Medicaid Advisory Committee Monthly Report

MEDICAID ADVISORY COMMITTEE MONTHLY REPORT November 2009 MD COMAR Title PURPOSE AELR DATE REGISTER APPROVED COMMENTS DATE 10.09.05 Dental Services The purpose of this action is to update 06/04/2009 07/17/2009 Rate change after (.01-.07, .09, .10) dental terminology and services in order original submission. Emergency and to be consistent with the standard Modified and Proposed terminology and services used in the resubmitted to AELR. dental community and by the American Emergency approved Dental Association and to prepare for the 07/16/2009 administration of the Dental Program by the Administrative Service Organization (ASO) effective July 1, 2009. 10.09.02 (.07) Physicians’ Services The purpose of this proposal is to revise 07/09/2009 08/14/2009 11/16/2009 Proposed the Medical Assistance Program’s Physicians’ Services Provider Fee Manual by incorporating the American Medical Association’s Current Procedural Terminology (CPT) additions and deletions for 2009, and to decrease physician fees for certain evaluation and management, surgical, radiological and medical services and procedures because of projected Departmental budget deficits. 10.09.45 Mental Health Case The purpose of this action is to update the 7/29/2009 09/11/2009 Emergency approved (.01-.13) Management regulations as the Department is 08/21/2009 Emergency and reinstituting targeted case management as Proposed a result of legislative action taken in the 2009 General Assembly that resulted in a budget reduction. The Department is repealing COMAR 10.09.45, to be replaced with all new text under the same chapter. The legislature has required DMHM to reapply to the Center for Medicaid and Medicare Services for Medicaid State Plan amendment to implement Medicaid-reimbursed mental health case management services.

4/9/2018 Page #1 MEDICAID ADVISORY COMMITTEE MONTHLY REPORT November 2009 MD COMAR Title PURPOSE AELR DATE REGISTER APPROVED COMMENTS DATE 10.09.55 (.02, . Living At Home Waiver The purpose of this action is to include 07/28/2009 09/11/2009 27, .29, .new 15- Program budget limitation language to payment 3, .26-3) procedures. In addition, the Living at Proposed Home Waiver Program will be including the regulations to cover case management as a waiver service. The Living at Home Waiver previously offered case management as an administrative service. 10.09.65 (.19) Maryland Medicaid To implement the mid-year adjustment to 9/9/2009 10/23/2009 Managed Care Program: the calendar year 2009 MCO’s Managed Care HealthChoice and PAC capitation rates. Organizations

10.09.65 (.14) Primary Adult Care. 10.09.46 (.02) Home and Community- The purpose of this proposal is to change 09/14/2009 10/23/2009 Proposed Based Services Waiver participant eligibility requirements to for Adults with Traumatic allow individuals in the Employed Brain Injury Individuals with Disabilities (EID) Program to participate in the Traumatic Brain Injury Waiver (TBI). 10.09.27 (.06) Home Care for Disabled The purpose of this action is to include 09/30/2009 11/6/2009 Proposed Children Under a Model budget limitation language to payment Waiver procedures and maintain the current rate of reimbursement for certified nursing assistant and home health aide services in accordance with the Department's budget for Fiscal Year 2010. 10.09.68 (.02 Maryland Medicaid The purpose of this action is to allow 09/08/2009 11/06/2009 and .03) Managed Care Program: HealthChoice enrollees to receive self- Proposed School-Based Health referred primary care services at school- Centers. based health centers.

4/9/2018 Page #2 MEDICAID ADVISORY COMMITTEE MONTHLY REPORT November 2009 MD COMAR Title PURPOSE AELR DATE REGISTER APPROVED COMMENTS DATE 10.09.54 (.33) Home/Community Based The purpose of this action is to include 10/26/2009 Proposed Services Waiver for Older transition services language to payment Adults procedures. In addition, the proposal will add budget limitation language to payment procedures, will maintain rates at Fiscal Year 2009 levels during the period July 1, 2009 through September 30, 2009, and will reduce provider reimbursement rates by 2 percent effective October 1, 2009. 10.09.56 (.22) Waiver for Children with The purpose of this action is to include 10/26/2009 Proposed Autism Spectrum budget limitation language to payment Disorder procedures which will maintain rates at Fiscal Year 2009 levels during the period July 1, 2009 through September 30, 2009, and will reduce provider reimbursement rates by 2 percent effective October 1, 2009. 10.09.07 (.04, . Medical Day Care The purpose of this action is to add 10/27/2009 08) budget limitation language that will Proposed maintain rates at Fiscal Year 2009 levels during the period July 1, 2009 through September 30, 2009, and will reduce the provider reimbursement rate by 2 percent effective October 1, 2009. In addition, the staffing requirements for registered nurses are established. 10.09.11 Maryland Children’s The purpose of this action is to amend 10/29/2009 (.07-.09) Health Program and clarify requirements specified in regulations relating to signatures required 10.09.24 (.04, . Medical Assistance on an application, child care expenses, 07) Eligibility self-employment income disregards, and exclusions to income so that regulations Primary Adult Care are consistent with policy and procedures 10.09.60 (.12) Program implemented as a result of : 1) The expansion of Medical Assistance (MA)

4/9/2018 Page #3 MEDICAID ADVISORY COMMITTEE MONTHLY REPORT November 2009 MD COMAR Title PURPOSE AELR DATE REGISTER APPROVED COMMENTS DATE eligibility coverage to families and children and 2) Exclusions to income included in Policy Alert No. 07-1 of the Maryland MA Eligibility Policy Manual. 10.09.23 Early and Periodic The purpose of this action is to repeal two 10/29/2009 (.01-.12) Screening, Diagnosis, and chapters of regulations, COMAR Treatment (EPSDT) 10.09.23 Early and Periodic Screening, Services Diagnosis, and Treatment (EPSDT) Screening Services and COMAR 10.09.37 Expanded Early and 10.09.37 Expanded Early and Periodic (Repeal) Periodic Screening, Screening, Diagnosis, and Treatment Emergency and Diagnosis and Treatment (EPSDT) Referred Services, and Proposed (EPSDT) Referred promulgate a new unified chapter under COMAR 10.09.23. The purpose of the consolidation is to bring the screening, diagnosis and treatment requirements together in one chapter so that readers can more easily understand all the benefits and requirements of the EPSDT program. Additionally, environmental lead investigations will be added as a service, which is consistent with a State Plan Amendment submitted to the Centers for Medicare & Medicaid Services (CMS). 10.09.20 (.02, . Personal Care Services The purpose of this action is to specify 11/10/2009 03, .07) that the per diem annual rate adjustments Proposed shall be subject to the limitations of the State budget; clarify the licensing and/or certification requirements for Assisted Living Facilities, Residential Service Agencies, and individual providers; and add language which allows the Department or its designee to request physician approval of providers’ health status beyond the initial application period.

4/9/2018 Page #4 MEDICAID ADVISORY COMMITTEE MONTHLY REPORT November 2009 MD COMAR Title PURPOSE AELR DATE REGISTER APPROVED COMMENTS DATE 10.09.53 Early and Periodic The purpose of this action is to include 11/10/2009 Screening, Diagnosis, and budget limitation language to payment Treatment: Private Duty procedures and maintain the current rate Nursing of reimbursement for private duty nursing services in accordance with the Department’s budget for Fiscal Year 2010.

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