Current through Register Vol. 51, No. 19, September 20, 2024
The Program covers routine care and the following supplies,
equipment, and services when appropriate to meet the needs of the
recipient:
A. Those described in the
Department of Health and Human Services regulations entitled "Requirements for
Long Term Care Facilities", 42 CFR Part 483, Subpart B (1996), subject to
limitations in Regulation .05 of this chapter.
F.
Specialized rehabilitative therapy services which meet the conditions listed
below:
(1) Physical Therapy. Physical therapy
services for Medical Assistance Program purposes are those services furnished
to a recipient which meet all of the following conditions:
(a) The services are directly and
specifically related to a plan of care designed by the physician after any
needed consultation with the qualified physical therapist;
(b) The services are of such a level of
complexity and sophistication or the condition of the recipient needs the
judgment, knowledge, or skills of a qualified physical therapist;
The services are performed by or under the supervision of a
qualified physical therapist;
(d) The services are provided with the
expectation, based on the assessment made by the physician of the recipient's
restorative potential after any needed consultation with the qualified physical
therapist, that the recipient will improve significantly in a reasonable, and
generally predictable, period of time;
(e) The services are considered under
accepted standards of medical practice to be a specific and effective treatment
for the recipient's condition; and
(f) The services are reasonable and necessary
to the treatment of the recipient's condition.
(2) Occupational Therapy. Occupational
therapy services for Medical Assistance Program purposes are those which meet
the following conditions:
(a) The services are
directly and specifically related to a plan of care designed by the physician
after any needed consultation with the qualified occupational
therapist;
(b) The services are on
a level of complexity and sophistication or the condition of the recipient
needs the judgment, knowledge, and skills of a qualified occupational
therapist;
(c) The services are
performed by a qualified occupational therapist;
(d) The services are for the purposes of
improving or restoring functions which have been impaired by illness or injury
or, if function has been permanently lost or reduced by illness or injury, to
improve the individual's ability to perform those tasks required for
independent functioning;
(e) The
services are considered under accepted standards of medical practice to be a
specific and effective treatment for the recipient's condition; and
(f) The services are reasonable and necessary
to the treatment of the recipient's condition.
(3) Speech Therapy. Speech therapy services
for Medical Assistance Program purposes are those services furnished to a
recipient which meet all of the following conditions:
(a) The services are directly and
specifically related to a plan of care designed by the physician after any
needed consultation with the qualified speech and language
pathologist;
(b) The services are
of such a level of complexity and sophistication or the condition of the
recipient needs the judgment, knowledge, and skills of a qualified speech and
language pathologist;
(c) The
services are performed by or under the supervision of a qualified speech and
language pathologist;
(d) The
services are provided with the expectation, based on the assessment made by the
physician of the recipient's restorative potential after any needed
consultation with the qualified speech and language pathologist, that the
recipient will improve significantly in a reasonable, and generally
predictable, period of time;
(e)
The services are considered under accepted standards of medical practice to be
a specific and effective treatment for the recipient's condition; and
(f) The services are reasonable and necessary
to the treatment of the recipient's condition.
G. Supplies and equipment necessary to meet
the needs of the recipient, including but not limited to:
(1) ABD pads.
(2) Adhesive strip bandages.
(3) Adhesive tape (regular and
non-allergenic).
(4) Airways-oral
and nasal.
(5) Alcohol and alcohol
sponges.
(6) Ambu bags.
(7) Antiseptics and cleansing agents
(over-the-counter).
(8)
Applicators.
(9)
Bandages.
(10) Beds, high-low,
adjustable.
(11) Bed pans and
urinals.
(12) Bed rails.
(13) Bibs.
(14) Body lotions
(over-the-counter).
(15)
Canes.
(16) Catheters (including
Foley or other indwelling).
(17)
Catheter trays.
(18) Chest or body
restraints.
(19) Clean catch
kits.
(20) Clinical medicine
glasses-disposable or otherwise.
(21) Cotton and cotton balls.
(22) Covered water pitchers.
(23) Crutches.
(24) Dentifrices and denture
adhesives.
(25) Denture
cups.
(26) Deodorant (personal and
room).
(27) Diagnostic aids
(Clinitest, Acetest, Hematest, Testape, etc.).
(28) Dietary supplements (including tube
feeding).
(29) Disposable diapers
or incontinency care pads.
(30)
Disposable wash cloths.
(31) Douche
apparatus.
(32) Drainage bags and
catheter tubing.
(33) Emesis
basins.
(34) Enema
apparatus.
(35) Enemas and douches
(including prepared).
(36) Eye
pads.
(37) First aid
supplies.
(38) Gauzes.
(39) Hot water bottles and covers.
(40) Hydraulic lifts.
(41) Ice bags.
(42) Infusionarm boards.
(43) Intermittent positive pressure breathing
machines (I.P.P.B.).
(44)
Intravenous poles, portable.
(45)
Irrigation trays.
(46) Levine
tubes (plastic or regular).
(47)
Lubricants and oils.
(48) Mouth
washes.
(49) Nasal
atomizers.
(50) Needles (cardiac,
clysis or intravenous, permanent or disposable).
(51) Oxygen for occasional and emergency use.
Continuous oxygen is covered under the provisions of COMAR 10.09.18 Oxygen and
Related Respiratory Equipment Services.
(52) Oxygen masks, cannulas, catheters, and
related equipment, including portable equipment for use with occasional or
emergency oxygen. Equipment used for continuous use oxygen is covered under the
provision of COMAR 10.09.18 Oxygen and Related Respiratory Equipment
Services.
(53) Paper
tissues.
(54) Personal toilet items
(toothbrush, soap, shampoo, razor, shaving cream, sanitary pads).
(55) Petroleum jelly.
(56) Powder, medicated or
non-medicated-over-the-counter.
(57) Pumps, aspiration and suction.
(58) Rectal tubes.
(59) Rubber or plastic gloves and finger
cots.
(60) Rubber or plastic
pants.
(61) Rubber or plastic
sheeting.
(62) Rubber or sponge
rings.
(63) Sand bags.
(64) Scales, including chair
scales.
(65) Sheepskin, natural or
synthetic.
(66) Slings.
(67) Special mattresses for decubiti
care.
(68)
Sphygmomanometers.
(69)
Stethoscopes.
(70) Stryker and
Foster frames.
(71) Suction
machines, gastric and tracheal.
(72) Suction tubing.
(73) Surgical dressings, including sterile
sponges.
(74) Suture removal
kits.
(75) Suture trays.
(76) Syringes, plastic, glass, or
bulb.
(77) Tape removers.
(78) Thermometers, oral, rectal, universal,
bath.
(79) Tongue
depressors.
(80) Tracheostomy
equipment and supplies.
(81)
Traction equipment.
(82) Trapeze
and bed frame equipment.
(83)
Trays, cut-down.
(84)
Tubing.
(85) Walkers and
walkerettes.
(86) Wheel
chairs.
