- A. In this chapter, the following terms have the meanings indicated.
B. Terms Defined.
- (1) “CMS” means Centers for Medicare and Medicaid Services.
- (2) “Department” means the Maryland Department of Health.
- (3) “Mammography” means the radiographic examination of the soft tissues of the breast.
- (4) “Medical Assistance Program” means the program of comprehensive medical and other health-related care for indigent and medically indigent persons.
- (5) “Medically necessary” means medically necessary as defined in COMAR 10.09.36.01.
- (6) “Medicare” means the insurance program administered by the federal government under Title XVIII of the Social Security Act, 42 U.S.C. §1395 et seq.
- (7) “NPI” means National Provider Identifier.
- (8) “Program” means the Medical Assistance Program.
- (9) “Portable X-ray provider” means an entity that moves its portable X-ray equipment that is separate from and unattached to the vehicle to a fixed location (e.g. a physician’s office or nursing home).
(10) “Provider” means:
- (a) An individual, association, partnership, corporation, unincorporated group, or any other person authorized, licensed, or certified to provide services for Program recipients and who, through appropriate agreement with the Department, has been identified as a Program provider by the issuance of an individual account number;
- (b) An agent, employee, or related party of a person identified in §B(10)(a) of this regulation; or
- (c) An individual or any other person with an ownership interest in a person identified in §B(10)(a) of this regulation.
- (11) “Recipient” means an individual who is certified as eligible for, and is receiving, Medical Assistance benefits.
Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland
Effective date: April 28, 2014 (41:8 Md. R. 472)
Regulation .04A amended effective January 1, 2018 (44:26 Md. R. 1214)
Regulation .05A amended effective January 1, 2018 (44:26 Md. R. 1214)
Regulation .05K adopted effective January 1, 2018 (44:26 Md. R. 1214)
Regulation .07C, I amended effective July 4, 2016 (43:13 Md. R. 712)
Regulation .07D amended effective February 27, 2017 (44:4 Md. R. 252)
Regulation .07J adopted effective January 1, 2018 (44:26 Md. R. 1214)