Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 3
Subtitle 22 - DEVELOPMENTAL DISABILITIES
Chapter 10.22.17 - Fee Payment System for Licensed Residential and Day Programs
Section 10.22.17.12 - Contract
Universal Citation: MD Code Reg 10.22.17.12
Current through Register Vol. 51, No. 19, September 20, 2024
A. If the Department preauthorizes a professional service, the Administration shall reimburse the provider for professional services according to the rate schedule in Regulation .08J(4) of this chapter except that the Administration may procure services to be reimbursed at a higher rate if:
(1) The provider submits documentation that
it cannot find a professional to render services at this rate;
(2) The usual and customary rate charged by
the professional for the service is above the rate in Regulation .08J(4) of
this chapter; and
(3) The rate that
the Maryland Medical Assistance Program reimburses the professional for this
service is higher than the rate established by Regulation .08J(4) of this
chapter.
B. The Administration may procure services needed by an individual as documented in the IP and preauthorized but not covered by rates or supplemental services in accordance with the State's requirements.
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