PROPOSAL
Maryland Register
Issue Date: September 29, 2017
Volume 44 • Issue 20 • Pages 952—953
Title 10
MARYLAND DEPARTMENT OF HEALTH
Subtitle 09 MEDICAL CARE PROGRAMS
10.09.12 Disposable Medical Supplies and Durable Medical Equipment
Authority: Health-General Article, §§2-104(b), 15-103, 15-105, and 15-129, Annotated Code of Maryland
Notice of Proposed Action
[17-243-P]
The Secretary of Health proposes to amend Regulations .03—.05 and .07 under COMAR 10.09.12 Disposable Medical Supplies and Durable Medical Equipment.
Statement of Purpose
The purpose of this action is to:
(1) Update participation criteria for DMS/DME providers to require Medicare approval status, based on CMS guidance;
(2) Remove corrective shoes as an item not covered under this chapter; and
(3) Require that the ordering provider be enrolled in the Maryland Medical Assistance Program and be identified on the invoice.
Comparison to Federal Standards
There is no corresponding federal standard to this proposed action.
Estimate of Economic Impact
The proposed action has no economic impact.
Economic Impact on Small Businesses
The proposed action has minimal or no economic impact on small businesses.
Impact on Individuals with Disabilities
The proposed action has no impact on individuals with disabilities.
Opportunity for Public Comment
Comments may be sent to Michele Phinney, Director, Office of Regulation and Policy Coordination, Maryland Department of Health, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to mdh.regs@maryland.gov, or fax to 410-767-6483. Comments will be accepted through October 30, 2017. A public hearing has not been scheduled.
.03 Conditions for Participation.
To participate in the Program, the provider:
A. Effective January 1, 2018, shall be in an approved status with Medicare;
[A.] B. [Shall] Effective April 1, 2012 through December 31, 2017, shall, unless exempt from Medicare accreditation requirements:
(1) (text unchanged)
(2) [Effective November 1, 2011, provide] Provide documentation of:
(a)—(b) (text unchanged)
(3) [Effective April 1, 2012, be] Be accredited or terminated from the Program;
[B.] C. (text unchanged)
[C. If located more than 25 miles from the border of Maryland, shall provide to the Program documentation demonstrating that the enrollment and screening requirements of 42 CFR Part 455, Subpart E, have been performed within the 12 months preceding the application for initial enrollment or revalidation of enrollment by:
(1) A Medicare contractor; or
(2) The Medicaid agency or the Children’s Health Insurance Program of another state;]
D.—I. (text unchanged)
.04 Covered Services.
A. The following medically necessary items are covered when ordered by [a prescriber] an individual who is enrolled as a provider in the Program on the date of service:
(1)—(9) (text unchanged)
B.—F. (text unchanged)
.05 Limitations.
The Program does not cover:
A.—C. (text unchanged)
D. The following durable medical equipment:
(1)—(4) (text unchanged)
[(5) Corrective shoes;]
[(6)] (5)—[(20)] (19) (text unchanged)
E.—L. (text unchanged)
M. Rental of equipment for any period longer than 90 days without renewed documentation of continued medical need from the prescriber for each 90-day period; [and]
N. Modifications to motor vehicles[.];
O. Disposable medical supplies and durable medical equipment ordered by an individual who is not enrolled as a provider in the Program on the date of service; and
P. Disposable medical supplies and durable medical equipment ordered by an entity, facility, or other provider that is not an individual.
.07 Payment Procedures.
A.—Y. (text unchanged)
Z. The disposable medical supplies or durable medical equipment provider shall identify the individual who ordered the disposable medical supplies and durable medical equipment by recording the individual practitioner’s National Provider Identifier (NPI) number on the claim.
DENNIS SCHRADER
Secretary of Health
