Nursing facilities with licensed nursing facility beds, which have been determined by the Department to meet the standards for ventilator care under COMAR 10.07.02, shall be reimbursed as follows:

1. A. Services for residents receiving ventilator care shall be reimbursed as follows:

   1. (1) The Nursing Service rate identified in Regulation .12 of this chapter shall be calculated with a facility average Medicaid case mix index that includes only residents receiving ventilator care; and
   2. (2) An amount of $285 shall be added to the total prospective rate;
2. B. The facility average Medicaid case mix index for rates under §A of this regulation are not subject to the Medicaid case mix index equalizer adjustment in Regulation .12F(6) of this chapter;
3. C. Nursing facilities adding ventilator care services for the first time, which have been determined by the Department to meet the standards for ventilator care under COMAR 10.07.02, shall be reimbursed as described in §A of this regulation, except that the facility average Medicaid case mix index is assumed to be that of RUG classification ES3 (or its future equivalent);
4. D. The facility should request this rate from the Department at least 60 days before the opening of the ventilator unit;
5. E. For years between periods when the Nursing Services prices are rebased, the final price for Ventilator costs shall be adjusted as set forth in Regulation .09D of this chapter; and
6. F. For residents not receiving ventilator care, the Initial Facility Nursing Service rate identified in Regulation .12 of this chapter shall be calculated with a facility average Medicaid case mix index that excludes residents receiving ventilator care.

Authority: Health-General Article, §§2-104(b), 15-103, 15-105, 19-14B-01, and 19-310.1, Annotated Code of Maryland

Effective date: July 9, 1975 (2:15 Md. R. 1070)

Regulation .03E amended effective January 30, 1976 (3:4 Md. R. 216)

Regulation .03H amended effective December 31, 1975 (3:4 Md. R. 216)

Regulation .03Q adopted as an emergency provision effective July 1, 1977 (4:15 Md. R. 1143); adopted permanently effective October 21, 1977 (4:22 Md. R. 1671)

Regulation .03X amended effective September 29, 1976 (3:20 Md. R. 1143)

Regulation .05 amended effective August 17, 1977 (4:17 Md. R. 1298)

Regulation .06 amended as an emergency provision effective April 1, 1977 (4:8 Md. R. 631); emergency status extended at 4:17 Md. R. 1291)

Regulation .06 amended effective August 17, 1977 (4:17 Md. R. 1298)

Regulation .06B amended effective January 30, 1976 (3:4 Md. R. 216)

Regulation .06C adopted as an emergency provision effective July 1, 1977 (4:15 Md. R. 1143); adopted permanently effective October 21, 1977 (4:22 Md. R. 1671)

Regulation .07 amended effective August 17, 1977 (4:17 Md. R. 1298)

Regulation .09 amended effective August 17, 1977 (4:17 Md. R. 1298)

Regulation .09A amended effective September 29, 1976 (3:20 Md. R. 1143)

Regulation .09B amended as an emergency provision effective April 1, 1977 (4:8 Md. R. 631); emergency status extended at 4:17 Md. R. 1291

Regulation .09B, D amended effective January 30, 1976 (3:4 Md. R. 216)

Regulation .09A amended as an emergency provision effective July 1, 1977 (4:15 Md. R. 1143); amended permanently effective October 21, 1977 (4:22 Md. R. 1671)

Regulation .09A amended as an emergency provision effective June 13, 1978 (5:13 Md. R. 1039)

Regulations .03 and .09 amended as an emergency provision effective January 1, 1978 (5:1 Md. R. 15)

Regulations .03, .06, .08, and .09 amended as an emergency provision effective March 15, 1978 (5:9 Md. R. 681)

Chapter revised effective July 1, 1978 (5:13 Md. R. 1051)

Regulations .01U, HH, II, LL; .02; .03; .04G; .07; .09; .11E amended effective December 14, 1979 (6:25 Md. R. 1980)

Regulation .01M-1 and M-2 adopted effective July 1, 1980 (7:13 Md. R. 1278)

Regulations .01O, .03D, and .11E amended effective January 1, 1980 (6:26 Md. R. 2074)

Regulations .01JJ, KK; .07-1; .08A-1 adopted effective December 14, 1979 (6:25 Md. R. 1980)

Regulation .01P repealed effective January 1, 1980 (6:26 Md. R. 2074)

Regulation .05A repealed effective December 14, 1979 (6:25 Md. R. 1980)

Regulation .07B amended as an emergency provision effective July 1, 1978 (5:14 Md. R. 1132); adopted permanently effective November 3, 1978 (5:22 Md. R. 1673)

Regulation .07-2 adopted effective July 1, 1980 (7:13 Md. R. 1278)

Regulation .08E amended as an emergency provision effective July 1, 1978 (5:14 Md. R. 1131); adopted permanently effective November 3, 1978 (5:22 Md. R. 1673)

Regulation .11 amended effective December 20, 1982 (9:25 Md. R. 2482)

Regulation .16A, B amended effective August 17, 1981 (8:16 Md. R. 1365)

Regulation .18 adopted effective October 25, 1982 (9:21 Md. R. 2106)

Chapter revised effective January 1, 1983 (9:25 Md. R. 2480)

Regulation .01B amended effective June 6, 1983 (10:11 Md. R. 975); August 10, 1987 (14:16 Md. R. 1773)

Regulation .01B amended as an emergency provision effective July 1, 1986 (13:14 Md. R. 1627); adopted permanently effective December 1, 1986 (13:21 Md. R. 2320)

Regulation .03 amended as an emergency provision effective February 18, 1983 (10:6 Md. R. 536)

Regulation .03P amended, Q adopted effective June 6, 1983 (10:11 Md. R. 975)

Regulation .03R adopted effective January 30, 1984 (11:2 Md. R. 113)

Regulation .03S adopted effective July 28, 1986 (13:15 Md. R. 1734)

Regulation .03T and U adopted effective August 10, 1987 (14:16 Md. R. 1773)

Regulation .04G amended effective October 29, 1984 (11:21 Md. R. 1812)

Regulation .05 amended effective June 1, 1988 (15:11 Md. R. 1331)

Regulation .07B amended and .07H adopted as an emergency provision effective June 27, 1983 (10:14 Md. R. 1257); adopted permanently effective October 24, 1983 (10:21 Md. R. 1901)

Regulation .07B amended effective June 6, 1983 (10:11 Md. R. 975); August 10, 1987 (14:16 Md. R. 1773)

Regulation .07B and E amended effective July 1, 1984 (11:12 Md. R. 1063)

Regulation .07B, C, F, G amended and .07C-1 adopted as an emergency provision effective July 1, 1986 (13:15 Md. R. 1729); adopted permanently effective December 1, 1986 (13:22 Md. R. 2398)

Regulation .07C amended effective October 29, 1984 (11:21 Md. R. 1812)

Regulation .07D amended effective July 18, 1983 (10:14 Md. R. 1262); July 1, 1987 (14:13 Md. R. 1473); June 1, 1988 (15:11 Md. R. 1331); July 1, 1988 (15:13 Md. R. 1553)

Regulation .07D amended as an emergency provision effective January 26, 1988 (15:4 Md. R. 469); adopted permanently effective May 15, 1988 (15:8 Md. R. 1009)

Regulation .07E amended effective January 27, 1986 (13:2 Md. R. 137); July 1, 1988 (15:13 Md. R. 1533); September 5, 1988 (15:18 Md. R. 2147)

Regulation .07E amended as an emergency provision effective July 1, 1986 (13:14 Md. R. 1627); adopted permanently effective December 1, 1986 (13:21 Md. R. 2320)

Regulation .07G amended effective December 29, 1986 (13:26 Md. R. 2807)

Regulation .07H repealed effective August 10, 1987 (14:16 Md. R. 1773)

Regulation .08 amended as an emergency provision effective July 1, 1985 (12:14 Md. R. 1427); emergency status expired November 4, 1985

Regulation .08 amended effective November 4, 1985 (12:22 Md. R. 2103)

Regulation .09A amended effective September 5, 1988 (15:18 Md. R. 2147)

Regulation .10E amended effective August 10, 1987 (14:16 Md. R. 1773)

Regulation .10I amended effective January 30, 1984 (11:2 Md. R. 113); September 10, 1984 (11:18 Md. R. 1584)

Regulation .12D repealed effective August 10, 1987 (14:16 Md. R. 1773)

Regulation .13E amended as an emergency provision effective January 1, 1983 (10:1 Md. R. 21); adopted permanently effective May 1, 1983 (10:7 Md. R. 634)

Regulation .13F amended as an emergency provision effective July 1, 1986 (13:15 Md. R. 1729); adopted permanently effective December 1, 1986 (13:22 Md. R. 2398)

Regulation .14K adopted as an emergency provision effective June 27, 1983 (10:14 Md. R. 1257); adopted permanently effective October 24, 1983 (10:21 Md. R. 1901)

Regulation .14K repealed effective August 10, 1987 (14:16 Md. R. 1773)

Regulation .17A amended effective May 12, 1986 (13:9 Md. R. 1029)

Regulation .19 amended effective June 6, 1983 (10:11 Md. R. 974)

Chapter revised effective November 27, 1989 (16:23 Md. R. 2505)

Regulations .01, .07—.12, .16, and .25 amended as an emergency provision effective January 14, 1992 (19:3 Md. R. 299); emergency status expired June 30, 1992

Regulations .01, .07—.13, .16, .17, .23, and .25 amended as an emergency provision effective July 1, 1992 (19:14 Md. R. 1272); amended permanently effective November 1, 1992 (19:21 Md. R. 1891)

Regulations .01, .04, .08—.11, .16, .17, .20, .21, and .23 amended as an emergency provision effective July 1, 2005 (32:19 Md. R. 1584); emergency status expired August 31, 2005

Regulation .01B amended effective March 19, 1990 (17:5 Md. R. 638); December 29, 1997 (24:26 Md. R. 1758)

Regulation .01B amended as an emergency provision effective May 1, 2004 (31:12 Md. R. 908); amended permanently effective August 16, 2004 (31:16 Md. R. 1255)

Regulation .01B amended effective May 9, 2005 (32:9 Md. R. 848); December 9, 2005 (32:24 Md. R. 1904)

Regulation .01B amended as an emergency provision effective July 16, 2009 (36:17 Md. R. 1310); amended permanently effective October 5, 2009 (36:20 Md. R. 1527)

Regulation .01B amended effective January 24, 2011 (38:2 Md. R. 84); October 3, 2011 (38:20 Md. R. 1202); October 14, 2013 (40:20 Md. R. 1652)

Regulation .02 amended effective December 29, 1997 (24:26 Md. R. 1758)

Regulation .03 amended effective March 19, 1990 (17:5 Md. R. 638); December 29, 1997 (24:26 Md. R. 1758)

Regulation .03V amended effective October 3, 2011 (38:20 Md. R. 1202)

Regulation .03W adopted effective October 3, 2011 (38:20 Md. R. 1202)

Regulations .04, .10L, .11F, O, and .25B amended as an emergency provision effective July 3, 1990 (17:16 Md. R. 1986); amended permanently effective November 1, 1990 (17:21 Md. R. 2529)

Regulations .04, .05, .07—.11, .13, .16, and .25 amended and new Regulation .09-1 adopted as an emergency provision effective October 1, 1999 (26:23 Md. R. 1775); adopted permanently effective January 9, 2000 (26:27 Md. R. 2015)

Regulation .04 amended effective August 15, 1994 (21:16 Md. R. 1383); December 29, 1997 (24:26 Md. R. 1758)

Regulation .04D repealed effective March 18, 2013 (40:5 Md. R. 411)

Regulation .04E amended effective December 9, 2005 (32:24 Md. R. 1904); March 18, 2013 (40:5 Md. R. 411)

Regulation .04BB adopted as an emergency provision effective April 1, 2008 (35:9 Md. R. 892); emergency status expired September 3, 2008

Regulation .04BB adopted effective September 22, 2008 (35:19 Md. R. 1716)

Regulation .05 amended as an emergency provision effective July 1, 2003 (30:15 Md. R. 990); emergency status expired December 31, 2003

Regulation .05 amended effective February 16, 2004 (31:3 Md. R. 207)

Regulation .05G amended effective December 29, 1997 (24:26 Md. R. 1758)

Regulation .06 amended effective December 29, 1997 (24:26 Md. R. 1758); July 8, 2002 (29:13 Md. R. 990)

Regulations .07—.11 amended as an emergency provision effective December 1, 2001 (29:1 Md. R. 17)

Regulations .07—.11-1 and .26 amended as an emergency provision effective July 1, 1995 (22:15 Md. R. 1114); emergency status expired November 1, 1995; amended permanently effective November 6, 1995 (22:22 Md. R. 1658)

Regulation .07 amended effective July 8, 2002 (29:13 Md. R. 990)

Regulation .07 amended as an emergency provision effective July 1, 2003 (30:15 Md. R. 990); emergency status expired December 31, 2003

Regulation .07 amended effective February 16, 2004 (31:3 Md. R. 207)

Regulation .07 amended as an emergency provision effective July 16, 2009 (36:17 Md. R. 1310); amended permanently effective October 5, 2009 (36:20 Md. R. 1527)

Regulation .07 amended effective November 28, 2011 (38:24 Md. R. 1502); March 18, 2013 (40:5 Md. R. 411); December 12, 2013 (40:24 Md. R. 2016); December 11, 2014 (41:24 Md. R. 1427)

Regulation .07A amended effective June 25, 1990 (17:12 Md. R. 1494)

Regulation .07A-2 adopted effective February 12, 2007 (34:3 Md. R. 297)

Regulation .07A-2 amended as an emergency provision effective July 1, 2007 (34:15 Md. R. 1345); emergency status extended at 35:3 Md. R. 286; emergency status expired June 24, 2008

Regulation .07A-2, C amended as an emergency provision effective April 1, 2008 (35:9 Md. R. 892); emergency status expired September 3, 2008

Regulation .07A-2, C amended effective September 22, 2008 (35:19 Md. R. 1716)

Regulation .07A-3 adopted effective September 22, 2008 (35:19 Md. R. 1716)

Regulation .07A-3 amended effective April 6, 2009 (36:7 Md. R. 523)

Regulation .07A-4 adopted effective April 6, 2009 (36:7 Md. R. 523)

Regulation .07B amended effective February 12, 2007 (34:3 Md. R. 297)

Regulation .07C amended effective March 19, 1990 (17:5 Md. R. 638)

Regulation .07C-1 amended effective April 5, 2010 (37:7 Md. R. 570)

Regulation .07C-2 and C-3 adopted effective April 5, 2010 (37:7 Md. R. 570)

Regulation .07C-4 adopted effective December 27, 2010 (37:26 Md. R. 1787)

Regulation .07-1 adopted as an emergency provision effective May 1, 2004 (31:12 Md. R. 908); adopted permanently effective August 16, 2004 (31:16 Md. R. 1255)

Regulation .07-1F, I amended effective April 10, 2006 (33:7 Md. R. 668); August 27, 2007 (34:17 Md. R. 1508); September 22, 2008 (35:19 Md. R. 1716)

Regulation .07-1I amended as an emergency provision effective July 16, 2009 (36:17 Md. R. 1310); amended permanently effective October 5, 2009 (36:20 Md. R. 1527)

Regulation .07-1I amended effective January 24, 2011 (38:2 Md. R. 84); October 3, 2011 (38:20 Md. R. 1202); February 18, 2013 (40:3 Md. R. 218); February 3, 2014 (41:2 Md. R. 91); December 11, 2014 (41:24 Md. R. 1427)

Regulations .08—.11-1, .17, .20, and .21 amended as an emergency provision effective July 1, 1996 (23:15 Md. R. 1081); amended permanently effective November 4, 1996 (23:22 Md. R. 1496)

Regulations .08—.11 amended as an emergency provision effective July 1, 1997 (24:16 Md. R. 1149) (Emergency provisions are temporary and not printed in COMAR)

Regulations .08—.11 amended as an emergency provision effective July 1, 1998 (25:15 Md. R. 1181); amended permanently effective October 19, 1998 (25:21 Md. R. 1574)

Regulations .08—.11, .13, and .16 amended as an emergency provision effective July 1, 1999 (26:16 Md. R. 1237 and 26:18 Md. R. 1369); emergency status expired September 30, 1999

Regulation .08 amended as an emergency provision effective July 1, 2003 (30:15 Md. R. 990); emergency status expired December 31, 2003

Regulation .08 amended effective February 16, 2004 (31:3 Md. R. 207); September 22, 2008 (35:19 Md. R. 1716); March 18, 2013 (40:5 Md. R. 411)

Regulation .08B amended effective July 1, 1993 (20:12 Md. R. 996); October 20, 1997 (24:21 Md. R. 1449); December 9, 2005 (32:24 Md. R. 1904)

Regulation .08B, E amended as an emergency provision effective July 1, 2007 (34:15 Md. R. 1345); emergency status extended at 35:3 Md. R. 286; emergency status expired June 24, 2008

Regulation .08B, E amended as an emergency provision effective April 1, 2008 (35:9 Md. R. 892); emergency status expired September 3, 2008

Regulation .08B, E amended effective April 6, 2009 (36:7 Md. R. 523); December 27, 2010 (37:26 Md. R. 1787); November 28, 2011 (38:24 Md. R. 1502); December 12, 2013 (40:24 Md. R. 2016)

Regulation .08B, E, H amended effective September 22, 2008 (35:19 Md. R. 1716)

Regulation .08E amended effective July 1, 1993 (20:12 Md. R. 996); June 6, 1994 (21:11 Md. R. 951); November 7, 1994 (21:22 Md. R. 1876); October 20, 1997 (24:21 Md. R. 1449); December 9, 2005 (32:24 Md. R. 1904)

Regulations .08E, .09E, and .10L amended as an emergency provision effective January 6, 1994 (21:2 Md. R. 95); emergency status extended at 21:9 Md. R. 744; emergency status expired June 5, 1994

Regulations .08E, .09E, and .10L amended as an emergency provision effective July 1, 1994 (21:16 Md. R. 1379); emergency status expired November 7, 1994

Regulation .08H adopted effective September 11, 2006 (33:18 Md. R. 1505)

Regulation .08H repealed as an emergency provision effective July 1, 2007 (34:15 Md. R. 1345); emergency status extended at 35:3 Md. R. 286; emergency status expired June 24, 2008

Regulation .08H repealed as an emergency provision effective April 1, 2008 (35:9 Md. R. 892); emergency status expired September 3, 2008

Regulation .09B amended effective July 1, 1993 (20:12 Md. R. 996); October 20, 1997 (24:21 Md. R. 1449)

Regulation .09E amended effective July 1, 1993 (20:12 Md. R. 996); June 6, 1994 (21:11 Md. R. 951); November 7, 1994 (21:22 Md. R. 1876); October 20, 1997 (24:21 Md. R. 1449)

Regulation .09E amended as an emergency provision effective July 1, 2003 (30:15 Md. R. 990); emergency status expired December 31, 2003

Regulation .09E amended effective February 16, 2004 (31:3 Md. R. 207); December 9, 2005 (32:24 Md. R. 1904)

Regulation .09E amended as an emergency provision effective July 1, 2007 (34:15 Md. R. 1345); emergency status extended at 35:3 Md. R. 286; emergency status expired June 24, 2008

Regulation .09E amended as an emergency provision effective April 1, 2008 (35:9 Md. R. 892); emergency status expired September 3, 2008

Regulation .09E amended effective April 6, 2009 (36:7 Md. R. 523); December 27, 2010 (37:26 Md. R. 1787); November 28, 2011 (38:24 Md. R. 1502)

Regulation .09E, F amended effective March 18, 2013 (40:5 Md. R. 411)

Regulation .09E, H amended effective September 22, 2008 35:19 Md. R. 1716)

Regulation .09H adopted effective September 11, 2006 (33:18 Md. R. 1505)

Regulation .09H repealed as an emergency provision effective July 1, 2007 (34:15 Md. R. 1345); emergency status extended at 35:3 Md. R. 286

Regulation .09H repealed as an emergency provision effective April 1, 2008 (35:9 Md. R. 892); emergency status expired September 3, 2008

Regulation .10 amended as an emergency provision effective July 1, 2003 (30:15 Md. R. 990); emergency status expired December 31, 2003

Regulation .10 amended effective February 16, 2004 (31:3 Md. R. 207)

Regulation .10C amended effective September 20, 2010 (37:19 Md. R. 1283)

Regulation .10G amended effective December 9, 2005 (32:24 Md. R. 1904)

Regulation .10G amended as an emergency provision effective July 1, 2007 (34:15 Md. R. 1345); emergency status extended at 35:3 Md. R. 286; emergency status expired June 24, 2008

Regulation .10G amended as an emergency provision effective April 1, 2008 (35:9 Md. R. 892); emergency status expired September 3, 2008

Regulation .10G amended effective September 22, 2008 35:19 Md. R. 1716); April 6, 2009 (36:7 Md. R. 523); December 27, 2010 (37:26 Md. R. 1787); November 28, 2011 (38:24 Md. R. 1502); March 18, 2013 (40:5 Md. R. 411); December 12, 2013 (40:24 Md. R. 2016)

Regulation .10I amended as an emergency provision effective July 1, 2001 (28:16 Md. R. 1480); amended permanently effective October 1, 2001 (28:19 Md. R. 1684)

Regulation .10L amended effective July 1, 1993 (20:12 Md. R. 996); June 6, 1994 (21:11 Md. R. 951); November 7, 1994 (21:22 Md. R. 1876); October 20, 1997 (24:21 Md. R. 1449)

Regulation .10N adopted as an emergency provision effective April 1, 2008 (35:9 Md. R. 892); emergency status expired September 3, 2008

Regulation .10N adopted effective September 22, 2008 35:19 Md. R. 1716)

Regulation .11 amended as an emergency provision effective July 1, 2001 (28:16 Md. R. 1480); amended permanently effective October 1, 2001 (28:19 Md. R. 1684)

Regulation .11 amended effective July 8, 2002 (29:13 Md. R. 990)

Regulation .11 amended as an emergency provision effective July 1, 2003 (30:15 Md. R. 990); emergency status expired December 31, 2003; March 18, 2013 (40:5 Md. R. 411)

Regulation .11 amended effective February 16, 2004 (31:3 Md. R. 207)

Regulation .11C amended effective July 1, 1993 (20:12 Md. R. 996)

Regulation .11C amended as an emergency provision effective January 6, 1994 (21:2 Md. R. 95); emergency status extended at 21:9 Md. R. 744 and 21:16 Md. R. 1379; emergency status expired August 14, 1994

Regulation .11C amended effective August 15, 1994 (21:16 Md. R. 1383); November 7, 1994 (21:22 Md. R. 1876); October 20, 1997 (24:21 Md. R. 1449); December 9, 2005 (32:24 Md. R. 1904)

Regulation .11C amended as an emergency provision effective July 1, 2007 (34:15 Md. R. 1345); emergency status extended at 35:3 Md. R. 286; emergency status expired June 24, 2008

Regulation .11C amended as an emergency provision effective April 1, 2008 (35:9 Md. R. 892); emergency status expired September 3, 2008

Regulation .11C amended effective September 22, 2008 35:19 Md. R. 1716); April 6, 2009 (36:7 Md. R. 523); December 27, 2010 (37:26 Md. R. 1787); December 12, 2013 (40:24 Md. R. 2016)

Regulation .11G amended effective August 15, 1994 (21:16 Md. R. 1383); October 20, 1997 (24:21 Md. R. 1449); December 9, 2005 (32:24 Md. R. 1904); April 5, 2010 (37:7 Md. R. 570); December 12, 2013 (40:24 Md. R. 2016)

Regulation .11U adopted effective August 15, 1994 (21:16 Md. R. 1383)

Regulation .11U adopted as an emergency provision effective April 1, 2008 (35:9 Md. R. 892; emergency status expired September 3, 2008

Regulation .11U adopted effective September 22, 2008 35:19 Md. R. 1716)

Regulation .11-1 adopted as an emergency provision effective January 6, 1994 (21:2 Md. R. 96); adopted permanently effective May 1, 1994 (21:7 Md. R. 530)

Regulation .11-1 repealed as an emergency provision effective July 1, 2003 (30:15 Md. R. 990); emergency status expired December 31, 2003

Regulation .11-1 repealed effective February 16, 2004 (31:3 Md. R. 207)

Regulations .11-1—.11-6 adopted effective January 24, 2011 (38:2 Md. R. 84)

Regulation .11-1A amended effective November 28, 2011 (38:24 Md. R. 1502)

Regulation .11-2E amended effective November 28, 2011 (38:24 Md. R. 1502)

Regulation .12A amended effective February 12, 2007 (34:3 Md. R. 297)

Regulation .13 amended effective March 19, 1990 (17:5 Md. R. 638)

Regulation .13E amended as an emergency provision effective July 1, 2001 (28:16 Md. R. 1480); amended permanently effective October 1, 2001 (28:19 Md. R. 1684)

Regulation .13I amended as an emergency provision effective January 28, 1991 (18:3 Md. R. 301); emergency status expired April 8, 1991 (18:9 Md. R. 1004)

Regulation .13I amended as an emergency provision effective April 9, 1991 (18:9 Md. R. 1005); amended permanently effective October 7, 1991 (18:18 Md. R. 2004)

Regulation .13L adopted effective August 15, 1994 (21:16 Md. R. 1383)

Regulation .13P adopted as an emergency provision effective April 1, 2008 (35:9 Md. R. 892); emergency status expired September 3, 2008

Regulation .13P adopted effective September 22, 2008 35:19 Md. R. 1716)

Regulation .14 amended effective June 6, 1994 (21:11 Md. R. 951)

Regulation .14C-1 adopted as an emergency provision effective July 1, 2001 (28:16 Md. R. 1480); adopted permanently effective October 1, 2001 (28:19 Md. R. 1684)

Regulation .14G amended effective March 19, 1990 (17:5 Md. R. 638)

Regulation .15 amended effective March 19, 1990 (17:5 Md. R. 638); October 3, 2011 (38:20 Md. R. 1202)

Regulation .15A amended effective March 17, 2003 (30:5 Md. R. 366)

Regulation .15B amended as an emergency provision effective May 1, 2004 (31:12 Md. R. 908); amended permanently effective August 16, 2004 (31:16 Md. R. 1255)

Regulation .16 amended effective February 19, 1990 (17:3 Md. R. 297); December 29, 1997 (24:26 Md. R. 1758); July 8, 2002 (29:13 Md. R. 990); March 18, 2013 (40:5 Md. R. 411)

Regulation .16D amended effective April 5, 2010 (37:7 Md. R. 570)

Regulations .16E and G, and .17J amended and .17K adopted as an emergency provision effective April 4, 1991 (18:9 Md. R. 1004); adopted permanently effective July 22, 1991 (18:14 Md. R. 1609)

Regulations .16E and G amended and .30 adopted as an emergency provision effective January 1, 1991 (18:2 Md. R. 146); emergency status expired April 8, 1991 (18:9 Md. R. 1005)

Regulation .16E amended effective September 27, 2004 (31:19 Md. R. 1432); October 14, 2013 (40:20 Md. R. 1652)

Regulation .16F amended effective March 17, 2003 (30:5 Md. R. 366)

Regulation .16F amended as an emergency provision effective July 1, 2003 (30:15 Md. R. 990); emergency status expired December 31, 2003

Regulation .16F amended effective February 16, 2004 (31:3 Md. R. 207); December 9, 2005 (32:24 Md. R. 1904); April 6, 2009 (36:7 Md. R. 523); December 27, 2010 (37:26 Md. R. 1787); November 28, 2011 (38:24 Md. R. 1502)

Regulation .16G amended effective June 3, 1996 (23:11 Md. R. 810)

Regulation .17 amended effective July 8, 2002 (29:13 Md. R. 990); May 9, 2005 (32:9 Md. R. 848); December 9, 2005 (32:24 Md. R. 1904); March 18, 2013 (40:5 Md. R. 411); December 11, 2014 (41:24 Md. R. 1427)

Regulation .17K amended and L—O adopted effective June 6, 1994 (21:11 Md. R. 951)

Regulation .18A amended effective March 18, 2013 (40:5 Md. R. 411)

Regulations .20—.23 amended as an emergency provision effective January 6, 1994 (21:2 Md. R. 96); adopted permanently effective May 1, 1994 (21:7 Md. R. 531)

Regulation .20 amended as an emergency provision effective July 1, 1998 (25:15 Md. R. 1181); amended permanently effective October 19, 1998 (25:21 Md. R. 1574)

Regulation .20 amended effective December 9, 2005 (32:24 Md. R. 1904)

Regulation .21 amended effective December 9, 2005 (32:24 Md. R. 1904)

Regulation .22 amended as an emergency provision effective April 1, 2008 (35:9 Md. R. 892); emergency status expired September 3, 2008

Regulation .22 amended effective September 22, 2008 35:19 Md. R. 1716)

Regulation .23 amended effective December 9, 2005 (32:24 Md. R. 1904)

Regulation .24A, B amended as an emergency provision effective July 1, 2003 (30:15 Md. R. 990); emergency status expired December 31, 2003

Regulation .24A, B amended effective February 16, 2004 (31:3 Md. R. 207); March 18, 2013 (40:5 Md. R. 411)

Regulation .25B amended effective August 15, 1994 (21:16 Md. R. 1383); February 16, 2004 (31:3 Md. R. 207); February 12, 2007 (34:3 Md. R. 297); March 18, 2013 (40:5 Md. R. 411)

Regulation .25C amended as an emergency provision effective July 1, 2003 (30:15 Md. R. 990); emergency status expired December 31, 2003

Regulation .27A amended effective June 6, 1994 (21:11 Md. R. 951)

Regulation .27A-1 adopted as an emergency provision effective October 16, 1995 (22:22 Md. R. 1654); adopted permanently effective January 15, 1996 (23:1 Md. R. 25)

Regulation .27C amended effective December 29, 1997 (24:26 Md. R. 1758)

Regulation .28 amended effective January 24, 2011 (38:2 Md. R. 84)

Regulation .30 adopted effective May 9, 2005 (32:9 Md. R. 848)

Chapter revised effective April 13, 2015 (42:7 Md. R. 567)

Regulation .07-1I amended effective December 19, 2016 (43:25 Md. R. 1384); January 1, 2018 (44:26 Md. R. 1214)

Regulation .07-2 amended effective February 29, 2016 (43:4 Md. R. 331)

Regulation .07-2L, M adopted effective December 19, 2016 (43:25 Md. R. 1384)

Regulation .07-2N adopted effective January 1, 2018 (44:26 Md. R. 1214)

Regulation .10-1B amended effective February 29, 2016 (43:4 Md. R. 331); December 19, 2016 (43:25 Md. R. 1384)

Regulation .11-2B amended effective December 19, 2016 (43:25 Md. R. 1384)

Regulation .11-7C amended effective December 19, 2016 (43:25 Md. R. 1384)

Regulation .11-8C amended effective December 19, 2016 (43:25 Md. R. 1384)

Regulation .12-1A, B amended effective February 29, 2016 (43:4 Md. R. 331)

Regulation .13O amended effective February 29, 2016 (43:4 Md. R. 331)

Regulation .15-1 amended effective February 29, 2016 (43:4 Md. R. 331)

Regulation .15-1D amended effective December 19, 2016 (43:25 Md. R. 1384)

Regulation .16-1G amended effective February 29, 2016 (43:4 Md. R. 331)

Regulation .16-1I adopted effective February 29, 2016 (43:4 Md. R. 331)

Regulation .25C adopted effective December 19, 2016 (43:25 Md. R. 1384)

Regulation .28B amended effective February 29, 2016 (43:4 Md. R. 331)

Chapter revised effective July 2, 2018 (45:13 Md. R. 664)

Regulation .01B amended effective June 14, 2021 (48:12 Md. R. 472)

Regulation .07 amended effective August 7, 2023 (50:15 Md. R. 681)

Regulation .07G amended effective May 20, 2019 (46:10 Md. R. 486); December 30, 2019 (46:26 Md. R. 1164); November 14, 2022 (49:23 Md. R. 995); September 16, 2024 (51:18 Md. R. 808), March 31, 2025 (52:6 Md. R. 267)

Regulation .07H, I adopted effective November 14, 2022 (49:23 Md. R. 995)

Regulation .08H amended effective May 20, 2019 (46:10 Md. R. 486); December 30, 2019 (46:26 Md. R. 1164); June 14, 2021 (48:12 Md. R. 472); November 14, 2022 (49:23 Md. R. 995); August 7, 2023 (50:15 Md. R. 681); September 16, 2024 (51:18 Md. R. 808); March 31, 2025 (52:6 Md. R. 267)

Regulation .11B amended effective May 20, 2019 (46:10 Md. R. 486)

Regulation .13A amended effective May 20, 2019 (46:10 Md. R. 486)

Regulation .15 amended effective June 14, 2021 (48:12 Md. R. 472)

Regulation .19 amended effective June 14, 2021 (48:12 Md. R. 472

Regulation .19A amended effective November 14, 2022 (49:23 Md. R. 995)

Regulation .21P adopted effective November 14, 2022 (49:23 Md. R. 995)

Regulation .22B amended effective November 14, 2022 (49:23 Md. R. 995)

Regulation .30 amended effective December 30, 2019 (46:26 Md. R. 1164)