Issue Date: November 13, 2015
Volume 42 • Issue 23• Pages 1448—1449
DEPARTMENT OF HEALTH AND MENTAL HYGIENE
Subtitle 09 MEDICAL CARE PROGRAMS
10.09.23 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services
Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland
Notice of Proposed Action
The Secretary of Health and Mental Hygiene proposes to amend Regulation .07 under COMAR 10.09.23 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services.
Statement of Purpose
The purpose of this action is to update the per diem rate for participants receiving services in an Intermediate Care Facility for substance use disorder treatment.
Comparison to Federal Standards
There is no corresponding federal standard to this proposed action.
Estimate of Economic Impact
The proposed action has no economic impact.
Economic Impact on Small Businesses
The proposed action has minimal or no economic impact on small businesses.
Impact on Individuals with Disabilities
The proposed action has no impact on individuals with disabilities.
Opportunity for Public Comment
Comments may be sent to Michele Phinney, Director, Office of Regulation and Policy Coordination, Department of Health and Mental Hygiene, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to firstname.lastname@example.org, or fax to 410-767-6483. Comments will be accepted through December 14, 2015. A public hearing has not been scheduled.
.07 Payment Procedures.
A.—C. (text unchanged)
D. Reimbursement of Medically Monitored Intensive Inpatient Treatment Services Provided in an Intermediate Care Facility.
(1) (text unchanged)
(2) The Department shall pay the intermediate care facility the lower of the provider’s usual and customary charge or the provider’s per diem costs for covered services according to the principles established under Title XVIII of the Social Security Act, up to a maximum of [$350] $400 per day. [The average increase in the Department’s reimbursement to the provider per inpatient day for each fiscal year over the cost-settled rate for the previous fiscal year may not exceed the rate of increase of the Hospital Wage and Price Index plus 1 percentage point, described in 42 CFR §413.40, as amended. The target rate percentage increase for each calendar year shall equal the prospectively estimated increase in the Hospital Wage and Price Index (market basket index) for each calendar year, plus 1 percentage point. Since the cost reporting period spans portions of 2 calendar years, the Program shall calculate an appropriate prorated percentage rate based on the published calendar year percentage rates.] The $400 per day maximum payment will be updated annually by the Centers for Medicare and Medicaid Service’s published federal fiscal year market basket increase percentage relating to hospitals excluded from the prospective payment system.
(3)—(4) (text unchanged)
E.—F. (text unchanged)
VAN T. MITCHELL
Secretary of Health and Mental Hygiene