24.02.</text>
      </paragraph>
      <paragraph num="(12)">
        <text>“Open formulary” means all U.S. Food and Drug Administration-approved prescription medications and related devices that are not on the list of excluded drugs and other products maintained by the Department per COMAR 10.18.06.04-1.</text>
      </paragraph>
      <paragraph num="(13)">
        <text>“Recipient” means an individual who is enrolled in the Temporary Assistance Program.</text>
      </paragraph>
      <paragraph num="(14)">
        <text>“Resident” means an individual:</text>
        <paragraph num="(a)">
          <text>Who is living in the State voluntarily with the intention of making it that individual’s home and not for a temporary purpose; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>For whom any temporary absence from the State is coupled with an intent to return so as not to interrupt the continuity of residence.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(15)">
        <text>“Temporary Assistance Program (TAP)” means the program administered by the Department that provides short term MADAP services as specified in Regulation .05 of this chapter for low income eligible individuals.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Eligibility.">
    <text>To be eligible for benefits, an individual shall meet the following criteria:</text>
    <paragraph num="A.">
      <text>Be a resident of Maryland;</text>
    </paragraph>
    <paragraph num="B.">
      <text>Be infected with HIV; and</text>
    </paragraph>
    <paragraph num="C.">
      <text>Have a pending application to Medical Assistance or LIS.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Application and Enrollment.">
    <paragraph num="A.">
      <text>Application.</text>
      <paragraph num="(1)">
        <text>The agent of the applicant shall submit a completed TAP application to the Department on the form designated by the Department that includes:</text>
        <paragraph num="(a)">
          <text>Responses to all applicable questions; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>A copy of the completed application or other verifiable documentation for Medical Assistance or LIS enrollment.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>The agent of the applicant or the applicant may voluntarily withdraw the application at any time without prejudice.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The Department shall:</text>
        <paragraph num="(a)">
          <text>Review and process a TAP application by the end of the first business day following receipt;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Approve a TAP application if the:</text>
          <paragraph num="(i)">
            <text>TAP application is complete;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Applicant is determined to be eligible; and</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Department is able to ascertain that the applicant will likely be found eligible for Medical Assistance or LIS;</text>
          </paragraph>
        </paragraph>
        <paragraph num="(c)">
          <text>Issue a client identification number if the TAP application is approved;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Disapprove a TAP application if the:</text>
          <paragraph num="(i)">
            <text>TAP application is incomplete; or</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Agent of the applicant fails to provide sufficient information or documentation to determine eligibility; and</text>
          </paragraph>
        </paragraph>
        <paragraph num="(e)">
          <text>Contact the agent of the applicant with the status of the TAP application.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Enrollment.</text>
      <paragraph num="(1)">
        <text>A recipient shall be approved for coverage beginning the first day of the month in which the:</text>
        <paragraph num="(a)">
          <text>TAP application was received; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Recipient will need access to medications through TAP.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>Benefits shall end on the date that a determination of Medical Assistance or LIS coverage occurs.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Covered Services.">
    <paragraph num="A.">
      <text>The recipient shall obtain a prescription for each drug or other product ordered for the recipient.</text>
    </paragraph>
    <paragraph num="B.">
      <text>The Department shall pay for a prescription drug or other product not excluded from the open formulary if the prescription is ordered and signed by a health care practitioner for a recipient.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Recovery of Payments.">
    <text>If benefits have been incorrectly paid or another payer has been identified, the Department shall seek recovery of the amount of those payments.</text>
  </regulation>
  <regulation prefix="Regulation" num=".07" heading="Fraud.">
    <text>The Department shall pursue cases of suspected misrepresentation or fraud pursuant to Criminal Law Article, §8-503, Annotated Code of Maryland, or any other applicable statutory provision.</text>
  </regulation>
  <regulation prefix="Regulation" num=".08" heading="Confidentiality.">
    <text>Except when communicating with the parties listed in §B of this regulation and unless otherwise authorized by law, the agent of an applicant, or the agent of a recipient, the Department:</text>
    <paragraph num="A.">
      <text>Shall keep all applicant and recipient personal information confidential;</text>
    </paragraph>
    <paragraph num="B.">
      <text>May not disclose personal information kept on an applicant or recipient without written consent of the:</text>
      <paragraph num="(1)">
        <text>Applicant;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Recipient;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Applicant’s parent or legal guardian; or</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Recipient’s parent or legal guardian;</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Shall comply with the laws and regulations concerning the privacy and security of protected health information under:</text>
      <paragraph num="(1)">
        <text>Health-General Article, Title 4, Subtitle 3, Annotated Code of Maryland; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The Health Insurance Portability and Accountability Act of 1996 (HIPAA), 42 U.S.C. §§1320d et seq., as amended, the HITECH Act, 42 U.S.C. §§17932, et seq., as amended, and 45 CFR Parts 160 and 164, as amended, and their implementing regulations; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>Shall ensure that all interactive video technology-assisted communication comply with HIPAA patient privacy and security regulations.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".09" heading="Availability of Funding and Program Termination.">
    <paragraph num="A.">
      <text>If sufficient monies are not available to fund TAP, the Department shall take the action necessary to eliminate a deficit which may include program termination.</text>
    </paragraph>
    <paragraph num="B.">
      <text>If TAP is terminated, the Department shall provide benefits for each current recipient in accordance with Regulation .04B of this chapter.</text>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Health-General Article, §§2-104(b), 2-104(j), 2-105(a), and 18-102(a), Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: March 28, 2016 (43:6 Md. R. 408)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .02B amended effective May 20, 2019 (46:10 Md. R. 488)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .04B amended effective May 20, 2019 (46:10 Md. R. 488)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .05B amended effective May 20, 2019 (46:10 Md. R. 488)</annotation>
  </annotations>
</chapter>