Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 3
Subtitle 11 - MATERNAL AND CHILD HEALTH
Chapter 10.11.03 - Children's Medical Services Program
Section 10.11.03.11 - General Conditions of Provider Participation
Universal Citation: MD Code Reg 10.11.03.11
Current through Register Vol. 51, No. 19, September 20, 2024
A. A provider of services which are covered by the CMS Program shall comply with the following general requirements:
(1) For fee for service reimbursement, be
approved by Medical Assistance in writing as a Medical Assistance
provider;
(2) For copay and
deductible reimbursement, be a participating provider with the insurance plan
purchased by the CMS Program for the family;
(3) Request preauthorization on the forms
designated by the CMS Program;
(4)
Adhere to administrative procedures that are established by the CMS Program for
the specific treatment services; and
(5) Maintain adequate records, including
prescriptions, for a minimum of 6 years, and make them available upon request
to the Department or the Department's designee.
B. he approval referenced in §A(1) of this regulation shall specify, at a minimum, the following:
(1) Approved services which may be provided;
and
(2) Duration of approval
status.
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