Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 3
Subtitle 14 - CANCER CONTROL
Chapter 10.14.04 - Breast Cancer Program
Section 10.14.04.02 - Definitions
Universal Citation: MD Code Reg 10.14.04.02
Current through Register Vol. 51, No. 19, September 20, 2024
A. In this chapter, the following terms have the meanings indicated.
B. Terms Defined.
(1) "Annual gross income" means the total
amount of income received by the applicant and, if applicable, the applicant's
spouse, each year from all sources before taxes are withheld.
(2) "Applicant" means an individual who has
applied to receive services under this chapter.
(3) "Biennial" means once every other
year.
(4) "Breast and Cervical
Cancer Program" means the program that is:
(a)
Administered by:
(i) A local health
department; or
(ii) A private
entity that contracts with the Department to render services in Baltimore City
and Calvert County under the Breast and Cervical Cancer Program;
(b) Established for the early
detection of breast and cervical cancer; and
(c) Funded by:
(i) The federal Centers for Disease Control
and Prevention;
(ii) The Breast
Cancer Program under Health-General Article, §20-116, Annotated Code of
Maryland; or
(iii) Both.
(5) "Breast Cancer
Program" means the program created by Health-General Article, §20-116,
Annotated Code of Maryland, to provide:
(a) At
least biennial screening mammograms and clinical breast examinations to
low-income, underinsured and low-income, uninsured women 40 years old through
49 years old;
(b) Annual screening
mammograms and clinical breast examinations to low-income, underinsured and
low-income, uninsured women 50 years old or older; and
(c) Diagnosis and treatment for individuals
who are identified by the Breast Cancer Program as being in need.
(6) "Clinical breast examination"
means a physical examination of the breast performed by a health care
professional for the purpose of detecting breast cancer.
(7) "Contract" means the written agreement
between a local health department and a health care provider for the provision
of breast cancer services.
(8)
"Copayment" means the set amount of money that an individual who is enrolled in
a health insurance plan is responsible for paying each time the individual
receives a medical service after the deductible, if applicable, has been
paid.
(9) "Deductible" means a
specific sum of money that an individual who is enrolled in a health insurance
plan is required to pay before the individual's health insurance plan
reimburses the individual or the individual's medical provider for covered
medical services received.
(10)
"Department" means the Maryland Department of Health and Mental
Hygiene.
(11) "Diagnosis" means a
histopathologic finding of breast cancer in a biopsy specimen.
(12) "Eligible individual" means an applicant
who meets the requirements of Regulation .03 of this chapter.
(13) "Enrollee" means an eligible individual
who has been accepted into the Breast Cancer Program.
(14) "Free-standing ambulatory surgical
center" means a facility that:
(a) Provides
ambulatory surgical services;
(b)
Is physically separate from a hospital or hospital grounds;
(c) Is certified by Medicare to provide
ambulatory surgical services in Maryland or a jurisdiction bordering Maryland
under the laws of that jurisdiction; and
(d) Complies with COMAR
10.09.42.02B and
.03B.
(15) "Home health
services provider" means a public or private agency, organization, or part of
an agency or organization licensed in Maryland or a jurisdiction bordering
Maryland that:
(a) Meets one of the following
licensure requirements:
(i) If the provider is
a home health agency located in Maryland, the provider is licensed under
Health-General Article, Title 19, Subtitle 4, Annotated Code of
Maryland;
(ii) If the provider is a
home health agency located in a jurisdiction bordering Maryland, the provider
is legally authorized to provide home health services under the laws of that
jurisdiction;
(iii) If the provider
is part of a hospital or related institution located in Maryland, the provider
is licensed under Health-General Article, Title 19, Subtitle 3, Annotated Code
of Maryland; or
(iv) If the
provider is an individual who has a contractual agreement with the Department
to provide skilled nursing care to eligible individuals, the individual is a
nurse who is licensed under Health Occupations Article, Title 8, Subtitle 3,
Annotated Code of Maryland, to practice registered nursing;
(b) Provides nursing or physical
therapy services in the home; and
(c) Meets the requirements for participation
in Medicare.
(16)
"Hospital" means an institution which is located:
(a) In Maryland, that is:
(i) Subject to the provisions of
Health-General Article, Title 19, Subtitle 3, Annotated Code of Maryland;
and
(ii) Licensed pursuant to COMAR
10.07.01; or
(b) In a
jurisdiction bordering Maryland, that is licensed pursuant to applicable
standards established by the jurisdiction in which the hospital is
located.
(17) "Local
health department" means a governmental entity that provides public health
services on behalf of a county in Maryland or Baltimore City.
(18) "Mammogram" means an X-ray examination
of the breast to detect breast cancer that uses equipment:
(a) Specifically dedicated for mammography,
including:
(i) X-ray tubes;
(ii) Filters;
(iii) Compression devices;
(iv) Screens;
(v) Films; and
(vi) Cassettes; and
(b) That is designed to deliver an average
radiation exposure of less than one rad mid-breast with two views for each
breast.
(19) "Medical
Assistance" means the program that:
(a)
Provides comprehensive medical and other health-related care for eligible
individuals; and
(b) Is
administered by the State under Title XIX of the Social Security Act,
42 U.S.C. § 1396.
(20) "Medical laboratory" means a laboratory
that:
(a) Examines tissue specimens in
connection with the diagnosis, treatment, or control of human disease or the
assessment of human health or nutritional or medical conditions; and
(b) Is in compliance with the applicable
license requirements for a medical laboratory providing services for Maryland
residents including, but not limited to the requirements:
(i) For Medicare certification;
(ii) Set forth in Health-General Article,
Title 17, Annotated Code of Maryland;
(iii) Set forth in COMAR 10.10.01-10.10.08;
and
(iv) Of the federal Clinical
Laboratories Improvement Act,
42 U.S.C. § 263a.
(21) "Medical supply company" means a
provider of disposable medical supplies or durable medical equipment that, to
the extent required by law, is licensed and legally authorized to practice or
deliver services in Maryland or in a jurisdiction bordering Maryland under the
laws of that jurisdiction.
(22)
"Medicare" means the medical insurance program administered by the federal
government under Title XVIII of the Social Security Act,
42 U.S.C. § 1395.
(23) "Nurse anesthetist" means a registered
nurse who is:
(a) Certified as a nurse
anesthetist in Maryland or a jurisdiction bordering Maryland under the laws of
that jurisdiction; and
(b)
Currently collaborating with an anesthesiologist or other physician who is
licensed to practice medicine:
(i) In
Maryland as prescribed by COMAR 10.27.06; or
(ii) In a jurisdiction bordering Maryland
under the laws of that jurisdiction.
(24) "Nurse practitioner" means a registered
nurse who is certified:
(a) By the Maryland
Board of Nursing to engage in the activities specified in COMAR 10.27.07;
or
(b) As a nurse practitioner in a
jurisdiction bordering Maryland under the laws of that jurisdiction.
(25) "Participating medical
provider under the Breast and Cervical Cancer Program" means a health care
provider who has entered into a written agreement with a local health
department or the private entity that contracts with the Department to render
services in Baltimore City and Calvert County under the Breast and Cervical
Cancer Program to provide breast cancer services to an enrollee.
(26) "Participating medical provider under
the Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment
Program" means any of the following:
(a) A
physician who meets the requirements of COMAR
10.14.02.04A;
(b) A nurse practitioner who meets the
requirements of COMAR
10.14.02.05A;
(c) A nurse anesthetist who meets the
requirements of COMAR
10.14.02.06A;
(d) A physical therapist who meets the
requirements of COMAR
10.14.02.07A;
(e) A pharmacy that meets the requirements of
COMAR 10.14.02.08A;
(f) A hospital that meets the requirements of
COMAR 10.14.02.09A;
(g) A medical supply company that meets the
requirements of COMAR
10.14.02.10A;
(h) A home health service provider that meets
the requirements of COMAR
10.14.02.11A;
(i) A medical laboratory that meets the
requirements of COMAR
10.14.02.12A;
or
(j) A free-standing ambulatory
surgical center that meets the requirements of COMAR
10.14.02.13A.
(27) "Pharmacy" means
an establishment or institution that holds a permit to provide pharmacy
services under Health Occupations Article, Title 12, Subtitle 4, Annotated Code
of Maryland.
(28) "Physical
therapist" means an individual who is licensed or registered to practice
physical therapy:
(a) In Maryland under
Health Occupations Article, Title 13, Subtitle 3, Annotated Code of Maryland;
or
(b) In a jurisdiction bordering
Maryland under the laws of that jurisdiction.
(29) "Physician" means an individual who is
licensed to practice medicine:
(a) In Maryland
under Health Occupations Article, Title 14, Subtitle 3, Annotated Code of
Maryland; or
(b) In a jurisdiction
bordering Maryland under the laws of that jurisdiction.
(30) "Recipient of service" means an enrollee
who has received a covered service under this chapter.
(31) "Registered nurse" means an individual
who is licensed to practice registered nursing:
(a) In Maryland under Health Occupations
Article, Title 8, Subtitle 3, Annotated Code of Maryland; or
(b) In a jurisdiction bordering Maryland
under the laws of that jurisdiction.
(32) "Reimbursement for Breast and Cervical
Cancer Diagnosis and Treatment Program" means the program operated by the
Department to pay for breast and cervical cancer diagnostic and treatment
procedures for eligible women under COMAR 10.14.02.
(33) "Resident" means an individual who is
currently residing in Maryland.
(34) "Screening" means a medical test to
detect cancer.
(35) "Surgical
consult" means a consultation with a surgeon for advice on the recommended
follow-up of the results of screening tests that are not considered
normal.
(36) "Treatment" means the
medical management and care of a patient for breast cancer.
(37) "Ultrasound" means a medical test in
which high frequency sound waves are used to make an image of a specific area
of the breast to determine if a breast lump is a fluid-filled cyst or a solid
mass.
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.