Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.52 - Service Coordination for Children with an IEP or Enrolled in the Autism Waiver
Section 10.09.52.04 - Covered Services - IEP Service Coordination
Universal Citation: MD Code Reg 10.09.52.04
Current through Register Vol. 51, No. 19, September 20, 2024
A. The Program shall reimburse for the services in §§B-D of this regulation when the services have been documented, pursuant to the requirements of this chapter, as medically necessary.
B. Initial IEP.
(1) Definition. "Unit of service" means:
(a) A completed initial IEP, signed by all
members of the IEP team; and
(b) At
least one contact by the participant's service coordinator in person, in
writing, via telehealth, or by telephone with the participant or the
participant's parent, on the participant's behalf relating to development of
the IEP.
(2) The covered
services include convening and conducting an IEP team to:
(a) Perform a multidisciplinary assessment of
the participant; and
(b) Develop an
initial IEP.
C. Ongoing IEP Service Coordination.
(1) Ongoing IEP service coordination is
provided by a participant's service coordinator.
(2) Definition. For purposes of this section,
"unit of service" means:
(a) At least one
contact per month by the service coordinator in person, via telehealth, by
telephone, or by written progress notes or log with the participant or the
participant's parent, on the participant's behalf relating to the child's
ongoing IEP service coordination; and
(b) The provision of all other necessary
services covered under these regulations.
(3) As necessary, the Program shall include
as covered services the following:
(a) Acting
as a central point of contact relating to IEP services for a
participant;
(b) Maintaining
contact with:
(i) The child's direct service
providers, as applicable, which may include, but not be limited to, the child's
Maryland Medicaid Managed Care Program provider or the Rare and Expensive case
management provider; and
(ii) A
participant or the participant's parent through in-person visits, written
communication, telephone calls, telehealth, and follow-up service as
necessary;
(c)
Implementing the IEP by referring the participant to direct service providers,
assisting the participant in gaining access to services specified in the IEP,
and providing linkage to agreed-upon direct service providers of
services;
(d) Discussing with
direct service providers the services needed and available for the participant,
assessing the quality and quantity of services being provided, following up to
identify any obstacles to a participant's utilization of services, coordinating
the service delivery, and performing ongoing monitoring to determine whether
the services are being delivered in an integrated fashion as recommended in the
IEP and meet the participant's current needs;
(e) Providing a participant or the
participant's parent with information and direction that will assist them in
successfully accessing and using the services recommended in the IEP;
(f) Informing a participant's parent of the
participant's and the family's rights and responsibilities in regard to
specific programs and resources recommended in the IEP; and
(9) Reviewing at least annually at a meeting
or by other means acceptable to the participant's parent and others involved in
the review process:
(i) The degree of a
participant's progress toward achieving the goals established in the IEP;
and
(ii) Whether the goals or
recommended services need to be revised.
(4) Administrative, supervisory, and
monitoring services associated with the ongoing service coordination, including
coordinating with the child's primary care provider, are included as part of
the service.
D. IEP Review.
(1) Definition. "Unit of service"
means:
(a) A completed initial 60-day,
interim, or annual IEP review as evidenced by a revised IEP or, if a revised
IEP was not done, documented by the IEP team; and
(b) At least one contact by the IEP service
coordinator or IEP team in person, by telephone, via telehealth, or by written
communication with the participant or the participant's parent, on the
participant's behalf.
(2) The covered services include convening
and conducting an IEP team to:
(a) Perform a
multidisciplinary reassessment of the participant's status and service needs;
and
(b) Review and revise, as
necessary, the participant's IEP.
Disclaimer: These regulations may not be the most recent version. Maryland may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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