Issue Date: February 1, 2019
Volume 46 • Issue 3 • Page 138-144
MARYLAND DEPARTMENT OF HEALTH
Subtitle 52 PREVENTIVE
10.52.08 Maryland HIV
Prevention Case Management Program
Article, §§2-104(b) and (j), 2-105(a), and
18-102(a), Annotated Code of Maryland
Notice of Proposed
The Secretary of Health proposes to adopt new Regulations .01—.16 under
a new chapter, COMAR 10.52.08 Maryland HIV Prevention Case Management
Statement of Purpose
The purpose of this action is to establish regulations for the
Maryland HIV Prevention Case Management Program (Prevention Program), which
provides prevention and wraparound services for individuals at elevated risk
for acquiring HIV. These regulations include recipient eligibility criteria for
the Prevention Program. Regulations for eligibility criteria are required by
Ch. 46 (S.B. 91), Acts of 2016, Public Health — State-Identified HIV Priorities
in order to use rebates received by the Maryland Department of Health (the
Department) from the Maryland AIDS Drug Assistance Program (MADAP) to fund the
This proposal further establishes regulations for the Prevention
Program related to:
(1) Program funding;
(2) Application for funding from the Department;
(3) Navigation program design and operation;
(4) Recipient screening, care plan, application, and enrollment
into the program;
(5) Covered services;
(6) Recovery of payments;
(9) Availability of funding and program termination;
(10) Changes in eligibility and enrollment;
(11) Reconsideration and appeal;
(12) Payment procedures; and
(13) Cause for suspension or removal, and imposition of sanctions.
Comparison to Federal
There is no corresponding federal standard to this proposed
Estimate of Economic
I. Summary of Economic Impact. This proposal will have an economic impact on
the Department and local health departments or community-based organizations if
a local health department or a community-based organization applies to
establish a program to provide HIV prevention and wraparound services funded by
the Department. Local health departments and community-based organizations that
are approved will receive funding from the Department to provide these
services. Because these programs are not yet established, and the Department
does not know how many local health departments or community-based
organizations will apply, the economic impact is indeterminable. In addition,
the cost to establish programs may vary across jurisdictions as costs of
services provided will vary widely. MADAP drug rebate funds will be used. The
cost of this program will be dependent on the number of approved grant applications,
but is not expected to exceed $2,000,000 annually.
II. Types of Economic Impact.
A. On issuing agency:
Up to $2,000,000
B. On other State agencies:
C. On local governments:
D. On regulated industries or
E. On other industries or trade
F. Direct and indirect effects on
Assumptions. (Identified by Impact Letter
and Number from Section II.)
Through the Maryland HIV Prevention Case Management Program, the Department
will provide grant funding to local health departments and community-based
organizations to provide HIV prevention and wraparound services. This funding
will come from the Department, so there will be an increase in expenditures.
Because the Department does not know how many organizations will apply and be
approved for funding or how much funding will be needed, this impact is
indeterminable, but is not expected to exceed $2,000,000 annually.
Local health departments may apply for grant funding to provide HIV
prevention and wraparound services. If local health departments apply for and
receive funding, these regulations will result in a positive economic impact
on local health departments. Because the Department does not know how many
local health departments will apply for funding or how much funding will be
needed, this impact is indeterminable.
Through the establishment of the Maryland HIV Prevention Case Management
Program, individuals at elevated risk for acquiring HIV will be able to
access HIV prevention and wraparound services. These services will benefit
these individuals and may include financial assistance. Because the
Department does not know how many individuals will participate in the program
or how much financial assistance will be needed, this impact in
Economic Impact on Small
The proposed action has minimal or no economic impact on small
Impact on Individuals
The proposed action has no impact on individuals with
Opportunity for Public
Comments may be sent to Jake Whitaker, Acting 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 firstname.lastname@example.org, or fax to 410-767-6483.
Comments will be accepted through March 4, 2019. A public hearing has not been
The purpose of the Maryland HIV Prevention Case Management Program
A. Provide community-based prevention services for individuals at
elevated risk for acquiring human immunodeficiency syndrome (HIV) including:
(1) Routine testing;
(2) Risk reduction counseling; and
(3) Pre-exposure prophylaxis (PrEP); and
B. Address the needs of recipients that would otherwise present
barriers to accessing prevention services including:
(4) Vocational assistance; and
(5) Health care needs including:
(a) Primary health care services; and
(b) Behavioral health care services.
A. In this chapter, the following terms have the meanings
B. Terms Defined.
(1) “Acquired immunodeficiency syndrome (AIDS)” means the medical
condition caused by the human immunodeficiency virus.
(a) “Agent” means an individual who assists an applicant in
submitting an application for prevention services and is employed by an
organization that has received funding from the Department under the Maryland
HIV Prevention Case Management Program.
(b) “Agent” includes:
(i) A prevention navigator;
(ii) A case manager;
(iii) A licensed social worker;
(iv) A registered nurse; and
(v) Any other related professional who assists an individual in
submitting an application to a grantee.
(3) “Annual recertification form” means the form approved by the
Department on which a recipient provides information to the Department to
verify eligibility for the Prevention Program at the end of each enrollment
(4) “Antiretroviral therapy (ART)” means multiple anti-retroviral
medications that are prescribed to slow or stop the replication of HIV in the
(5) “Applicant” means an individual on whose behalf an application
has been submitted to a grantee for services under the Maryland HIV Prevention
Case Management Program and whose eligibility status is not yet determined.
(6) “Care plan” means an outline of a recipient’s engagement with
a case manager including the:
(a) Services needed by the recipient;
(b) Progress toward meeting those needs; and
(c) Responsibilities of the case manager and recipient toward
meeting those goals or needs.
(7) “Case management services” means the assignment of a
recipient’s case to a case manager for ongoing assessment and coordination of
the various services needed to engage in the Maryland HIV Prevention Case
(8) “Community-based organization (CBO)” means a public or private
(a) Is representative of a community or significant segments of a
(b) Provides educational, health, or social services to
individuals in the community.
(9) “Department” means the Maryland Department of Health.
(10) “Engaged” means actively enrolled in services with the case
(a) Meeting in-person at least quarterly with a case manager; and
(b) Keeping in contact with a case manager by phone, email, or
messaging application at least once per month.
(11) “Enrollment period” means the period of time a recipient may
receive Maryland HIV Prevention Case Management Program benefits.
(12) “Grantee” means an organization that:
(a) Receives funding from the Maryland Prevention Case Management
(b) Employs at least one agent; and
(i) At least one covered service; and
(ii) Financial assistance for the client to engage in covered
services offered outside the organization.
(13) “Gross income” means the income derived from sources provided
in Regulation .06B of this chapter before any deductions.
(14) “Human immunodeficiency virus (HIV)” means the virus that
(15) Identity Documents.
(a) “Identity documents” means documents that are used by a recipient
to prove identity to access:
(i) Medical services;
(ii) Social services;
(iv) Employment; or
(v) Other services.
(b) “Identity document” includes a:
(i) Social Security card;
(ii) Birth certificate;
(iii) Driver’s license; and
(iv) State identification card.
(16) “LGBTQIA+” means lesbian, gay, bisexual, transgender, queer,
intersex, asexual, and other genders and sexual identities.
(17) “Navigation program” means a program established according to
Regulations .04 and .05 of this chapter by a grantee that is approved by the
Department to provide HIV prevention services to a recipient or to pay for HIV
prevention services for a recipient using Prevention Program funds.
(18) “nPEP” means non-occupational Post-Exposure Prophylaxis,
which is prescribing ART or other U.S. Food and Drug Administration-approved
medications for someone who is currently HIV-negative and at increased risk for
HIV acquisition due to a non-work-related known or suspected exposure to HIV
that occurred in the preceding 72 hours.
(a) “Payor” means an organization that pays for medical, social,
or other services as part of the Maryland HIV Prevention Case Management
(b) “Payor” includes a:
(i) Public insurance plan;
(ii) Private insurance plan;
(iii) Foundation or other source of grant funding; and
(iv) Pharmaceutical patient assistance program or foundation
pharmaceutical assistance program.
(20) “PrEP” means HIV pre-exposure prophylaxis, which is
prescribing ART or other U.S. Food and Drug Administration-approved medications
for the prevention of HIV to an individual who is HIV-negative and at increased
risk of acquiring HIV due to sexual contact or sharing of injection drug
equipment with an individual living with HIV or of unknown HIV status.
(21) “Prevention navigator” means an individual employed by a
(a) Assists an applicant or recipient in:
(i) Assessing needs;
(ii) Applying for services; and
(iii) Following up on referrals; and
(b) Provides services to recipients including:
(i) Health education;
(ii) Health literacy support; and
(iii) Prevention counseling.
(22) “Prevention Program” means the Maryland HIV Prevention Case
(23) “Recipient” means an individual who is enrolled in Prevention
(24) “Resident” means an individual:
(a) Who lives in Maryland voluntarily with the intention of making
the State the individual’s home and not for a temporary purpose; and
(b) For whom any temporary absence from the State is coupled with
an intent to return so as not to interrupt the continuity of residence.
(25) “Sexually transmitted infection (STI)” means an infection
passed from one person to another person through sexual contact.
(26) “Visit” means an appointment at the office of a service
provider, between the recipient and a case manager, prevention navigator,
health care provider, or other professional that is billable by health
.03 Program Funding.
A. The Department may provide funding to a
CBO or a local health department approved to establish and operate a navigation
B. Funding may cover:
(1) Case management services provided by an agent at a local
health department or CBO;
(2) The estimated cost for a local health department or CBO to
directly provide covered services to recipients; and
(3) The estimated cost for a local health department or CBO to
provide payments to external organizations for covered services provided to
C. A local health department or a CBO that is approved to operate
a navagation program:
(1) May apply to the Department for grant funding to cover case
management and services each State fiscal year; and
(2) Shall include in the application for grant funding community
input and feedback to identify community needs and estimate costs for services
for each funding period.
.04 Application for
Funding from the Department.
A. A CBO or local health department that applies to receive
funding from the Department to establish a navigation program:
(1) Shall submit an application to the Department that includes:
(a) Responses to all applicable questions; and
(b) Any supporting documentation indicated on the application;
(2) May voluntarily withdraw an application at any time; and
(3) May submit a new application at any time.
B. The Department shall:
(1) Request additional information or changes to the application
if necessary; and
(2) Respond in writing to the applicant within 60 calendar days
indicating the disposition of the application and explanation of the decision.
C. The Department shall:
(1) Review the application; and
(a) Approve the application if the:
(i) Application is complete; and
(ii) The navigation program meets the requirements of Regulation
.05 of this chapter; or
(b) Disapprove the application if the:
(i) Application does not provide sufficient information or
documentation on the program; or
(ii) Navigation program does not meet the requirements of
Regulation .05 of this chapter.
D. A CBO or local health department whose application is
disapproved may appeal the decision to the Director of the Infectious Disease
Prevention and Health Services Bureau in the Department by submitting the
request in writing within 30 calendar days of the date postmarked on the notice
E. If a CBO or local health department submits an appeal, the
Director of the Infectious Disease Prevention and Health Services Bureau shall
within 60 days:
(1) Grant or deny the appeal; and
(2) Respond in writing to the CBO or local health department:
(a) Indicating whether the appeal has been granted or denied; and
(b) Providing an explanation of the decision.
.05 Navigation Program
Design and Operation.
The grantee approved to operate a navigation program:
A. Shall ensure that all navigaton program staff have:
(1) Appropriate levels of expertise in working with individuals
who are members of vulnerable populations such as people of color, members of
the LGBTQIA+ community, and people who use drugs;
(2) Knowledge of harm reduction strategies; and
(3) Skills in implementing harm reduction strategies;
B. Shall ensure that all program staff receive training approved
by the Department to work with vulnerable populations and to provide referrals
(1) Community services;
(2) Counseling; and
(3) Preventative education;
C. Shall ensure that all program staff demonstrate sensitivity to
participant differences including:
(2) Behavioral; and
D. Shall ensure that information collected to identify program
participants is kept confidential according to:
(1) Health-General Article, Title 4, Subtitle 3, Annotated Code of
(2) The Health Insurance Portability and Accountability Act of
1996 (HIPAA), 42 U.S.C. §§1320d et seq., as amended, the HITECH Act, 42 U.S.C.
§§17932, et seq., as amended, and 45 CFR Parts 160 and 164, as amended, and
their implementing regulations; and
E. May not discriminate against participants based on factors
including but not limited to:
(4) Socioeconomic status;
(5) Sexual orientation;
(6) Gender identity;
(9) Race; and
.06 Recipient Eligbility
for Program Services.
A. To be eligible for prevention program benefits, an individual
shall meet the following criteria:
(1) Be a resident;
(2) Have one of the following factors for increased risk of
acquisition of HIV:
(a) A recently diagnosed STI;
(b) A partner known to be living with HIV, if the partner:
(i) Is not prescribed ART; or
(ii) Takes ART inconsistently;
(c) Sharing of injection drug equipment;
(d) Be a member of one of the following populations:
(i) Individuals identifying as a gay, bisexual, or
(ii) Individuals identifying as transgender; or
(iii) Individuals engaging in commercial sex work; or
(e) Be sexually active with no or inconsistent use of condoms in a
zip code with:
(i) Increased prevalence or incidence of HIV; or
(ii) Low viral suppression among people living with HIV;
(3) Have a projected gross income that is less than or equal to
138 percent of the Federal Poverty Level Guidelines, as updated annually in the
Federal Register by the U.S. Department of Health and Human Services under
authority of 42 U.S.C. §9902(2); and
(4) Not be eligible to enroll with or be enrolled with another
payor that covers all services provided by the Prevention Program.
B. Gross Income.
(1) Gross income includes income derived from:
(a) Wages and salaries, including tips;
(b) Net income from self-employment or business;
(c) Unemployment compensation;
(d) Social Security payments, including disability payments;
(f) Retirement or pension;
(g) Investments, including dividends or interest;
(h) Rental income; and
(i) Other taxable income, such as prizes, awards, and gambling
(2) Gross income does not include income derived from:
(a) Child support;
(c) Supplemental Social Security income;
(d) Veterans’ disability payments;
(e) Workers’ compensation; and
(f) Proceeds from loans, such as student loans, home equity loans,
or bank loans.
C. The Prevention Program shall be the payor of last resort for a
.07 Recipient Screening,
Care Plan, Application, and Enrollment into the Program.
(1) The agent shall complete a needs assessment and a sexual
health screening for the applicant or recipient during each visit.
(2) The needs assessed shall include but are not limited to:
(b) Access to food;
(d) Job readiness;
(e) Educational or vocational needs;
(f) Behavioral health;
(g) Medical needs;
(i) Linguistic needs;
(j) Legal needs; and
(k) Health education and literacy.
(3) A sexual health screening shall include sexual health
(4) If a recipient is enrolled in a Prevention Program that
includes PrEP, the recipient shall meet with a health care provider with
prescribing capability on a quarterly basis to complete recommended laboratory
B. Care Plan. The agent shall:
(1) Develop a care plan based on the assessment and screening
completed per §A of this regulation; and
(2) Update the care plan during each visit to track progress or
identify new needs.
(1) The agent shall assist the client in completing an application
on the form designated by the Department that includes:
(b) A copy of the requested verification documentation, including
proof of residence and gross income.
(2) The agent or the applicant may voluntarily withdraw the
application at any time without prejudice.
(3) The agent shall submit the application to the grantee for
review and approval.
(4) The grantee shall:
(i) The application is complete;
(ii) The applicant is determined to be eligible; and
(iii) All necessary verification documents are included with the
(i) Application is incomplete; or
(ii) Applicant fails to provide sufficient information or
documentation to determine eligibility.
(5) After a determination has been made in accordance with §C(4)
of this regulation, the grantee shall contact the applicant with the status of
(1) A recipient shall be enrolled in the Prevention Program
beginning the first day of the month in which the approved application was
(2) Prevention Program benefits for the recipient shall be
discontinued automatically after 12 months from the date of enrollment if the
client does not complete an annual recertification form, or sooner should
program funding from the Department be exhausted.
(3) A recipient:
(a) Shall be notified in writing by the agent and grantee 30 days
prior to the termination of benefits; and
(b) Subject to application approval and availability of funds, may
complete an annual recertification form to receive continuing benefits.
(1) To receive Prevention Program benefits, a recipient shall
remain engaged with the agent.
(2) If the recipient does not remain engaged with the agent, the
recipient may be disenrolled from the Prevention Program.
(3) If a recipient is disenrolled from the Prevention Program due
to lack of engagement, the recipient may reapply for Prevention Program
.08 Covered Services.
A. If a recipient is enrolled with a payor that provides some of
the services provided by the Prevention Program, the Prevention Program shall
be billed only for services not covered by the payor.
B. The grantee:
(1) May provide covered program services directly; and
(2) May refer recipients to an outside organization and pay for
the services on behalf of the recipient.
C. The agent employed by the grantee shall obtain and keep on file
documentation of costs and receipt of payment for services paid for under §B(2)
of this regulation.
D. Prevention Program services covered by a grantee shall include:
(1) Medical services including:
(a) Office visits;
(b) Laboratory services;
(d) PrEP or nPEP medications provided to a recipient; and
(e) Durable medical equipment not covered by insurance or another
(2) Behavioral health services identified in the recipient’s care
(a) Mental health therapy;
(b) Psychiatric services; and
(c) Substance use disorder services;
(3) HIV prevention services identified in the recipient’s care
(b) Harm reduction counseling;
(c) Health education;
(d) Risk reduction counseling; and
(e) Navigation, outreach, and case management to improve adherence
(4) If the recipient is able to afford ongoing rental housing
payments based on net income, one-time financial assistance for housing that is
equal to the recipient’s share of the costs for 1 month’s rent payment required
(a) Obtain rental housing; or
(b) If the recipient is under threat of eviction, maintain rental
(5) Financial assistance for up to 12 months of:
(a) Transitional housing;
(b) Emergency housing; or
(c) Rapid rehousing;
(6) One-time financial assistance not exceeding $1,000 for utility
arrears to prevent a utility shut-off;
(7) Emergency food assistance paid via grocery store gift cards;
(8) If other financial aid sources have been exhausted, one-time
financial assistance for education including:
(a) Adult literacy course tuition, fees, and books;
(b) Adult basic education course tuition, fees, and books;
(c) GED preparatory class tuition, fees, and books;
(d) GED exam fees;
(e) Tuition for a driver’s license preparation course to enable
the recipient to obtain a driver’s license for the purposes of employment as
driver for a taxi, rideshare, or delivery company;
(f) Tuition, fees, and materials for a single career preparation
(g) Tuition, fees, and materials for completing a career
preparation certificate program up to 20 credits or 800 hours at the community
college in the recipient’s county of residence; and
(h) Tuition, fees, and materials for completing a career
preparation certificate program above 20 credits or 800 hours, subject to
approval by the Department and availability of funds;
(9) Job-readiness services, including:
(a) Education on:
(i) Interviewing skills;
(ii) Resume writing; and
(iii) Job searching;
(b) Resume proofreading and editing;
(c) Mock interviews and feedback; and
(d) Provision of donated interview attire;
(10) Child care services needed for the recipient to receive
services identified in the recipient’s care plan;
(11) Transportation assistance for the recipient to receive
services identified in the recipient’s care plan including but not limited to:
(a) Public transit assistance; and
(b) A voucher for a taxi or car service;
(12) Provided that the services are not available directly from
the service provider and the service provider is not required by law to provide
the services, linguistic services needed for the recipient to receive medical
or social services identified in the recipient’s care plan;
(13) Legal services including:
(a) Assistance with paperwork and fees required for identification
to obtain employment, medical care, or other services identified in the
recipient’s care plan;
(b) Assistance for a transgender recipient seeking to change the
name or gender marker on identity documents; and
(c) Assistance with expungement services to help improve the
ability of the recipient to obtain employment or access to educational
(14) Recovery services needed as a result of sexual assault,
intimate partner violence, or interpersonal violence of which the recipient was
(15) Financial literacy education and tax filing education or assistance;
(16) If private health or dental insurance is necessary for the
recipient to receive services identified in the recipient’s care plan,
financial assistance for health or dental insurance premiums to purchase a plan
on Maryland Health Connection.
.09 Recovery of
A. If benefits have been incorrectly paid or another payor has
been identified, the Department shall seek recovery of the amount of those
B. A grantee shall inform the Department if benefits have been incorrectly
paid or another payor has been identified.
A. The Department shall pursue cases of suspected
misrepresentation or fraud pursuant to Criminal Law Article, §8-503, Annotated
Code of Maryland, or any other applicable statutory provision.
B. A grantee shall inform the Department of suspected
misrepresentation or fraud that may be pursued under the Criminal Law Article,
§8-503, Annotated Code of Maryland, or any other applicable statutory
Except when otherwise authorized by law, the agent of an
applicant, the agent of a recipient, the grantee, and the Department:
A. Shall keep all applicant and recipient personal information
B. May not disclose personal information kept on an applicant or recipient
without written consent of the:
(3) Applicant’s parent or legal guardian; or
(4) Recipient’s parent or legal guardian;
C. Shall comply with the laws and regulations concerning the
privacy and security of protected health information under:
D. Shall ensure that all interactive video technology-assisted
communication comply with HIPAA patient privacy and security regulations.
.12 Availability of
Funding and Program Termination.
A. If sufficient monies are not available to fund the Prevention
Program, the Department shall take the action necessary to eliminate a deficit
which may include program termination or restricting eligibility for the program.
B. If the program is terminated, the Department shall continue to
provide benefits for each currently enrolled recipient through the earlier of:
(1) The end of the recipient’s 12-month enrollment period; or
(2) 6 months from the date of program termination.
.13 Changes in
Eligibility and Disenrollment.
A. A recipient shall notify the agent or Department within 60
business days of a change in:
(1) Availability of third-party or insurance payment for covered
(2) Gross income; or
B. If the agent or Department determines that a change reported in
§A of this regulation results in the recipient no longer qualifying for
Prevention Program services, the agent or the Department shall disenroll the
C. The notice of disenrollment shall:
(1) Be mailed to the recipient at least 15 business days before
the effective date of disenrollment;
(2) Include an explanation of the action;
(3) Cite the section of regulations supporting the action; and
(4) Explain the right of the recipient to request reconsideration
or an appeal of the decision.
D. If the recipient is
determined to be ineligible before the end of the current enrollment period
because of a change in residency, medical, or financial eligibility criteria,
the disenrollment shall be the earlier of:
(1) The date on which the recipient’s current enrollment ends; or
(2) The first day of the month that is at least 15 calendar days
after the date of the notice of ineligibility for benefits.
.14 Reconsideration and
A. An applicant or recipient who has been notified by the
Department or grantee of ineligibility for or disenrollment from Prevention
Program benefits may request reconsideration of the decision by submitting a
letter of reconsideration with additional supporting documentation or
information to the agent or Department within 30 business days of the
B. If an applicant or recipient submits a letter of
reconsideration within 30 days of notification of ineligibility or
disenrollment from the Prevention Program for reconsideration, the grantee or
(1) Review all additional supporting documentation provided by the
applicant or recipient within 10 business days of the grantee or Department’s
receipt of the request for reconsideration; and
(2) Issue a final decision in writing to the applicant or
C. An applicant or recipient may appeal the reconsideration
decision by requesting in writing a hearing with the Office of Administrative
D. The Office of Administrative Hearings shall:
(1) Conduct a hearing according to the procedures set forth in
(2) Hold a hearing to review the decision within 45 days of the
postmarked date on the letter requesting a hearing; and
(3) Issue a decision in writing to the applicant or recipient.
.15 Payment Procedures.
A. The grantee shall:
(1) Pay for covered services directly to the vendor on behalf of
the recipient; and
(2) Report amounts paid for services in the expenditure reports
required by the Department.
B. The agent shall obtain documentation of payments due to outside
organizations and receipt of payment made on behalf of the recipient.
C. Payment for services, other than gift cards for the purchase of
food, may not be provided directly to the recipient.
D. If the recipient has an insurance plan that covers any of the
services provided by the Prevention Program, the grantee or Department shall
pay the service provider the balance remaining after the insurance plan pays
.16 Cause for Suspension
or Removal, and Imposition of Sanctions.
A. If the Department determines that a service provider or service
provider’s employee, or both, has failed to comply with federal or State laws
and regulations or has engaged in fraud or abuse, the Department may:
(1) Suspend the service provider from receiving payments from
Prevention Program funds;
(2) Withhold payment to the service provider; or
(3) Permanently ban the service provider from receiving funds from
the Prevention Program and bar future payments to the service provider.
B. If a service provider or the service provider’s employee is
barred from Medicaid or Medicare, the Department shall bar the service provider
or service provider’s employee.
C. A service provider that is barred or suspended from receiving
payments according to this regulation shall notify a recipient that the
provider is no longer able to accept payment from the Prevention Program and
that the recipient may:
(1) Find a new provider through the recipient’s agent or the
(2) Pay for services directly to continue with the service
ROBERT R. NEALL
Secretary of Health
201 W. Preston Street, Baltimore, MD 21201-2399
(410) 767-6500 or 1-877-463-3464