Current through Register Vol. 51, No. 19, September 20, 2024
A.
A grantee that is funded to conduct cancer research by the Fund may use the
grant funds:
(1) For basic, clinical,
translational, applied, or community-based participatory research;
(2) To support:
(a) The individuals engaged in the research;
and
(b) The individual's support
staff; and
(3) To
purchase office supplies.
B. A grantee that is funded to conduct cancer
primary prevention or secondary prevention by the Fund may use the grant funds
for:
(1) Education;
(2) Outreach;
(3) Policy changes;
(4) Provider interventions;
(5) Clinical services;
(6) Case management;
(7) Quality assurance;
(8) Data collection; or
(9) Partnership development.
C. If a grantee is funded to
conduct cancer secondary prevention services, the Fund shall provide to the
grantee reimbursement for a clinical service at a rate not higher than the rate
that:
(1) Medicare pays for the clinical
service in the region; or
(2) The
HSCRC has approved for the clinical service, if the clinical service is
provided by a HSCRC-regulated facility.
D. If a grantee is funded to conduct cancer
secondary prevention or treatment, the grantee shall only provide clinical
services to individuals who:
(1) Are Maryland
residents; and
(2) Have an annual
family income that is not more than 250 percent of the federal poverty
guidelines.
E. If a
grantee is funded to conduct cancer treatment, a grantee may use the grant
funds:
(1) For grants awarded before January
1, 2014 to provide MHIP reimbursement, to pay up to a maximum of $15,000 for
direct costs per individual per year for the premium, deductible, coinsurance,
and copay of the MHIP costs and for services not covered under MHIP;
or
(2) To pay up to a specified
amount, as determined by the Department, for direct costs per individual per
year for the:
(a) Deductible and patient
contribution amount for the reimbursed medical procedure or service for insured
individuals; and
(b) Medical
procedure or service not covered under their health insurance policy for
individuals who meet the eligibility criteria of §D of this regulation;
or
(3) To pay up to a
maximum of $20,000 for direct costs per individual per year for the cancer
treatment costs under the individual's treatment plan:
(a) Who meet the eligibility criteria in
§D of this regulation; and
(b)
At a rate not to exceed the rate that Medical Assistance pays for clinical
services or the rate that the HSCRC has approved for the clinical services, if
treatment is provided by a HSCRC-regulated facility.
F. If a grantee is funded to pay
for cancer treatment:
(1) Under §E(1) of
this regulation, the grantee shall only pay or direct the Department to pay
MHIP the following for services directly related to the treatment of cancer for
the individual diagnosed with cancer:
(a)
Premiums;
(b)
Deductibles;
(c) Coinsurance;
and
(d) Copays;
(2) Under §E(2) of this
regulation, the grantee shall only pay or direct the Department to pay the
deductible and patient contribution amount for the reimbursed medical procedure
or service that the individual is required to pay for the services directly
related to the diagnosis and treatment of cancer; and
(3) May not pay any amount for the
individual's spouse, children, or other family members' health insurance
costs.
G. For the
purpose of §F(1) and (2) of this regulation, the Department shall pay the
health insurance costs out of the funds that are set aside for the
grantee.
H. In addition to the
direct costs allowed under §E of this regulation, the Fund shall also pay
a maximum of 7 percent of the indirect costs to local health department
grantees or non-local health department grantees.
