Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.69 - Maryland Medicaid Managed Care Program: Rare and Expensive Case Management
Section 10.09.69.13 - Preauthorization Requirements
Universal Citation: MD Code Reg 10.09.69.13
Current through Register Vol. 51, No. 19, September 20, 2024
A. Except for initial assessments unless otherwise specified, preauthorization by the Department or its designee is required for all services under Regulation .11 of this chapter.
B. The Department or its designee shall issue preauthorization when the Department:
(1) Determines that services are medically
necessary; and
(2) Authorizes the
services before the initiation or continuance of the requested
service.
C. Authorization of services shall be rescinded by the Department or its designee when:
(1) The participant is admitted to a
hospital, residential treatment center, nursing facility, or ICF/IID;
(2) The participant is no longer REM
eligible;
(3) The Department
determines the care is no longer medically necessary; or
(4) The participant dies.
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.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
