1. A. Cause for suspension or removal and imposition of sanctions for providers shall be in accordance with COMAR 10.09.36.

2. B. If the Department determines that a provider has failed to accurately assess the rehabilitative, cognitive, behavioral, and functional abilities and deficits, or medical service needs of an applicant or consumer, and to accurately convey such an assessment to the Department for purposes of obtaining an authorization to provide medical day care services, the Department shall:

   1. (1) Suspend all eligibility decisions based upon assessments submitted by the provider until such time as the provider's assessment is validated by an independent assessment conducted by the Department's utilization control agent or the Department's designee; and
   2. (2) Conduct remedial training of provider staff in accurately assessing rehabilitative, cognitive, behavioral, and functional abilities and deficits, or medical service needs, and in accurately conveying such assessments to the Department or its designee for purposes of establishing medical eligibility for medical day care service.

Authority: Health-General Article, §§2-104(b), 15-103, and 15-111, Annotated Code of Maryland

Effective date:

Regulations .01—.12 adopted as an emergency provision effective July 1, 2008 (35:17 Md. R. 1482); adopted permanently effective October 6, 2008 (35:20 Md. R. 1775)

Regulation .01B amended effective February 15, 2016 (43:3 Md. R. 273); May 20, 2019 (46:10 Md. R. 485)

Regulation .03 amended effective May 20, 2019 (46:10 Md. R. 485)

Regulation .03B amended effective February 15, 2016 (43:3 Md. R. 273)

Regulation .06B amended effective May 20, 2019 (46:10 Md. R. 485)