Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 3
Subtitle 14 - CANCER CONTROL
Chapter 10.14.02 - Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment
Section 10.14.02.06 - Nurse Anesthetist Services
Universal Citation: MD Code Reg 10.14.02.06
Current through Register Vol. 51, No. 19, September 20, 2024
A. To be considered a participating nurse anesthetist in the Program, the provider shall:
(1) Be a certified nurse anesthetist in
Maryland or a jurisdiction bordering Maryland;
(2) Be currently collaborating with an
anesthesiologist or other physician who is licensed to practice medicine in
Maryland or a jurisdiction bordering Maryland in the manner prescribed by COMAR
10.27.06 or by the jurisdiction in which the service is provided;
(3) Agree to accept, for each covered medical
procedure performed or service provided, the following reimbursement including,
if applicable, a medical management fee as described in Regulation .15 of this
chapter:
(a) The current Medical Assistance
approved rate in the State for an eligible patient who is uninsured or who has
insurance that does not provide coverage for a reimbursed procedure or
service;
(b) The reimbursement rate
approved by the insurer plus the payment of the deductible and the patient
contribution amount by the Department for an eligible patient who has
insurance, other than Medicare, that provides coverage for a certain procedure
or service;
(c) The reimbursement
rate approved by Medicare plus the payment of the deductible and patient
contribution amount by the Department for an eligible patient who is covered by
Medicare only; or
(d) For an
eligible patient who has insurance that provides reimbursement for a covered
procedure or service that is less than the current Medical Assistance approved
rate, the reimbursement rate approved by the insurer plus the difference
between the reimbursement rate approved by the insurer and the Medical
Assistance approved rate in the State plus the payment of the deductible by the
Department;
(4) Agree to
abide by the provisions set forth in this section by signing and sending to the
Department the designated Departmental form; and
(5) Agree to the medical, financial, and reporting
requirements of the Program pursuant to Regulation .04A(5)-(6), (9), and (10)
of this chapter.
B. An eligible health care provider may be a certified nurse anesthetist.
C. The reimbursed medical procedure is anesthesia required for the diagnosis and treatment of breast cancer or cervical cancer.
D. Non-reimbursed medical procedures and services include an anesthesia procedure or service not related to the diagnosis and treatment of breast cancer and cervical cancer.
E. The participating nurse anesthetist provider shall accept the responsibilities pursuant to Regulation .04E(1)-(5), F, and G of this chapter.
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