Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.95 - Special Psychiatric Hospitals
Section 10.09.95.03 - Conditions for Participation
Universal Citation: MD Code Reg 10.09.95.03
Current through Register Vol. 51, No. 19, September 20, 2024
A. A provider shall meet all conditions for participation as set forth in COMAR 10.09.36.03.
B. To participate in the Program as a special psychiatric hospital services provider, the provider shall:
(1) Meet the requirements of Title XIX
of the Social Security Act for participation as a hospital, as issued by the
Department of Health and Human Services;
(2) Meet the following staffing requirements
24 hours per day, 7 days per week:
(a)
On-call or on-site physician services including psychiatric
physicians;
(b) On-site registered
nurses;
(c) On-site advanced
cardiac life support services;
(3) If licensed to provide inpatient
psychiatric services for individuals younger than 21 years old:
(a) Meet the requirements for participation
as defined in 42 CFR § 440.160; and
(b) Provide acute psychiatric services as
defined in 42 CFR Part 441, Subpart D;
(4) Directly provide or make available
through contractual arrangements or transfer agreements, medically necessary
covered services;
(5) Accept
payment by the Program as payment in full for the covered service;
(6) Make available to the Department or its
designee the participant's medical record for review and certification of
medical necessity for admission and continuation of stay;
(7) Maintain documentation of each contact
with the participant as part of the medical record, which, at a minimum,
includes:
(a) Date of service;
(b) A plan of treatment as defined in
Regulation .01B of this chapter;
(c) The participant's chief medical complaint
or reason for visit;
(d) A
description of the services provided, including:
(i) Progress notes;
(ii) Imaging studies;
(iii) Laboratory results;
(iv) Medication administration records;
and
(v) Discharge summary;
and
(e) A signature,
electronic or handwritten, along with the printed or typed name of the
individual providing care, with the appropriate title;
(8) Submit to the Department or its designee
within 5 months of the close of the hospital's fiscal year, as required by the
Department, a hospital cost report for outpatient services which are subject to
cost settlement in accordance with Regulation .11 of this chapter;
C. If an out-of-State or District of Columbia hospital, the special psychiatric hospital shall:
(1) Unless a waiver has been granted by the
Secretary of Health and Human Services, have in effect a utilization review
plan applicable to all participants who receive Medical Assistance under Title
XVII of the Social Security Act which meets the requirements of § 1861(k)
of the Social Security Act; and
(2)
Comply with applicable regulations of this chapter and COMAR
10.09.36.
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