An MCO applicant shall include in its application the following information or descriptions:

1. A. A narrative description of the clinical expertise and experience of the MCO's network for special needs populations in a format specified by the Department;
2. B. Written evidence of the applicant's ability to comply with specific quality access, data, and performance measurements to satisfy the general requirements for all special needs populations specified in COMAR 10.67.04.04;

3. C. Written evidence, including treatment protocols, of the applicant’s ability to provide the range of clinical and support services specified in COMAR 10.67.04.05—.10 and .13, to ensure appropriate and coordinated services to the following special populations:

   1. (1) Children with special health care needs;
   2. (2) Individuals with a physical disability;
   3. (3) Individuals with a developmental disability;
   4. (4) Pregnant and postpartum women;
   5. (5) Individuals who are homeless; and
   6. (6) Individuals with HIV/AIDS; and
4. D. Referral protocols that demonstrate the conditions under which PCPs will make the arrangements for children with special health care needs to be referred to MCO specialty care networks and when appropriate the behavioral health ASO for services as described in COMAR 10.09.59 or 10.09.80.

Authority: Health-General Article §§15-102 and 15-103, Annotated Code of Maryland

Effective date:

Regulations .01—.11 adopted as an emergency provision effective November 8, 1996 (23:25 Md. R. 1730)

Regulations .01—.11 adopted effective March 10, 1997 (24:5 Md. R. 408)

Regulation .01 repealed effective December 27, 2010 (37:26 Md. R. 1787)

Regulation .02C repealed effective April 16, 2012 (39:7 Md. R. 492)

Regulation .03F, G amended effective December 23, 2002 (29:25 Md. R. 1981)

Regulation .03H amended effective February 2, 2004 (31:2 Md. R. 82)

Regulation .03T amended effective February 26, 2018 (45:4 Md. R. 205)

Regulation .04 amended effective June 30, 2008 (35:13 Md. R. 1180)

Regulation .04F amended effective December 23, 2002 (29:25 Md. R. 1981)

Regulation .05 amended effective October 28, 2013 (40:21 Md. R. 1775); February 16, 2015 (42:3 Md. R. 316); February 1, 2016 (42:23 Md. R. 1434)

Regulation .05A amended effective December 27, 2010 (37:26 Md. R. 1787); December 31, 2018 (45:26 Md. R. 1244)

Regulation .06 amended as an emergency provision effective July 1, 1998 (25:16 Md. R. 1261); amended permanently effective January 1, 1999 (25:26 Md. R. 1925)

Regulation .06 amended effective June 30, 2008 (35:13 Md. R. 1180)

Regulation .06E amended effective October 28, 2013 (40:21 Md. R. 1775)

Regulation .06G amended effective February 16, 2015 (42:3 Md. R. 316)

Regulation .07A amended effective December 23, 2002 (29:25 Md. R. 1981)

Regulation .07E amended effective February 16, 2015 (42:3 Md. R. 316)

Regulation .08 repealed effective April 19, 2010 (37:8 Md. R. 615)

Regulation .08 adopted effective December 24, 2012 (39:25 Md. R. 1612)

Regulation .09 amended effective April 19, 2010 (37:8 Md. R. 615); December 27, 2010 (37:26 Md. R. 1787)

Regulation .09G amended effective October 5, 2009 (36:20 Md. R. 1528)

Regulation .09K amended effective December 23, 2002 (29:25 Md. R. 1981)

Regulation .10C, D amended effective February 16, 2015 (42:3 Md. R. 316)

Regulation .11 amended effective February 26, 2018 (45:4 Md. R. 205)

Regulation .11C amended as an emergency provision effective November 1, 2008 (35:24 Md. R. 2069); amended permanently effective February 23, 2009 (36:4 Md. R. 353)

Chapter transferred from COMAR 10.09.64 effective November 1, 2019 (46:22 Md. R. 977)

Regulation .03I amended effective April 28, 2025 (52:8 Md. R. 359)