1. A. A provider shall meet all conditions for participation as set forth in COMAR 10.09.36.03.

2. B. To participate in the Program as a special psychiatric hospital services provider, the provider shall:

   1. (1) Meet the requirements of Title XIX of the Social Security Act for participation as a hospital, as issued by the Department of Health and Human Services;

   2. (2) Meet the following staffing requirements 24 hours per day, 7 days per week:

      1. (a) On-call or on-site physician services including psychiatric physicians;
      2. (b) On-site registered nurses;
      3. (c) On-site advanced cardiac life support services;

   3. (3) If licensed to provide inpatient psychiatric services for individuals younger than 21 years old:

      1. (a) Meet the requirements for participation as defined in 42 CFR §440.160; and
      2. (b) Provide acute psychiatric services as defined in 42 CFR Part 441, Subpart D;
   4. (4) Directly provide or make available through contractual arrangements or transfer agreements, medically necessary covered services;
   5. (5) Accept payment by the Program as payment in full for the covered service;
   6. (6) Make available to the Department or its designee the participant’s medical record for review and certification of medical necessity for admission and continuation of stay;

   7. (7) Maintain documentation of each contact with the participant as part of the medical record, which, at a minimum, includes:

      1. (a) Date of service;
      2. (b) A plan of treatment as defined in Regulation .01B of this chapter;
      3. (c) The participant’s chief medical complaint or reason for visit;

      4. (d) A description of the services provided, including:

         1. (i) Progress notes;
         2. (ii) Imaging studies;
         3. (iii) Laboratory results;
         4. (iv) Medication administration records; and
         5. (v) Discharge summary; and
      5. (e) A signature, electronic or handwritten, along with the printed or typed name of the individual providing care, with the appropriate title;
   8. (8) Submit to the Department or its designee within 5 months of the close of the hospital’s fiscal year, as required by the Department, a hospital cost report for outpatient services which are subject to cost settlement in accordance with Regulation .11 of this chapter;

3. C. If an out-of-State or District of Columbia hospital, the special psychiatric hospital shall:

   1. (1) Unless a waiver has been granted by the Secretary of Health and Human Services, have in effect a utilization review plan applicable to all participants who receive Medical Assistance under Title XVII of the Social Security Act which meets the requirements of §1861(k) of the Social Security Act; and
   2. (2) Comply with applicable regulations of this chapter and COMAR 10.09.36.

Authority: Health-General Article, §§2-104(b), 15-102.8, 15-103, and 15-105, Annotated Code of Maryland

Effective date: April 10, 2017 (44:7 Md. R. 354)

Regulation .05B amended effective September 9, 2019 (46:18 Md. R. 774); May 1, 2023 (50:8 Md. R. 338)

Regulation .07A amended effective December 31, 2018 (45:26 Md. R. 1245)