Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.33 - Health Homes
Section 10.09.33.04 - Conditions for Health Home Provider Participation
Current through Register Vol. 51, No. 19, September 20, 2024
To be eligible as a health home, a provider shall:
A. Meet the conditions for provider participation in the Medical Assistance Program, as set forth in COMAR 10.09.36.03;
B. Meet the approval requirements set forth in Regulation .02 of this chapter;
C. Be accredited by, or demonstrate evidence of having started the accreditation process from, an approved accrediting body as a health home;
D. For PRP and MTS health homes serving minors, demonstrate a minimum of 3 years of experience serving minors, which may be achieved as an independent practice or as a member of a broader agency, with exceptions designated by the Department;
E. At the time of enrollment as a health home, be registered or be able to provide documentation of starting the process of registration with CRISP in order to receive hospital encounter alerts;
F. At the time of enrollment as a health home, be registered or be able to provide documentation of starting the process of registration with one of the following organizations in order to receive access to real-time pharmacy data for participants:
G. At the time of enrollment as a health home, have an internal protocol for reviewing and responding to hospital encounter alerts and pharmacy use data;
H. Directly provide, or subcontract for the provision of, health home services to all participants;
I. Maintain an electronic database with the ability to, at minimum:
J. Maintain a file for each participant that includes:
K. Safeguard the confidentiality of the participants' records in accordance with State and federal laws and regulations;
L. Provide on-call and crisis intervention services by telephone 24 hours a day, 7 days a week to participants and, as appropriate, their caregivers, or if the participant is a minor, the minor's parent or guardian;
M. Be responsible for meeting all health home service requirements, including services performed by a business or individual subcontracted to provide such services;
N. Convene health home staff meetings every 6 months, at minimum, to plan and implement goals and objectives of functioning as a health home;
O. Collaborate with MCOs and the ASO to improve participant outcomes; and
P. Agree to participate in federal and State-required evaluation activities, including:
