The purpose of the Maryland Dent-Care Loan Assistance Repayment Program (MDC-LARP) is to increase access to oral health services for Maryland Medical Assistance Program (MMAP) recipients by increasing the number of dentists who treat that population. The MDC-LARP is funded through Maryland general funds and provides loan repayment for Maryland licensed dentists dependent upon available annual funding. A dentist who participates in this program shall agree to provide oral health care services to a minimum of 30 percent MMAP recipients as a proportion of their total patient population, document this information, and submit confirming written reports. To be eligible for Maryland Dent-Care Loan Assistance Repayment Program (MDC-LARP) repayment assistance, an individual: Shall be employed as a full-time dentist in Maryland; Shall demonstrate financial need; Shall have received a dental degree from a college or university in Maryland or from an accredited U.S. dental school; Shall have a valid unrestricted license to practice dentistry in Maryland at the time the service obligation begins; May not have breached an obligation for service to a federal, state, or local government entity; Shall have no unserved obligations for service to a federal, state, or local government, or to another entity, with the exception of U.S. Department of Health and Human Services' Primary Care Loans, Exceptional Financial Need Scholarships, and Financial Assistance for Disadvantaged Health Professions Students aid; Shall have outstanding eligible higher education loans; May not be in default on any eligible higher education loan; and Shall agree to provide services as provided in Regulation .07 of this chapter. Service obligations shall be rendered at an eligible practice site, which is any federal, state, local, or private for-profit or nonprofit dental facility (including a solo, group, or incorporated private practice) that treats all persons and agrees to the statutory requirement that a minimum of 30 percent of the patients treated each year for 3 years are in a private or clinical setting serving Maryland medical assistance program recipients. Loans eligible for repayment assistance are any loans for undergraduate or graduate dental professional study obtained for tuition, educational expenses, or living expenses from a college, university, government, commercial source, or an organization, institution, association, society, or corporation that is exempt from taxation under §501(c)(3) or (4) of the Internal Revenue Code of 1986. An MDC-LARP recipient shall provide documentation that commercial loans were used for payment of tuition, educational expenses, or living expenses. The Maryland Department of Health, Office of Primary Care Services (MDH) shall be responsible for designating geographic dentist shortage areas in Maryland and reporting the designations annually to the Office for Student Financial Assistance according to a schedule that corresponds to the Maryland Dent-Care Loan Assistance Repayment Program (MDC-LARP) award cycle. Geographic areas designated by MDH shall coincide with Maryland's federal Dental Health Professions Shortage Areas (Dental HPSAs). In addition, MDH may identify other areas based on health status indicators that MDH deems appropriate. Designated dentist shortage areas shall be provided to the review panel as described in Regulation .05 of this chapter for the purpose of reviewing applications and designating underserved areas. A dentist does not have to practice in a Dental HPSA to be considered for an MDC-LARP. An individual shall complete an application and provide any additional information required by the Office of Student Financial Assistance (OSFA) and the Office of Oral Health (OOH) to be considered for Maryland Dent-Care Loan Assistance Repayment Program repayment assistance. The OOH is responsible for the development and distribution of application forms and materials. An applicant shall provide: A completed application; Proof of graduation from an accredited U.S. school of dentistry; Documentation of the amounts and the holders of the applicant's outstanding eligible higher education loans; Letters of recommendation from three individuals; Proof of a dental license issued by the Maryland State Board of Dental Examiners; and If entering a group practice or incorporated practice, a letter of intent from the employer stating that the other members of the practice are aware of the program and the requirements that need to be fulfilled; and If in solo practice, proof that the practice exists. Each applicant shall agree to provide any information or documentation requested by OSFA and OOH for the purpose of administering this program and, if requested, shall sign an authorization for the release of information to OFSA for the purpose of administering this program. An applicant’s failure or refusal to provide requested information or a signed release may result in a determination of ineligibility, the cancellation of an award, or the denial of a deferment, cancellation, suspension, or waiver request. The Office of Oral Health (OOH) shall appoint a Review Panel, which includes dentists who have experience treating Medicaid and low-income patients, to assist in the annual selection of Maryland Dent-Care Loan Assistance Repayment Program (MDC-LARP) recipients. The Review Panel shall be responsible for reviewing the eligible applicants and recommending to OOH which applicants should receive an award. The OOH shall make the final selection of MDC-LARP recipients. The Review Panel may consider the following criteria in making its recommendations to OOH: The dental health care needs of the geographic area where the dental practice is located; The professional competence and conduct of applicants; The applicant’s willingness to serve the 3-year requirement; The applicant’s personal or professional background and whether it demonstrates an understanding of the dental needs that exist in shortage areas or in underserved populations; and Additional criteria as determined by OOH to accommodate the goals of the MDC-LARP program. The total number of awards made each year shall be determined on an annual basis by the Office of Student Financial Assistance (OSFA) and the Maryland Department of Health (MDH) and shall be based on the amount of funds available. The award amount for new Maryland Dent-Care Loan Assistance Repayment Program (MDC-LARP) awards shall be determined on an annual basis by OSFA and MDH, and shall be based on the available annual funding, the number of selected recipients, a recipient’s total indebtedness from eligible higher education loans at the time of application, and the number of years the recipient agrees to serve in the program. An award shall be for a minimum of $10,000 per year and up to a maximum of $30,000 per year. An MDC-LARP award may not exceed the MDC-LARP recipient’s total indebtedness from eligible higher education loans. OSFA shall issue checks to selected MDC-LARP recipients within 60 days of completing their service year. A service year is the 365-day period commencing on the date of the first day the MDC-LARP recipient begins to fulfill the service obligation at an eligible practice site. Unless the MDC-LARP recipient does not fulfill the service obligation as scheduled, subsequent service years for that MDC-LARP recipient begin and end on the same dates as the first service year. The amount of the check shall equal the loan repayment amount specified for the service year in the contract between the MDC-LARP recipient and the Commission. A loan repayment check shall be made co-payable to the MDC-LARP recipient and the holder of the MDC-LARP recipient's eligible higher education loans. The MDC-LARP recipient shall endorse and forward the check to the loan holder. An MDC-LARP recipient shall notify OSFA if there is a change in the holder of a loan. An MDC-LARP recipient may receive renewal awards for up to a maximum of 3 years if the recipient continues to meet the eligibility criteria and have outstanding eligible higher education loans, depending on available funding. Individuals applying for an award renewal are neither given preference nor guaranteed renewal. The recipient of an Maryland Dent-Care Loan Assistance Repayment Program (MDC-LARP) award shall furnish the Office of Student Financial Assistance (OSFA) with written acceptance of the award and sign a promissory note that stipulates the: Obligations of an MDC-LARP recipient; Number of years to which the MDC-LARP recipient commits; Total and annual amounts of the MDC-LARP award; Penalties for breaching the promissory note; Circumstances under which the obligation may be deferred, canceled, suspended, or waived; and Other terms OSFA deems necessary. A recipient of an MDC-LARP award shall: Provide dental care services to Maryland Medical Assistance Program MMAP recipients equal to at least 30 percent of their practice for 1 year for each year the individual received an award; Provide dental care services in a full-time eligible practice site (full-time practice means a minimum of 40 hours per week); Provide at least 32 hours of the required 40 hours per week during normally scheduled office hours at an eligible practice site; and Ensure that no more than 35 workdays are spent away from the practice for holidays, vacation, continuing professional education, illness, or any other reason. Absences greater than 35 workdays in any given 52-week period shall extend the service obligation end date. While in practice at an eligible practice site, an MDC-LARP recipient shall: Sign up to be a Medical Assistance provider with the Maryland Healthy Smiles Program; Accept and render services to Maryland Medical Assistance Program recipients; Maintain a valid license to practice dentistry in the State of Maryland throughout the service obligation; Notify OSFA if the employment arrangement at the eligible practice site is terminated or changed; Notify OSFA if the repayment of a loan is undertaken by an entity defined in Education Article, §18-2401(b)(2), Annotated Code of Maryland; Keep timely records of services rendered to all Medicaid patients (both Network Provider Recipients and Maryland Medical Assistance Program Recipients) and provide the Department of Health Office of Oral Health with written reports of those services as allowed by federal and state confidentiality statutes and regulations; and Complete an exit interview at the end of the final service period. The Office of Student Financial Assistance (OSFA) shall require annual verification that a Maryland Dent-Care Loan Assistance Repayment Program (MDC-LARP) recipient is fulfilling their award obligations. Prior to issuing an MDC-LARP recipient's check for the first year of service, OSFA shall receive notice from the Maryland Department of Health Office of Oral Health (MDH) that confirms that the MDC-LARP recipient is providing appropriate service at that site. Prior to issuing a check for a subsequent year of service, OSFA shall receive confirmation from MDH that the MDC-LARP recipient provided services in the previous year and continues to practice at an eligible practice site. A Maryland Dent-Care Loan Assistance Repayment Program (MDC-LARP) recipient breaches the recipient’s obligations if: They do not begin their service obligation at an eligible practice site within 3 months of the close of the fiscal year in which the promissory note is executed; or The MDC-LARP recipient separates from the eligible practice site prior to fulfilling the service obligation and does not move to a site that complies with the program requirements. An MDC-LARP recipient who breaches their obligation shall be subject to the total of the following financial penalties: The total amounts paid to, or on behalf of, the recipient for loan repayments for any period of obligated service not served; An amount equal to the number of months of obligated service not completed multiplied by $7,500; and Interest on the amounts in §B(1) and (2) of this regulation at the maximum legal prevailing rate, as determined by the Treasurer of the United States, from the date of breach. In addition to the penalties in §B of this regulation, the State of Maryland is entitled to recover costs, fees, and expenses associated with the collection of these penalties, including attorney’s fees, as prescribed by State law or regulation Amounts not paid within 1 year of the breach shall be subject to garnishment of wages, deductions in Medicaid payments, and other collection methods. The Office of Student Financial Assistance shall report recipients who fail to pay their financial penalties within 1 year to the Maryland State Board of Dental Examiners. Recipients who fail to pay their financial penalties may be subject to disciplinary action by the Board of Dental Examiners. An MDC-LARP recipient's financial obligation to pay damages may not be released by discharge of bankruptcy under Title 11 of the United States Code. The Office of Student Financial Assistance (OSFA) may consider deferment, cancellation, suspension, or waiver of the obligation as provided in this regulation. OSFA may consider deferment for: Military service for a period not to exceed 3 years; Extended illness verified by a physician; Extenuating family circumstances to be decided on a case-by-case basis; and Maternity/paternity leave not to exceed 6 months. OSFA may consider cancellation, suspension, or waiver as follows: Any service or payment obligation incurred by a Maryland Dent-Care Loan Assistance Repayment Program (MDC-LARP) recipient is canceled upon the MDC-LARP recipient's death; and OSFA may waive or suspend an MDC-LARP recipient's service or payment obligation if, as determined by OSFA, compliance by the MDC-LARP recipient with the terms and conditions of the contract is impossible or would involve extreme hardship. The Maryland Department of Health Office of Oral Health shall be responsible for: Promoting and recruiting the Maryland Dent-Care Loan Assistance Repayment Program (MDC-LARP) program in conjunction with the Office of Student Financial Assistance (OSFA); Certifying eligible practice sites; Selecting eligible applicants; Notifying OSFA of selected eligible applicants; Confirming that MDC-LARP recipients are fulfilling their requirements; Appointing an individual to serve on the Review Panel; and Nominating individuals to serve on the Review Panel. Education Article, §§11-105(u), 18-204(c), and 18-2401—18-2408, Annotated Code of Maryland Effective date: August 28, 2017 (44:17 Md. R. 836)