1. A. Generally.

   1. (1) Payment to an MCO for each enrollee shall be at a fixed capitation rate, as specified in §B(4) of this regulation.
   2. (2) An MCO shall be reimbursed at rates set forth in this regulation only for individuals enrolled under the Maryland Medicaid Managed Care Program.
   3. (3) The capitation rate paid to an MCO by the Department shall be accepted as payment in full for all benefits provided by the MCO.
   4. (4) An MCO shall conform to the Department's computer coding requirements.
   5. (5) A capitation payment may not be made to an MCO on behalf of an enrollee for whom capitation payment for the same period has been made to any other MCO having an agreement with the Department.
   6. (6) The Department may consider a retroactive capitation payment to an MCO, if the MCO notifies the Department within 9 months of the first missed capitation payment for an enrollee for whom the MCO has not received all appropriate capitation payments.
   7. (7) Monies collected by an MCO for third party liability, as described in Regulation .18 of this chapter, are considered when calculating the capitation payments in §B(4) of this regulation.

2. B. Capitation Rate-Setting Methodology.

   1. (1) Families and Children. Capitation rates for enrollees who are waiver-eligible based upon receipt of benefits through TCA or programs for medically needy families and children, including SOBRA children and Maryland Children's Health Program (MCHP), shall be established as follows:

      1. (a) For enrollees eligible under COMAR 10.67.02.01A(1) or (3), and for children eligible under COMAR 10.67.02.01A(2) for whom the Department has sufficient clinical data, the Department shall:

         1. (i) Determine an adjusted clinical group (ACG) assignment utilizing an enrollee's past diagnostic record;
         2. (ii) Utilizing aggregated enrollee ACG data, on an annual basis define a limited number of risk adjustment categories that reflect levels of relatively homogenous resource utilization by ACG assignment; and
         3. (iii) Assign an enrollee to a risk adjustment category based upon the enrollee's ACG assignment;

      2. (b) Except as provided in §B(1)(c) of this regulation, for enrollees for whom the Department has insufficient data to generate an ACG assignment, the Department shall assign the enrollee to a risk adjustment category that reflects the enrollee's:

         1. (i) Age, residence, and gender; and
         2. (ii) Birth weight with respect to an enrollee born after December 31, 2004; and

      3. (c) On the basis of the enrollee's residence, the Department shall assign:

         1. (i) All SOBRA mothers enrolled pursuant to COMAR 10.67.02.01A(2) to one of the two “SOBRA mother” payment categories set forth in §B(4)(a) of this regulation; and
         2. (ii) Enrollees with HIV to one of the two HIV payment categories set forth in §B(4)(a) of this regulation.

   2. (2) Disabled. Capitation rates for enrollees who are waiver-eligible based upon receipt of benefits through SSI or as medically needy, aged, blind, or disabled shall be established as follows:

      1. (a) Except as provided in §B(2)(c) of this regulation, for enrollees for whom the Department has sufficient clinical data, the Department shall:

         1. (i) Determine an adjusted clinical group (ACG) assignment utilizing an enrollee's diagnostic record;
         2. (ii) Utilizing aggregated enrollee ACG data, on an annual basis define a limited number of risk adjustment categories that reflect levels of nearly homogenous resource utilization by ACG assignment; and
         3. (iii) Assign an enrollee to a risk adjustment category (RAC) based upon the enrollee's ACG assignment; and
      2. (b) Except as provided in §B(2)(c) of this regulation, for enrollees for whom the Department has insufficient data to generate an ACG assignment, the Department shall assign the enrollee to a risk adjustment category that reflects the enrollee's age, residence, and gender; and

      3. (c) On the basis of the enrollee's residence, the Department shall assign:

         1. (i) Enrollees with HIV to one of the two HIV payment categories set forth in §B(4)(b) of this regulation; and
         2. (ii) Enrollees with AIDS to one of the two AIDS payment categories set forth in §B(4)(b) of this regulation.

   3. (3) Supplemental Delivery/Newborn Payments.

      1. (a) In addition to the monthly payment specified in §B(4)(a) or (b) of this regulation for an enrollee's payment category, the Department shall pay an MCO one supplemental payment per pregnancy in the amount specified in §B(4)(c) of this regulation, upon delivery of one or more infants without regard to method, timing, or place of delivery.
      2. (b) An MCO shall have 12 months from the date of delivery to bill for the supplemental payment.

   4. (4) Except to the extent of adjustments required by §D of this regulation or by Regulations .19-1 through 19-3 of this chapter, the Department shall make payments monthly at the rates specified in the following tables:

      1. (a) Rate Table for Families and Children Effective January 1, 2020—December 31, 2020.

         	Age/RAC	Gender	PMPM Baltimore City	PMPM Montgomery County	PMPM Rest of State
         	Under age 1 Birth Weight 1500 grams or less	Both	$10,545.89	$9,424.40	$9,791.62
         	Under age 1 Birth Weight over 1500 grams	Both	$540.93	$483.41	$502.25
         	15	Male	$212.56	$189.96	$197.36
         		Female	$179.94	$160.82	$167.07
         	614	Male	$128.11	$114.49	$118.95
         		Female	$130.65	$116.76	$121.31
         	1520	Male	$156.36	$139.73	$145.18
         		Female	$200.42	$179.11	$186.09
         	2144	Male	$313.97	$244.47	$259.96
         		Female	$423.37	$329.65	$350.54
         	4564	Male	$649.86	$506.01	$538.07
         		Female	$710.21	$552.99	$588.03
         ACG-adjusted cells
         ACG 100, 200, 300, 400, 500, 600, 700, 900, 1000, 1100, 1200, 1300, 1600, 1710, 1711, 1712, 1720, 1721, 1722, 1730, 1731, 1732, 1800, 1900, 2000, 2100, 2200, 2300, 2400, 2500, 2800, 2900, 3000, 3100, 3200, 3300, 3400, 3500, 3800, 4210, 5100, 5110, 5200 5230, 5310, 5339	RAC 1F	Both	$246.88	$192.23	$204.41
         ACG 800, 1740, 1741, 1742, 1750, 2700, 3600, 1750, 1751, 1752, 2700, 3600, 3700, 3900, 4000, 4100, 4220, 4310, 4410, 4510, 4610, 4710, 4720, 4810, 5340	RAC 2F	Both	$404.93	$315.29	$335.27
         ACG 1400, 1500, 1750, 1761, 1762, 1770, 1771, 1772, 2600, 4320, 4520, 4620, 4820	RAC 3F	Both	$541.50	$421.63	$448.35
         ACG 4330, 4420, 4830, 4910, 4920, 5010, 5020, 5040	RAC 4F	Both	$765.47	$596.02	$633.79
         ACG 4430, 4730, 4930, 5030, 5050	RAC 5F	Both	$1,093.51	$851.45	$905.40
         ACG 4940, 5060	RAC 6F	Both	$1,395.82	$1,086.83	$1,155.70
         ACG 5070	RAC 7F	Both	$2,384.13	$1,856.36	$1,973.99
         ACG 100, 200, 300, 500, 600, 1100, 1600, 2000, 2400, 3400, 5100, 5110, 5200	RAC 1G	Both	$95.15	$85.03	$88.34
         ACG 400, 700, 900, 1000, 1200, 1300, 1710, 1711, 1712, 1800, 1900, 2100, 2200, 2300, 2800, 2900, 3000, 3100, 5310	RAC 2G	Both	$120.44	$107.63	$111.83
         ACG 1720, 1721, 1722, 1731, 1732, 1730, 2500, 3200, 3300, 3500, 3800, 4210, 5230, 5339	RAC 3G	Both	$155.94	$139.35	$144.78
         ACG 800, 1740, 1741, 1742, 1750, 2700, 3600, 1750, 1751, 1752, 2700, 3600, 3700, 3900, 4000, 4100, 4220, 4310, 4410, 4510, 4610, 4710, 4720, 4810, 5340	RAC 4G	Both	$216.35	$193.34	$200.87
         ACG 1400, 1500, 1750, 1761, 1762, 1770, 1771, 1772, 2600, 4320, 4520, 4620, 4820	RAC 5G	Both	$333.86	$298.36	$309.98
         ACG 4330, 4420, 4830, 4910, 4920, 5010, 5020, 5040	RAC 6G	Both	$412.16	$368.33	$382.68
         ACG 4430, 4730, 4930,4940, 5030, 5050, 5060, 5070	RAC 7G	Both	$1,171.43	$1,046.85	$1,087.64
         SOBRA Mothers			$782.58	$609.35	$647.96
         Persons with HIV	ALL	Both	$2,468.70	$2,468.70	$2,468.70

      2. (b) Rate Table for Disabled Individuals Effective January 1, 2020— December 31, 2020.

         	Age/RAC	Gender	PMPM Baltimore City	PMPM Montgomery County	PMPM Rest of State
         	Under Age 1	Both	$8,185.50	$8,185.50	$8,185.50
         	15	Male	$1,118.79	$1,118.79	$1,118.79
         		Female	$1,494.58	$1,494.58	$1,494.58
         	614	Male	$250.31	$250.31	$250.31
         		Female	$489.01	$489.01	$489.01
         	1520	Male	$257.52	$257.72	$257.52
         		Female	$315.55	$315.55	$315.55
         	2144	Male	$837.74	$685.54	$717.57
         		Female	$829.48	$678.78	$710.49
         	4564	Male	$2,287.81	$1,872.16	$959.63
         	4564	Female	$2,675.35	$2,189.29	$2,291.58
         ACG-adjusted cells
         ACG 100, 200, 300, 1100, 1300, 1400, 1500, 1600, 1710, 1711, 1712, 1720, 1721, 1722, 1730, 1731, 1732, 1900, 2400, 2600, 2900, 3400, 5100, 5110, 5200, 5310	RAC 10	Both	$327.55	$268.04	$280.57
         ACG 400, 500, 700, 900, 1000, 1200, 1740, 1741, 1742, 1750, 1751, 1752 1800, 2000, 2100, 2200, 2300, 2500, 2700, 2800, 3000, 3100, 3200, 3300, 3500, 3900, 4000, 4310, 5330	RAC 11	Both	$354.27	$289.90	$303.45
         ACG 600, 1760, 1761, 1762, 3600, 3700, 4100, 4320, 4410, 4710, 4810, 4820	RAC 12	Both	$691.31	$565.71	$592.15
         ACG 3800, 4210, 4220, 4330, 4420, 4720, 4910, 5320	RAC 13	Both	$810.19	$662.99	$693.97
         ACG 800, 4430, 4510, 4610, 5040, 5340	RAC 14	Both	$1,071.43	$876.77	$917.74
         ACG 1770, 1771, 1772, 4520, 4620, 4830, 4920, 5050	RAC 15	Both	$1,487.90	$1,217.58	$1,274.74
         ACG 4730, 4930, 5010	RAC 16	Both	$1,510.41	$1,235.99	$1,293.74
         ACG 4940, 5020, 5060	RAC 17	Both	$2,208.93	$1,807.61	$1,892.07
         ACG 5030, 5070	RAC 18	Both	$4,013.13	$3,284.02	$3,437.46
         Persons with AIDS	All	Both	$4,968.09	$3,504.83	$3,504.83
         Persons with HIV	All	Both	$4,255.37	$4,255.37	$4,255.37

      3. (c) Rate Table for Supplemental Payments for Delivery/Newborn and Hepatitis C Therapy Effective January 1, 2020 December 31, 2020.

         	Age/RAC	Gender	PMPM Baltimore City	PMPM Montgomery County	PMPM Rest of State
         Supplemental Payment Cells
         Delivery/Newborn-all births except live birth weight 1,500 grams or less and gestational age of 21 weeks or more	All	Both	$17,039.19	$13,490.76	$14,736.04
         Delivery/Newborn - live birth weight 1,500 grams or less and a gestational age of 21 weeks or more	All	Both	$86,856.32	$86,856.32	$86,856.32
         Delivery/Newborn by same enrollee - subsequent live birth weight 1,500 grams or less with a gestational age less than 21 weeks or does not meet the requirements in §B(4)(i) of this regulation	All	Both	$17,039.19	$13,490.76	$14,736.04
         Hepatitis C Therapy	All	Both	$15,662.46	$15,662.46	$15,662.46

      4. (d) Rate Table for Childless Adult Population Effective January 1, 2020—December 31, 2020.

         	Age/RAC	Gender	PMPM Baltimore City	PMPM Montgomery County	PMPM Rest of State
         	1944	Male	$389.33	$295.91	$342.16
         	1944	Female	$476.88	$361.99	$418.56
         	4564	Male	$1,069.91	$812.15	$939.07
         	4564	Female	$1,039.04	$788.71	$911.97
         ACG-adjusted cells
         ACG 100, 200, 300, 400, 500, 600, 700, 900, 1000, 1100, 1200, 1300, 1600, 1710, 1711, 1712, 1720, 1721, 1722, 1730, 1731, 1732, 1800, 1900, 2000, 2100, 2200, 2300, 2400, 2500, 2800, 2900, 3000, 3100, 3200, 3300, 3400, 3500, 3800, 4210, 5100, 5110, 5200 5230, 5310, 5339	RAC 1H	Both	$282.42	$247.88	$280.81
         ACG 800, 1740, 1741, 1742, 1750, 2700, 3600, 1750, 1751, 1752, 2700, 3600, 3700, 3900, 4000, 4100, 4220, 4310, 4410, 4510, 4610, 4710, 4720, 4810, 5340	RAC 2H	Both	$471.76	$414.07	$422.55
         ACG 1400, 1500, 1750, 1761, 1762, 1770, 1771, 1772, 2600, 4320, 4520, 4620, 4820	RAC 3H	Both	$489.23	$429.40	$439.99
         ACG 4330, 4420, 4830, 4910, 4920, 5010, 5020, 5040	RAC 4H	Both	$899.28	$789.30	$763.22
         ACG 4430, 4730, 4930, 5030, 5050	RAC 5H	Both	$1,155.28	$1,014.00	$955.15
         ACG 4940, 5060	RAC 6H	Both	$1,639.97	$1,439.41	$1,234.70
         ACG 5070	RAC 7H	Both	$2,477.09	$1,880.29	$2,174.15
         HIV	1964	Both	$2,991.40	$2,991.40	$2,991.40

      5. (e) Rate Table for Families and Children Effective January 1, 2021—December 31, 2021.

         	Age/RAC	Gender	PMPM Baltimore City	PMPM Montgomery County	PMPM Rest of State
         	Under age 1 Birth Weight 1500 grams or less	Both	$10,801.56	$10,084.05	$10,367.99
         	Under age 1 Birth Weight over 1500 grams	Both	$531.06	$498.78	$509.74
         	15	Male	$213.82	$199.61	$205.23
         		Female	$176.22	$164.52	$169.15
         	614	Male	$112.91	$105.41	$108.37
         		Female	$106.03	$98.98	$101.77
         	1520	Male	$188.76	$176.22	$181.18
         		Female	$185.28	$172.97	$177.84
         	2144	Male	$296.27	$238.54	$256.08
         		Female	$410.17	$330.24	$354.54
         	4564	Male	$727.80	$585.98	$629.09
         		Female	$681.00	$548.30	$588.63
         ACG-adjusted cells
         ACG 100, 200, 300, 400, 500, 600, 700, 900, 1000, 1100, 1200, 1300, 1400, 1500 1600, 1710, 1711, 1712, 1720, 1721, 1722, 1730, 1731, 1732, 1741, 1800, 1900, 2000, 2100, 2200, 2300, 2400, 2500, 2600, 2700, 2800, 2900, 3000, 3100, 3200, 3300, 3900, 3400, 3500, 3800, 4210, 4610, 5100, 5110, 5200 5230, 5310, 5339	RAC 1F	Both	$207.12	$166.76	$179.03
         ACG 800, 1740, 1741, 1742, 1750, 2700, 3600, 1732, 1750, 1751, 1752, 1761, 2700, 3200, 3300, 3600, 3700, 3900, 4000, 4100, 4220, 4310, 4320, 4410, 4510, 4610, 4620, 4710, 4720, 4810, 5010, 5340	RAC 2F	Both	$373.28	$300.54	$322.65
         ACG 1400, 1500, 1750, 1761, 1762, 1770, 1771, 1772, 2600, 4320, 4330, 4520, 4620, 4730, 4810, 4820,4910, 5020	RAC 3F	Both	$571.66	$494.12	$460.27
         ACG 0800, 1772, 4330, 4420, 4830, 4910, 4920, 5010, 5020, 5040	RAC 4F	Both	$735.65	$592.31	$635.87
         ACG 4430, 4730, 4920, 4930, 5030, 5050	RAC 5F	Both	$1,044.18	$840.70	$902.55
         ACG 4940, 5030,5060	RAC 6F	Both	$1,428.81	$1,150.40	$1,235.01
         ACG 5070	RAC 7F	Both	$2,469.99	$1,988.70	$2,134.97
         ACG 100, 200, 300, 500, 600, 0400, 0900, 1100, 1300, 1600, 2000, 2400, 3400, 3900, 4000, 4100, 5100, 5110, 5200	RAC 1G	Both	$78.17	$72.97	$75.03
         ACG 400, 700, 900, 0100, 1000, 1200, 1300, 1400, 1500, 1710, 1711, 1712, 1800, 1900, 2000, 2100, 2200, 2300, 2400, 2500, 2600, 2800, 2900, 3000, 3100, 3400, 3500, 5310, 5321	RAC 2G	Both	$109.00	$101.76	$104.63
         ACG 1200, 1711, 1712, 1720, 1721, 1722, 1731, 1732, 1730, 2500, 2700, 2900, 3200, 3300, 3500, 3600, 3700, 3800, 4210, 5230, 5311, 5339	RAC 3G	Both	$152.99	$142.83	$146.85
         ACG 800, 1721, 1722, 1740, 1741, 1742, 1750, 1751, 1752, 2700, 3600, 3700, 3900, 4000, 4100, 4220, 4310, 4410, 4510, 4520, 4610, 4710, 4720, 4810, 4332, 5340	RAC 4G	Both	$221.94	$207.20	$213.03
         ACG 1400, 1500,1731, 1732, 1741, 1750, 1751, 1761, 1762, 1770, 1771, 1772, 2600, 4320, 4520, 4620, 4820, 5010	RAC 5G	Both	$381.05	$355.74	$365.76
         ACG 0800, 1771, 1772, 4330, 4420, 4830, 4910, 4920, 5010, 5020, 5040	RAC 6G	Both	$443.16	$413.72	$425.37
         ACG 4430, 4730, 4930,4940, 5030, 5050, 5060, 5070	RAC 7G	Both	$1,167.92	$1,090.34	$1,121.04
         SOBRA Mothers			$756.99	$609.48	$654.31
         Persons with HIV	ALL	Both	$2,772.07	$2,772.07	$2,772.07

      6. (f) Rate Table for Disabled Individuals Effective January 1, 2021—December 31, 2021.

         	Age/RAC	Gender	PMPM Baltimore City	PMPM Montgomery County	PMPM Rest of State
         	Under Age 1	Both	$7,421.87	$7,421.87	$7,421.87
         	15	Male	$2,326.06	$2,326.06	$2,326.06
         		Female	$919.92	$919.92	$919.92
         	614	Male	$185.04	$185.04	$185.04
         		Female	$336.06	$336.06	$336.06
         	1520	Male	$158.42	$158.42	$158.42
         		Female	$277.79	$277.79	$277.79
         	2144	Male	$721.14	$592.87	$649.45
         		Female	$789.07	$648.18	$710.04
         	4564	Male	$2,317.01	$1,903.30	$2,084.95
         	4564	Female	$2,708.00	$2,224.47	$2,436.77
         ACG-adjusted cells
         ACG 100, 200, 300, 0500, 0600, 0700, 1000, 1100, 1200, 1300, 1400, 1500, 1600, 1710, 1711, 1712, 1720, 1721, 1722, 1730, 1731, 1732, 1741, 1900, 2000, 2100, 2200, 2400, 2500, 2600, 2700, 2900, 3400, 3500, 3800, 5100, 5110, 5200, 5310, 5331	RAC 10	Both	$244.87	$201.15	$220.35
         ACG 400, 500, 700, 900, 0300, 1000, 1400, 1200, 1712, 1732, 1740, 1741, 1742, 1750, 1751, 1752 1800, 1900, 2000, 2100, 2200, 2300, 2500, 2700, 2800, 3000, 3100, 3200, 3300, 3500, 3700, 3900, 4000, 4210, 4310, 4510, 4610, 4710, 5312, 5330	RAC 11	Both	$324.66	$266.89	$292.14
         ACG 600, 0100, 1721, 1751, 1752, 1760, 1761, 1762, 2900, 3600, 3700, 4100, 4220, 4320, 4330, 4410, 4710, 4720, 4810, 4820, 5010, 5322	RAC 12	Both	$575.63	$472.85	$517.98
         ACG 3800, 4100, 4210, 4220, 4330, 4410, 4420, 4520, 4620, 4720, 4730, 4820, 4910, 5020, 5320	RAC 13	Both	$815.35	$699.76	$733.69
         ACG 800, 1771, 4420, 4430, 4510, 4610, 4830, 4910, 5040, 5332, 5340	RAC 14	Both	$1,152.30	$946.55	$1,036.89
         ACG 1770, 1771, 1772, 4430, 4520, 4620, 4830, 4920, 5050	RAC 15	Both	$1,527.61	$1,254.85	$1,374.61
         ACG 0800, 4730, 4930, 5010, 5050	RAC 16	Both	$1,483.61	$1,465.14	$1,604.97
         ACG 4940, 5020, 5060	RAC 17	Both	$2,371.86	$1,948.35	$2,134.30
         ACG 5030, 5070, 5342	RAC 18	Both	$3,991.27	$3,278.61	$3,591.52
         Persons with AIDS	All	Both	$5,003.30	$3,607.01	$3,607.01
         Persons with HIV	All	Both	$4,554.33	$4,554.33	$4,554.33

      7. (g) Rate Table for Supplemental Payments for Delivery/Newborn and Hepatitis C Therapy Effective January 1, 2021—December 31, 2021.

         	Age/RAC	Gender	PMPM Baltimore City	PMPM Montgomery County	PMPM Rest of State
         Supplemental Payment Cells
         Delivery/Newborn-all births except live birth weight 1,500 grams or less and gestational age of 21 weeks or more	All	Both	$17,278.93	$12,566.25	$14,733.72
         Delivery/Newborn - live birth weight 1,500 grams or less and a gestational age of 21 weeks or more	All	Both	$93,700.08	$93,700.08	$93,700.08
         Delivery/Newborn by same enrollee - subsequent live birth weight 1,500 grams or less with a gestational age less than 21 weeks or does not meet the requirements in §B(4)(i) of this regulation	All	Both	$17,278.93	$12,566.25	$14,733.72

      8. (h) Rate Table for Childless Adult Population Effective January 1, 2021—December 31, 2021.

         	Age/RAC	Gender	PMPM Baltimore City	PMPM Montgomery County	PMPM Rest of State
         	1944	Male	$405.20	$315.63	$346.25
         	1944	Female	$484.26	$377.21	$413.81
         	4564	Male	$1,142.43	$889.88	$976.21
         	4564	Female	$1,144.65	$891.61	$978.11
         ACG-adjusted cells
         ACG 100, 200, 300, 400, 500, 600, 700, 900, 1000, 1100, 1200, 1300, 1500, 1600, 1710, 1711, 1712, 1720, 1721, 1722, 1730, 1731, 1732, 1741, 1742, 1752, 1800, 1900, 2000, 2100, 2200, 2300, 2400, 2500, 2700, 2800, 2900, 3000, 3100, 3200, 3300, 3400, 3500, 3800, 3900, 4000, 4210, 4310, 4510, 4710, 5100, 5110, 5200, 5230, 5310, 5339	RAC 1H	Both	$248.20	$193.33	$212.09
         ACG 800, 0900, 1000, 1400, 1731, 1740, 1741, 1742, 1750, 1761, 1762, 2300, 2600, 2700, 3600, 1750, 1751, 1752, 2700, 3600, 3700, 3900, 4000, 4100, 4220, 4310, 4320, 4410, 4510, 4610, 4710, 4720, 4810, 4820, 5340	RAC 2H	Both	$454.46	$353.99	$388.34
         ACG 1400, 1500, 1711, 1750, 1761, 1762, 1770, 1771, 1772, 2600, 4100, 4320, 4330, 4410, 4520, 4620, 4730, 4820, 5010, 5020	RAC 3H	Both	$583.20	$454.27	$498.34
         ACG 0800, 1751, 1772, 4330, 4420, 4830, 4910, 4920, 5010, 5020, 5040	RAC 4H	Both	$863.24	$672.41	$737.65
         ACG 4430, 4730, 4920, 4930, 5030, 5050	RAC 5H	Both	$1,249.46	$973.25	$1,067.68
         ACG 4930, 4940, 5060	RAC 6H	Both	$1,680.86	$1,309.28	$1,436.31
         ACG 5070	RAC 7H	Both	$2,579.16	$2,009.00	$2,203.91
         HIV	1964	Both	$3,135.78	$3,135.78	$3,135.78

      9. (i) Interpretation of Rate Table for Families and Children. The table found at §B(4)(a) of this regulation shows capitation rates for individuals who are:

         1. (i) Waiver eligible based on receipt of benefits through TCA or programs for medically needy families and children;
         2. (ii) SOBRA children;
         3. (iii) SOBRA mothers; and
         4. (iv) The Maryland Children's Health Program.
      10. (j) Interpretation of Rate Table for Disabled Individuals. The table found at §B(4)(b) of this regulation shows the capitation rates for individuals who are waiver-eligible based upon receipt of benefits through SSI or as medically needy, aged, blind, or disabled.
      11. (k) Interpretation of Rate Table for Supplemental Payment for Delivery/Newborn. The table found at §B(4)(c) of this regulation shows a supplemental payment made in connection with deliveries of MCO enrollees, regardless of the enrollee's payment category under COMAR 10.67.04.19B(4)(a) or (b).
      12. (l) Interpretation of Rate Tables in §B(4) of this regulation. “PMPM” means the per member per month payment rate.
   5. (5) Consistent with the terms set forth in Regulation .19-4 of this chapter, the Department may, in consultation with the Commissioner, adjust the capitation payment of an MCO if it determines that the MCO's loss ratio, not including any rebate received by the MCO is less than 85 percent.

3. C. The Department shall reimburse fee-for-service:

   1. (1) The Departmental share for any enrollee participating in the Stop Loss Program pursuant to Regulation .22 of this chapter; and
   2. (2) The cost of those services specified in COMAR 10.09.69.06.13 provided to the participant that have been authorized by the participant's case manager in accordance with the participant's plan of care.

4. D. Interim Rates Adjustments.

   1. (1) Under the circumstances described in §D(2) and (3) of this regulation, the Department shall adjust the capitation rates set forth in §B(4)(a), (b), (e), and (f) of this regulation to reflect changes in service costs during the contract year due to an occurrence listed in §D(2) of this regulation.

   2. (2) The Department shall adjust the payment rates specified in §B(4)(a)(h) of this regulation to reflect service cost changes that qualify under §D(3) of this regulation and result from:

      1. (a) An addition or deletion of services covered under the HealthChoice benefits package;
      2. (b) An increase or decrease in Medicaid fee-for-service payment rates or copayments, if the MCOs are obligated to adjust their payment rates to providers as a result of those fee-for-service rate changes;
      3. (c) An increase or decrease in the inpatient charge per case as calculated by the change in the restated unit cost provided annually by the HSCRC as compared to the data originally provided; or
      4. (d) An increase or decrease in the outpatient charge per visit as calculated by the change in the restated unit cost provided annually by the HSCRC as compared to the data originally provided.

   3. (3) The Department shall make an interim rates adjustment if the effect of an occurrence listed in §D(2) of this regulation is sufficient to result in program-wide overpayment or underpayment of at least 0.2 percent because of the difference between:

      1. (a) Service cost projections used to develop the rates set forth in §B(4)(a), (b), (e), and (f) of this regulation; and
      2. (b) Service costs for the same period, taking into account an occurrence that is listed in §D(2) of this regulation.
   4. (4) The Department shall make any interim rate adjustments required by this section in amounts that are proportionate to the overpayments or underpayments described in §D(3) of this regulation.
   5. (5) Provider rate adjustments as specified in §D(2)(b) of this regulation may not require the MCOs to pay providers more than the Medicaid fee-for-service rate.
   6. (6) The Department shall make supplemental payments to an MCO that reflect increases in MCO provider payments for trauma services described in COMAR 10.25.10.
   7. (7) The Department shall make an interim rates adjustment in Calendar Years 2022, 2023, 2024, and 2025 to account for changes in acuity due to alterations in redetermination and enrollment processes related to COVID-19.

5. E. Interim Rate Adjustment for Calendar Year 2025.

   1. (1) The Department shall re-open the capitation rates for interim rate adjustments in Calendar Year 2025 to revisit the following adjustments:

      1. (a) Risk adjustment;
      2. (b) Trend;
      3. (c) Administration;
      4. (d) Regional factors; and
      5. (e) Relational modeling.
   2. (2) To assist with the assessment, MCOs shall provide additional information to the Department upon request, including detailed claims data as well as a year-to-date HealthChoice Financial Monitoring Report for the calendar year.

Authority: Health-General Article, §§2-104, 15-101, 15-102.3, and 15-103; Insurance Article, §§15-112, 15-605, and 15-1008; Annotated Code of Maryland

Effective date:

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

Regulations .01—.23 adopted effective March 10, 1997 (24:5 Md. R. 408)

Regulation .01 amended as an emergency provision effective July 1, 2002 (29:15 Md. R. 1139); amended permanently effective October 28, 2002 (29:21 Md. R. 1645)

Regulations .02C, .04C, .08, .11, .15, .17A, .18, .20B, and .22C amended and Regulation .11-1 adopted as an emergency provision effective July 1, 1997 (24:16 Md. R. 1151); emergency status expired December 31, 1997

Regulation .02 amended effective February 9, 1998 (25:3 Md. R. 144); November 1, 1999 (26:22 Md. R. 1692); February 18, 2002 (29:3 Md. R.220)

Regulation .02 amended as an emergency provision effective July 1, 2002 (29:15 Md. R. 1139); amended permanently effective October 28, 2002 (29:21 Md. R. 1645)

Regulation .02 amended effective December 23, 2002 (29:25 Md. R. 1981)

Regulation .02G amended as an emergency provision effective July 1, 1998 (25:16 Md. R. 1261); adopted permanently effective January 1, 1999 (25:26 Md. R. 1925)

Regulation .02G and H amended as an emergency provision effective July 1, 2003 (30:21 Md. R. 1527); amended permanently effective November 10, 2003 (30:22 Md. R. 1580)

Regulation .03P amended as an emergency provision effective July 1, 1998 (25:16 Md. R. 1261); adopted permanently effective January 1, 1999 (25:26 Md. R. 1925)

Regulation .03T adopted effective February 18, 2002 (29:3 Md. R.220)

Regulation .03 repealed and new Regulation .03 adopted effective December 23, 2002 (29:25 Md. R. 1981)

Regulation .04C amended effective February 9, 1998 (25:3 Md. R. 144)

Regulation .05 amended as an emergency provision effective July 1, 1998 (25:16 Md. R. 1261); adopted permanently effective January 1, 1999 (25:26 Md. R. 1925)

Regulation .05 amended as an emergency provision effective July 1, 2002 (29:15 Md. R. 1139); amended permanently effective October 28, 2002 (29:21 Md. R. 1645)

Regulation .05K amended effective December 23, 2002 (29:25 Md. R. 1981)

Regulation .08 amended effective February 9, 1998 (25:3 Md. R. 144)

Regulation .08 amended as an emergency provision effective July 1, 1998 (25:16 Md. R. 1261); adopted permanently effective January 1, 1999 (25:26 Md. R. 1925)

Regulation .10B amended effective February 18, 2002 (29:3 Md. R.220)

Regulation .11 amended effective February 9, 1998 (25:3 Md. R. 144)

Regulation .11 amended as an emergency provision effective July 1, 1998 (25:16 Md. R. 1261); adopted permanently effective January 1, 1999 (25:26 Md. R. 1925)

Regulation .11 amended as an emergency provision effective July 1, 2000 (27:15 Md. R. 1397); amended permanently effective October 16, 2000 (27:20 Md. 1838)

Regulation .11 amended effective February 18, 2002 (29:3 Md. R.220); December 23, 2002 (29:25 Md. R. 1981)

Regulation .11-1 and .11-2 adopted February 9, 1998 (25:3 Md. R. 144)

Regulation .11-1 and .11-2E amended as an emergency provision effective July 1, 1998 (25:16 Md. R. 1261); adopted permanently effective January 1, 1999 (25:26 Md. R. 1925)

Regulations .11-1 and .11-2 amended as an emergency provision effective July 1, 2000 (27:15 Md. R. 1397); amended permanently effective October 16, 2000 (27:20 Md. R. 1838)

Regulation .15 amended effective February 9, 1998 (25:3 Md. R. 144); December 25, 2000 (27:25 Md. R. 2281); February 18, 2002 (29:3 Md. R.220)

Regulation .15B amended as an emergency provision effective July 1, 1998 (25:16 Md. R. 1261); adopted permanently effective January 1, 1999 (25:26 Md. R. 1925)

Regulation .15D, E amended as an emergency provision effective July 1, 2002 (29:15 Md. R. 1139); amended permanently effective October 28, 2002 (29:21 Md. R. 1645)

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

Regulation .17A amended effective February 9, 1998 (25:3 Md. R. 144); December 23, 2002 (29:25 Md. R. 1981)

Regulation .17B amended effective February 18, 2002 (29:3 Md. R.220)

Regulation .18 amended effective February 9, 1998 (25:3 Md. R. 144)

Regulation .18-1 adopted as an emergency provision effective April 7, 1998 (25:9 Md. R. 676); adopted permanently effective June 29, 1998 (25:13 Md. R. 993)

Regulation .18-1 amended effective December 25, 2000 (27:25 Md. R.2281)

Regulation .18-1C adopted effective November 1, 1999 (26:22 Md. R. 1692)

Regulation .19 amended as an emergency provision effective July 1, 1998 (25:16 Md. R. 1261); emergency status extended at 26:1 Md. R. 17, 26:6 Md. R. 480, and 26:8 Md. R. 614; emergency status expired May 1, 1999

Regulation .19 amended as an emergency provision effective May 1, 1999 (26:9 Md. R. 727 and 26:10 Md. R. 794); emergency status expired November 1, 1999

Regulation .19 amended effective November 1, 1999 (26:22 Md. R. 1692)

Regulation .19 amended as an emergency provision effective December 1, 1999 (26:25 Md. R. 1888); emergency status expired December 25, 2000

Regulation .19 amended effective December 25, 2000 (27:25 Md. R.2281)

Regulation .19 amended effective December 23, 2002 (29:25 Md. R. 1981)

Regulation .19A amended as an emergency provision effective March 31, 2001 (28:7 Md. R. 685); emergency status extended at 28:22 Md. R. 1931 and 29:4 Md. R. 413

Regulation .19B amended effective December 24, 2001 (28:25 Md. R. 2190)

Regulation .19B amended as an emergency provision effective July 1, 2002 (29:15 Md. R. 1139); amended permanently effective October 28, 2002 (29:21 Md. R. 1645)

Regulation .19D amended as an emergency provision effective July 1, 2003 (30:21 Md. R. 1527); amended permanently effective November 10, 2003 (30:22 Md. R. 1580)

Regulations .19-1—.19-3 adopted as an emergency provision effective December 1, 1999 (26:25 Md. R. 1888); emergency status expired December 25, 2000

Regulations .19-1—.19-4 adopted effective December 25, 2000 (27:25 Md. R. 2281)

Regulations .19-1 and .19-2 repealed and new Regulation .19-1 adopted effective December 24, 2001 (28:25 Md. R. 2190)

Regulation .19-1 repealed as an emergency provision effective July 1, 2003 (30:21 Md. R. 1527); repealed permanently effective November 10, 2003 (30:22 Md. R. 1580)

Regulations .19-3 and .19-4 amended and recodified to be new Regulations .19-2 and .19-3 effective December 24, 2001 (28:25 Md. R. 2190)

Regulation .19-3 amended as an emergency provision effective July 1, 2002 (29:15 Md. R. 1139); amended permanently effective October 28, 2002 (29:21 Md. R. 1645)

Regulation .19-3 amended effective December 23, 2002 (29:25 Md. R. 1981)

Regulation .19-4 adopted effective December 23, 2002 (29:25 Md. R. 1981)

Regulations .19-5 and.19-6 adopted as an emergency provision effective March 31, 2001 (28:7 Md. R. 685); emergency status extended at 28:22 Md. R. 1931; emergency status extended at 29:4 Md. R. 413

Regulation .20 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 .20 amended as an emergency provision effective July 1, 2003 (30:21 Md. R. 1527); amended permanently effective November 10, 2003 (30:22 Md. R. 1580)

Regulation .20A amended effective December 23, 2002 (29:25 Md. R. 1981)

Regulation .20B amended effective February 9, 1998 (25:3 Md. R. 144)

Regulation .21 amended effective December 25, 2000 (27:25 Md. R. 2281); December 24, 2001 (28:25 Md. R. 2190); July 7, 2003 (30:13 Md. R. 854)

Regulation .22 amended as an emergency provision effective May 1, 1999 (26:9 Md. R. 727 and 26:10 Md. R. 794); emergency status expired November 1, 1999

Regulation .22 amended as an emergency provision effective December 1, 1999 (26:25 Md. R. 1888); emergency status expired December 25, 2000

Regulation .22 amended as an emergency provision effective December 1, 2000 (27:26 Md. R. 2355); emergency status extended at 28:7 Md. R. 685; adopted permanently effective June 25, 2001 (28:12 Md. R. 1109)

Regulation .22 amended effective December 24, 2001 (28:25 Md. R. 2190)

Regulation .22A amended and F—J adopted effective November 1, 1999 (26:22 Md. R. 1692)

Regulation .22C amended effective February 9, 1998 (25:3 Md. R. 144)

Regulations .24 and .25 adopted as an emergency provision effective July 1, 1998 (25:16 Md. R. 1261); adopted permanently effective January 1, 1999 (25:26 Md. R. 1925)

Regulation .24 amended as an emergency provision effective December 1, 1999 (26:25 Md. R. 1888); emergency status expired December 25, 2000

Regulation .24 amended effective December 25, 2000 (27:25 Md. R.2281); December 23, 2002 (29:25 Md. R. 1981)

Regulation .24-1 adopted as an emergency provision effective December 1, 1999 (26:25 Md. R. 1888); emergency status expired December 31, 2000

Regulation .26 adopted effective February 18, 2002 (29:3 Md. R. 220)

Regulation .27 adopted effective February 18, 2002 (29:3 Md. R. 220)

Chapter revised effective February 2, 2004 (31:2 Md. R. 82)

Regulation .01 repealed effective February 16, 2015 (42:3 Md. R. 316)

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

Regulation .02 amended effective June 30, 2008 (35:13 Md. R. 1180); April 28, 2014 (41:8 Md. R. 471); February 16, 2015 (42:3 Md. R. 316); February 26, 2018 (45:4 Md. R. 205)

Regulation .02G amended as an emergency provision effective January 5, 2005 (32:6 Md. R. 634); amended permanently effective April 11, 2005 (32:7 Md. R. 679)

Regulation .02G, J, X amended effective November 7, 2016 (43:22 Md. R. 1221)

Regulation .02K amended effective December 24, 2012 (39:25 Md. R. 1613)

Regulation .02O, S 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)

Regulation .02V amended effective December 27, 2010 (37:26 Md. R. 1787)

Regulation .02Z adopted effective November 5, 2007 (34:22 Md. R. 1977)

Regulation .02CC amended effective October 5, 2009 (36:20 Md. R. 1528); March 14, 2016 (43:5 Md. R. 385)

Regulation .02DD adopted effective February 6, 2012 (39:2 Md. R. 141)

Regulation .02EE adopted effective December 24, 2012 (39:25 Md. R. 1613)

Regulation .02K, L amended effective October 28, 2013 (40:21 Md. R. 1775)

Regulation .02FF adopted effective October 28, 2013 (40:21 Md. R. 1775)

Regulation .03 amended effective February 12, 2018 (45:3 Md. R. 156)

Regulation .03A, B amended effective October 26, 2015 (42:21 Md. R. 1301)

Regulation .03B amended effective December 19, 2005 (32:25 Md. R. 1941); April 9, 2007 (34:7 Md. R. 698); November 5, 2007 (34:22 Md. R. 1977); June 30, 2008 (35:13 Md. R. 1180)

Regulation .03B 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)

Regulation .03B amended effective October 5, 2009 (36:20 Md. R. 1528); April 19, 2010 (37:8 Md. R. 615); December 27, 2010 (37:26 Md. R. 1787); February 6, 2012 (39:2 Md. R. 141); December 24, 2012 (39:25 Md. R. 1613); December 12, 2013 (40:24 Md. R. 2017); August 29, 2016 (43:17 Md. R. 955); November 7, 2016 (43:22 Md. R. 1221); December 31, 2018 (45:26 Md. R. 1245)

Regulation .04B amended effective April 10, 2006 (33:7 Md. R. 668); February 16, 2015 (42:3 Md. R. 316)

Regulation .04C amended effective June 30, 2008 (35:13 Md. R. 1180); February 26, 2018 (45:4 Md. R. 205)

Regulation .05I 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)

Regulation .05G amended effective February 16, 2015 (42:3 Md. R. 316)

Regulation .05K amended effective December 31, 2018 (45:26 Md. R. 1244)

Regulation .06C amended effective November 6, 2006 (33:22 Md. R. 1732)

Regulation .08 amended effective April 28, 2014 (41:8 Md. R. 471)

Regulation .08C, E amended effective February 16, 2015 (42:3 Md. R. 316)

Regulation .08I amended effective December 24, 2012 (39:25 Md. R. 1613)

Regulation .08K amended effective April 10, 2006 (33:7 Md. R. 668)

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

Regulation .10C amended effective November 6, 2006 (33:22 Md. R. 1732)

Regulation .10D amended effective April 10, 2006 (33:7 Md. R. 668)

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

Regulation .10F amended as an emergency provision effective January 5, 2005 (32:6 Md. R. 634); amended permanently effective April 11, 2005 (32:7 Md. R. 679)

Regulation .11 repealed effective February 16, 2015 (42:3 Md. R. 316)

Regulation .11E amended effective October 5, 2009 (36:20 Md. R. 1528)

Regulation .11F amended effective April 19, 2010 (37:8 Md. R. 615)

Regulation .11G 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)

Regulation .11-1 repealed effective February 16, 2015 (42:3 Md. R. 316)

Regulation .11-2 repealed effective February 16, 2015 (42:3 Md. R. 316)

Regulation .12B amended effective February 16, 2015 (42:3 Md. R. 316)

Regulation .12D repealed effective December 31, 2018 (45:26 Md. R. 1244)

Regulation .13F amended effective February 6, 2012 (39:2 Md. R. 141)

Regulation .14 amended effective February 16, 2015 (42:3 Md. R. 316)

Regulation .14A amended effective November 6, 2006 (33:22 Md. R. 1732)

Regulation .15 amended effective February 16, 2015 (42:3 Md. R. 316); February 26, 2018 (45:4 Md. R. 205); December 31, 2018 (45:26 Md. R. 1244)

Regulation .15B 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)

Regulation .15C amended effective April 9, 2007 (34:7 Md. R. 698)

Regulation .15D amended effective June 30, 2008 (35:13 Md. R. 1180)

Regulation .15E amended effective December 19, 2005 (32:25 Md. R. 1941); April 19, 2010 (37:8 Md. R. 615)

Regulation .15F amended effective April 10, 2006 (33:7 Md. R. 668)

Regulation .15L adopted effective June 30, 2008 (35:13 Md. R. 1180)

Regulation .16 repealed effective November 5, 2007 (34:22 Md. R. 1977)

Regulation .17 amended effective February 26, 2018 (45:4 Md. R. 205)

Regulation .17A amended effective November 6, 2006 (33:22 Md. R. 1732); June 30, 2008 (35:13 Md. R. 1180); February 6, 2012 (39:2 Md. R. 141)

Regulation .17B amended effective April 10, 2006 (33:7 Md. R. 668); June 30, 2008 (35:13 Md. R. 1180); October 5, 2009 (36:20 Md. R. 1528); February 1, 2016 (42:23 Md. R. 1434)

Regulation .18H amended effective November 5, 2007 (34:22 Md. R. 1977)

Regulation .18I, J adopted effective February 6, 2012 (39:2 Md. R. 141)

Regulation .19 amended as an emergency provision effective January 5, 2005 (32:6 Md. R. 634)

Regulation .19 amended as an emergency provision effective April 1, 2005 (32:9 Md. R. 847); amended permanently effective July 18, 2005 (32:14 Md. R. 1276)

Regulation .19 amended effective April 15, 2013 (40:7 Md. R. 611)

Regulation .19A, B amended as an emergency provision effective January 1, 2008 (35:3 Md. R. 286); amended permanently effective June 16, 2008 (35:12 Md. R. 1120)

Regulation .19A amended effective February 26, 2018 (45:4 Md. R. 205)

Regulation .19B amended effective December 20, 2004 (31:25 Md. R.1790); December 19, 2005 (32:25 Md. R. 1941); April 10, 2006 (33:7 Md. R. 669)

Regulation .19B amended as an emergency provision effective July 1, 2006 (33:20 Md. R. 1610); amended permanently effective October 23, 2006 (33:21 Md. R. 1675)

Regulation .19B amended as an emergency provision effective January 1, 2007 (34:4 Md. R. 396); amended permanently effective April 9, 2007 (34:7 Md. R. 699)

Regulation .19B amended as an emergency provision effective September 14, 2007 (34:21 Md. R. 1911); amended permanently effective November 19, 2007 (34:23 Md. R. 2027)

Regulation .19B amended effective January 12, 2009 (36:1 Md. R. 21); July 27, 2009 (36:15 Md. R. 1166); January 25, 2010 (37:2 Md. R. 67); June 14, 2010 (37:12 Md. R. 800); December 27, 2010 (37:26 Md. R. 1788); April 4, 2011 (37:8 Md. R. 431); April 30, 2012 (39:8 Md. R. 534); December 10, 2012 (39:24 Md. R. 1577); July 7, 2014 (41:13 Md. R. 752); February 16, 2015 (42:3 Md. R. 316); October 26, 2015 (42:21 Md. R. 1301); May 9, 2016 (43:9 Md. R. 530); February 27, 2017 (44:4 Md. R. 253); March 26, 2018 (45:6 Md. R. 319); August 26, 2019 (46:17 Md. R. 726)

Regulation .19D amended as an emergency provision effective February 11, 2004 (31:5 Md. R. 446); amended permanently effective May 24, 2004 (31:10 Md. R. 795)

Regulation .19D amended effective June 14, 2010 (37:12 Md. R. 800); October 26, 2015 (42:21 Md. R. 1301); February 27, 2017 (44:4 Md. R. 253); March 26, 2018 (45:6 Md. R. 319)

Regulation .19-1 adopted as an emergency provision effective January 5, 2005 (32:6 Md. R. 634); adopted permanently effective April 11, 2005 (32:7 Md. R. 679)

Regulation .19-3 amended as an emergency provision effective January 5, 2005 (32:6 Md. R. 634); amended permanently effective April 11, 2005 (32:7 Md. R. 679)

Regulation .19-3 amended effective June 19, 2006 (33:12 Md. R. 997); April 9, 2007 (34:7 Md. R. 698); June 14, 2010 (37:12 Md. R. 800); April 30, 2012 (39:8 Md. R. 534)

Regulation .19-3 repealed effective October 28, 2013 (40:21 Md. R. 1775)

Regulation .19-3 adopted effective April 28, 2014 (41:8 Md. R. 471)

Regulation .19-3A, B 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)

Regulation .19-3A, B amended effective October 5, 2009 (36:20 Md. R. 1528)

Regulation .19-3B amended effective December 24, 2012 (39:25 Md. R. 1613); February 3, 2014 (41:2 Md. R. 91)

Regulation .19-3C amended effective February 27, 2017 (44:4 Md. R. 253)

Regulation .19-3C, D amended effective October 26, 2015 (42:21 Md. R. 1301)

Regulation .19-5 adopted effective December 19, 2005 (32:25 Md. R. 1941)

Regulation .19-5 repealed and new Regulation .19-5 adopted effective December 31, 2018 (45:26 Md. R. 1244)

Regulation .19-5F amended effective February 16, 2015 (42:3 Md. R. 316)

Regulation .19-5G amended effective April 19, 2010 (37:8 Md. R. 615)

Regulation .19-5H amended effective April 19, 2010 (37:8 Md. R. 615); February 16, 2015 (42:3 Md. R. 316)

Regulation .20 amended effective August 8, 2011 (38:16 Md. R. 945); February 26, 2018 (45:4 Md. R. 205)

Regulation .20A amended as an emergency provision effective January 5, 2005 (32:6 Md. R. 634); amended permanently effective April 11, 2005 (32:7 Md. R. 679)

Regulation .20A amended effective April 10, 2006 (33:7 Md. R. 668); November 5, 2007 (34:22 Md. R. 1977); December 24, 2012 (39:25 Md. R. 1613); October 28, 2013 (40:21 Md. R. 1775); February 16, 2015 (42:3 Md. R. 316)

Regulation .20A, B amended effective November 6, 2006 (33:22 Md. R. 1732); April 19, 2010 (37:8 Md. R. 615)

Regulation .20A, D amended effective April 28, 2014 (41:8 Md. R. 471)

Regulation .20B, C amended effective June 30, 2008 (35:13 Md. R. 1180)

Regulation .20C 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)

Regulation .20E adopted effective August 29, 2016 (43:17 Md. R. 955)

Regulation .21 amended as an emergency provision effective January 5, 2005 (32:6 Md. R. 634); amended permanently effective April 11, 2005 (32:7 Md. R. 679)

Regulation .21 amended effective February 16, 2015 (42:3 Md. R. 316)

Regulation .21B amended effective June 19, 2006 (33:12 Md. R. 997); April 19, 2010 (37:8 Md. R. 615)

Regulation .22 amended as an emergency provision effective January 5, 2005 (32:6 Md. R. 634); amended permanently effective April 11, 2005 (32:7 Md. R. 679)

Regulation .22C, D amended effective November 6, 2006 (33:22 Md. R. 1732)

Regulation .23 amended effective June 30, 2008 (35:13 Md. R. 1180)

Regulation .23C amended effective November 7, 2016 (43:22 Md. R. 1221)

Regulation .23D 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)

Regulation .23D amended effective April 28, 2014 (41:8 Md. R. 471)

Regulation .24 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)

Regulation .24 repealed effective April 19, 2010 (37:8 Md. R. 615)

Regulation .25B amended effective November 6, 2006 (33:22 Md. R. 1732)

Regulation .28 adopted effective June 30, 2008 (35:13 Md. R. 1180)

Regulation .28 amended effective February 6, 2012 (39:2 Md. R. 141)

Regulation .28 repealed effective February 26, 2018 (45:4 Md. R. 205)

Chapter transferred from COMAR 10.09.65 effective November 1, 2019 (46:22 Md. R. 977)

Regulation .03B amended effective April 19, 2021 (48:8 Md. R. 309)

Regulation .15D amended effective May 18, 2020 (47:10 Md. R. 515)

Regulation .25B amended effective May 18, 2020 (47:10 Md. R. 515)

Regulation .27C amended effective May 18, 2020 (47:10 Md. R. 515)

Chapter revised effective October 18, 2021 (48:21 Md. R. 889)

Regulation .03-1 repealed and new Regulation .03-1 adopted effective June 24, 2024 (51:12 Md. R. 620)

Regulation .03-2B amended effective June 24, 2024 (51:12 Md. R. 620)

Regulation .03-2L adopted effective June 24, 2024 (51:12 Md. R. 620)

Regulation .03-2L repealed and new Regulation .03-2 adopted effective April 28, 2025 (52:8 Md. R. 359)

Regulation .03-2M adopted effective April 28, 2025 (52:8 Md. R. 359)

Regulation .15E amended effective June 24, 2024 (51:12 Md. R. 620)

Regulation .17B amended effective June 13, 2022 (49:12 Md. R. 641)

Regulation .18K adopted effective April 28, 2025 (52:8 Md. R. 359)

Regulation .19 amended effective April 4, 2022 (49:7 Md. R. 468)

Regulation .19B, D amended effective June 24, 2024 (51:12 Md. R. 620)

Regulation .19D amended effective April 28, 2025 (52:8 Md. R. 359)

Regulation .19E adopted effective April 28, 2025 (52:8 Md. R. 359)

Regulation .19-4A amended effective June 24, 2024 (51:12 Md. R. 620)

Regulation .19-4M, N amended effective June 13, 2022 (49:12 Md. R. 641)

Regulation .20A, C amended effective June 24, 2024 (51:12 Md. R. 618)