Md. Code Regs. 10.22.17.09

Current through Register Vol. 51, No. 20, October 4, 2024

Section 10.22.17.09 - Supplemental Services

A. The Administration may preauthorize supplemental services.

B. Supplemental services do not include any services that are in the State Medical Assistance Plan and can be provided to an individual and reimbursed under the Medical Assistance Program, or any services covered by private insurance or federal and State funded health programs.

C. Supplemental services include:

(1) Household furnishings and equipment, normally funded once per individual;

(2) Transportation equipment and expenses;

(3) Assistive technology;

(4) Medical equipment;

(5) Structural modifications for accessibility; and

(6) Other services as preauthorized by the Administration that directly benefit the individual.

D. Procedures for Requesting Authorization of Supplemental Services. On forms approved by the Administration, the provider shall submit documentation that justifies the:

(1) Request for supplemental services, and includes:

(a) Recommendations from the individual's team;

(b) Documentation from appropriate individuals; and

(c) Any other information required by the Administration; and

(2) Basis of the proposed costs, such as:

(a) Bids from vendors;

(b) Advertisements or invoices from retail or wholesale outlets selling goods and services to the general public; and

(c) Rates of a proposed vendor.

E. Administration Approval of Supplemental Services. In deciding whether to preauthorize a supplemental service, the Administration shall:

(1) Consider the documentation submitted by the provider in §D of this regulation that identifies the needs of the individual;

(2) Consider the proposed cost for the supplemental service and the availability of State funds;

(3) If appropriate, visit the individual in the setting where the service is to be provided; and

(4) Review the provider's efforts to meet the individual's needs with existing resources available at the site.

Md. Code Regs. 10.22.17.09