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<chapter num="16" heading="Registered Nurse — Workers' Compensation Medical Case Manager" title_num="10" subtitle_num="27">
  <regulation prefix="Regulation" num=".01" heading="Exclusion from Regulations.">
    <text>This chapter is not applicable to, and does not restrict or limit, a:</text>
    <paragraph num="A.">
      <text>Registered nurse from performing those functions which constitute the practice of registered nursing as defined by law; and</text>
    </paragraph>
    <paragraph num="B.">
      <text>Medical claims consultant from performing medical claims consultation as defined in this chapter.</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>“Board” means the Board of Nursing.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>“Board-approved course” means an educational offering specific to the case management of the injured worker under the Workers' Compensation Commission which meets the criteria established by the Board.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Commission” means the Workers' Compensation Commission.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Medical Case Management.</text>
        <paragraph num="(a)">
          <text>“Medical case management” means any type of contact, including electronic, written, and personal, with the injured worker, for the purpose of the planning and coordination of health services appropriate to achievement of medical rehabilitation of the injured worker.</text>
        </paragraph>
        <paragraph num="(b)">
          <text>“Medical case management” includes but is not limited to:</text>
          <paragraph num="(i)">
            <text>Case assessment;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Implementation and coordination of services with the injured worker, family, and health care providers;</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Evaluation of treatment results;</text>
          </paragraph>
          <paragraph num="(iv)">
            <text>Coordinating community re-entry;</text>
          </paragraph>
          <paragraph num="(v)">
            <text>Return to work with the employer of injury; and</text>
          </paragraph>
          <paragraph num="(vi)">
            <text>Referral for further vocational rehabilitation services.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(5)">
        <text>“Medical claims consultant” means a registered nurse who consults on medical aspects of an injured worker's rehabilitation without any contact with the injured worker.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>“Multistate licensure privilege” has the meaning set forth in COMAR 10.27.01.01B.</text>
      </paragraph>
      <paragraph num="(7)">
        <text>“Registered nurse (RN)” means an individual who:</text>
        <paragraph num="(a)">
          <text>Is licensed by the Board to practice registered nursing; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Has a multistate licensure privilege to practice registered nursing.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(8)">
        <text>“RN-WCCM” means a registered nurse-workers' compensation medical case manager.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Certification Requirements.">
    <paragraph num="A.">
      <text>For certification as an RN-WCCM, an applicant shall:</text>
      <paragraph num="(1)">
        <text>Hold a current license to practice registered nursing in this State or a multistate licensure privilege to practice registered nursing;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Submit documentation of successful completion of a Board-approved course;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Submit to the Board a completed application for certification as an RN-WCCM; and</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Pay all fees.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>The Board shall include on the RN's license the designation WCCM.</text>
    </paragraph>
    <paragraph num="C.">
      <text>Certification by Endorsement. An applicant from out-of-State shall meet the requirements as stated in this regulation.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Renewal of Certification.">
    <paragraph num="A.">
      <text>Unless renewed biennially, a certification to practice as an RN-WCCM expires at the same time as the registered nurse license.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Before certification as an RN-WCCM expires, the RN-WCCM may renew the certification for an additional term, if the RN—WCCM:</text>
      <paragraph num="(1)">
        <text>Is otherwise entitled to be certified;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Has practiced a minimum of 2,000 hours in the past 2 years as an RN—WCCM;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Submits a completed application for renewal on the form the Board requires; and</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Pays all fees.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>If the registered nurse does not meet the practice requirement stated in §B(2) of this regulation, the registered nurse shall complete a Board-approved course to be eligible for renewal of the RN-WCCM certification.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Notice to Workers' Compensation Commission.">
    <text>The Board shall:</text>
    <paragraph num="A.">
      <text>Notify the Commission of:</text>
      <paragraph num="(1)">
        <text>The status of any RN-WCCM regulated under this chapter; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Any RN-WCCM who fails to renew their certification; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Provide the Commission quarterly reports of disciplinary actions taken against any licensee governed by this chapter.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Scope of Practice.">
    <paragraph num="A.">
      <text>The RN-WCCM may perform medical case management of the injured worker as defined in this chapter.</text>
    </paragraph>
    <paragraph num="B.">
      <text>The RN-WCCM shall comply with all:</text>
      <paragraph num="(1)">
        <text>Other statutes or regulations governing registered nurse practice; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Laws, statutory policies, and procedures of the Commission.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>The RN-WCCM shall maintain medical records in accordance with Health-General Article, Title 4, Subtitle 4, Annotated Code of Maryland.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".07" heading="Course Approval.">
    <paragraph num="A.">
      <text>Each provider shall:</text>
      <paragraph num="(1)">
        <text>Submit a course proposal for approval before implementation and at least every 3 years thereafter; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Obtain from the Board a curriculum checklist detailing the content to be included in the course.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>All changes, additions, or deletions to the course shall be approved by the Board before implementation.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".08" heading="Course Requirements.">
    <paragraph num="A.">
      <text>Each course shall have a minimum of 16 hours of theory content.</text>
    </paragraph>
    <paragraph num="B.">
      <text>The curriculum shall include the following content areas:</text>
      <paragraph num="(1)">
        <text>An historical perspective of case management;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Insurance terms and types of coverage—general;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Federal and State insurance statutes and regulations governing workers' compensation;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Stakeholders—roles, responsibilities, ethical considerations, and goals;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Maryland Nurse Practice Act; and</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Case management, including:</text>
        <paragraph num="(a)">
          <text>Assessment;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Planning;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Implementation;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Evaluation;</text>
        </paragraph>
        <paragraph num="(e)">
          <text>Written reporting; and</text>
        </paragraph>
        <paragraph num="(f)">
          <text>Communication.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>The course offering shall use texts from a Board-approved list.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".09" heading="Faculty.">
    <paragraph num="A.">
      <text>Qualifications. Faculty shall hold a:</text>
      <paragraph num="(1)">
        <text>Current license in Maryland to practice registered nursing or a multistate licensure privilege to practice registered nursing; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Certification as a case manager by a certifying body recognized by the Board.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Responsibilities. Faculty shall:</text>
      <paragraph num="(1)">
        <text>Plan, implement, and evaluate the course at periodic planned intervals; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Develop and utilize written examinations to measure achievement of course objectives.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".10" heading="Unlawful Practice.">
    <paragraph num="A.">
      <text>Unless authorized to practice under this chapter, an individual may not use the words “registered nurse—workers' compensation medical case manager”, RN—WCCM, or any other words, letters, or symbols with the intent to represent that the individual is a registered nurse-workers' compensation medical case manager.</text>
    </paragraph>
    <paragraph num="B.">
      <text>An individual certified under this chapter is subject to disciplinary sanctions set forth in Health Occupations Article, Title 8, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="C.">
      <text>An individual may not practice medical case management for the Commission unless authorized under this chapter.</text>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Health-General Article, §4-403; Health Occupations Article, §§8-102 and 8-205; Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date:</annotation>
    <annotation type="History" subtype="Administrative History">Regulations .01—.10 adopted as an emergency provision effective August 2, 1999; adopted permanently effective November 15, 1999 (26:23 Md. R. 1777)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .02B amended effective July 2, 2018 (45:13 Md. R. 667)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .03 amended effective July 2, 2018 (45:13 Md. R. 667)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .04 amended effective July 2, 2018 (45:13 Md. R. 667)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .05A amended effective July 2, 2018 (45:13 Md. R. 667)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .06C adopted effective October 13, 2025 (52:20 Md. R. 1002)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .09A amended effective July 2, 2018 (45:13 Md. R. 667)</annotation>
  </annotations>
</chapter>