Proposed Action on Regulations
Title 08
DEPARTMENT OF NATURAL RESOURCES
Subtitle 18 BOATING—SPEED LIMITS AND
OPERATION OF VESSELS
08.18.26 Susquehanna River
Authority: Natural Resources Article, §§8-703 and 8-704, Annotated
Code of Maryland
Notice of Proposed Action
[22-285-P]
The Secretary of Natural Resources proposes to amend Regulation .06 under COMAR 08.18.26 Susquehanna River.
Statement of Purpose
The purpose of this action is to expand the existing speed zone
area both north and south in the Susquehanna River at Havre de Grace located
within Harford County. The current regulated area has a 6-knot speed limit zone
effective on Saturdays, Sunday, and State holidays during the boating season.
However, due to unsafe vessel activities in the area the Department is
extending those restrictions. This will mitigate demonstrated safety concerns
to both life and property. Additionally, the new regulated speed zone area will
promote safe vessel operations. The expanded area will have a 6-knot speed
limit zone effective on Saturdays, Sunday, and State holidays during the
boating season, consistent with the rule in the current speed zone.
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
Susquehanna River Regulations, Regulatory Staff, Department of Natural Resources
Fishing and Boating Services, 580 Taylor Avenue, E-4, Annapolis, MD 21401, or
call 410-260-8300, or email to boatingregspubliccomment.dnr@maryland.gov.
Comments will be accepted through February 13, 2023. A public hearing has not
been scheduled.
.06 Havre de Grace.
[Havre de Grace encompasses all of the area enclosed by a
line beginning at the Alliance Street sea wall, at or near Lat. 39° 32.502'N.,
Long. 76° 5.037' W., then running 90° (True) to a point, at or near Lat. 39°
32.502'N., Long. 76° 4.888' W., then running 355° (True) to a point, at or near
Lat. 39° 32.742'N., Long. 76° 4.913' W., then running 338° (True) to a point,
at or near Lat. 39° 32.870'N., Long. 76° 4.980' W., then running 272° (True) to
a point, at or near Lat. 39° 32.873'N., Long. 76° 5.128' W. This area has a
6-knot speed limit on Saturdays, Sundays, and State holidays during the boating
season.]
A. Area. All of the waters enclosed by a line beginning at a point
at or near Lat. 39° 32.262' N., Long. 76° 5.541' W., then running 176° to a
point, at or near Lat. 39° 32.113' N., Long. 76° 5.526' W., then running along
the North shore of Tydings Island Eastward to a point, at or near Lat. 39° 32.193'
N., Long. 76° 5.31' W., then running 93° to a point, at or near Lat. 39°
32.177' N., Long. 76° 4.902' W., then running 2° to a point, at or near Lat.
39° 32.502' N., Long. 76° 4.888' W., then running 355° to a point, at or near
Lat. 39° 32.742' N., Long. 76° 4.913' W., then running 338° to a point, at or
near Lat. 39° 32.87' N., Long. 76° 4.98' W., then running 328° to a point, at
or near Lat. 39° 33.226' N., Long. 76° 5.273' W., then running 252° to a point,
at or near Lat. 39° 33.185' N., Long. 76° 5.438' W., then running South along
shore to the point of beginning.
B. The speed limit for the area described in §A of this
regulation is 6 knots on Saturdays, Sundays, and State holidays during the
boating season.
JEANNIE HADDAWAY-RICCIO
Secretary of Natural Resources
Title 09
MARYLAND DEPARTMENT OF LABOR
Subtitle 12 DIVISION OF LABOR AND
INDUSTRY
09.12.81 Elevator, Escalator,
and Chairlift Safety
Authority: Public Safety Article, §§12-805, 12-806, and 12-809,
Annotated Code of Maryland
Notice of Proposed Action
[22-275-P-I]
The Commissioner of Labor and Industry proposes to amend
Regulation .02 under COMAR 09.12.81 Elevator, Escalator, and
Chairlift Safety.
Statement of Purpose
The purpose of this action is to amend the incorporation by
reference of ASME 18.1, Safety Standard for Platform Lifts and Stairway
Chairlifts to include ASME 18.1-2020, Safety Standard for Platform Lifts and
Stairway Chairlifts. These national consensus standards regulate the platform
lift and stairway lift industry. These updated consensus standards reflect
changes to the industry such as technological innovations and safety
applications.
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 Mischelle F Vanreusel, Acting Deputy
Commissioner, Division of Labor and Industry, 10946 Golden West Drive, Suite
160, or call 4107672225, or email to mischelle.vanreusel@maryland.gov. Comments
will be accepted through February 13, 2023. A public hearing has not been
scheduled.
Editor’s Note on Incorporation by Reference
Pursuant to State Government
Article, §7-207, Annotated Code of Maryland, ASME A18.1-2020 (Revision of ASME
A18.1-2017) Safety Standard for Platform Lifts and Stairway Chairlifts has been
declared a document generally available to the public and appropriate for
incorporation by reference. For this reason, it will not be printed in the
Maryland Register or the Code of Maryland Regulations (COMAR). Copies of this
document are filed in special public depositories located throughout the State.
A list of these depositories can be found on page 7 of this issue of the
Maryland Register, and is available online at www.dsd.state.md.us. The document
may also be inspected at the office of the Division of State Documents, 16
Francis Street, Annapolis, Maryland 21401.
.02 Safety Standard for Platform Lifts and Stairway Chairlifts.
A. Scope.
(1)—(11) (text unchanged)
(12) ASME A18.1-2020
(Revision of ASME A18.1-2017) Safety Standard for Platform Lifts and Stairway
Chairlifts is incorporated by reference.
B.—F. (text unchanged)
MATTHEW S.
HELMINIAK
Commissioner Labor and Industry
Title 10
MARYLAND DEPARTMENT OF HEALTH
Subtitle 09 MEDICAL CARE PROGRAMS
10.09.02 Physicians’ Services
Authority: Health-General Article, §§2-104(b), 15-103, and 15-105,
Annotated Code of Maryland
Notice of Proposed Action
[22-323-P-I]
The Secretary of Health proposes to amend Regulations .01, .03—.05, .07—.09, and .11 under COMAR 10.09.02 Physicians’ Services.
Statement of Purpose
The purpose of this action is to:
(1) Update the Maryland Medical Assistance Program Professional
Service Provider Manual and Fee Schedule incorporated by reference;
(2) Allow services rendered via telehealth to be reimbursed in
compliance with COMAR 10.09.49 and remove limitations on the reimbursement of
services rendered by telephone in accordance with S.B. 3, Acts of 2021;
(3) Clarify the services for which a provider may be reimbursed up
to acquisition costs;
(4) Allow physicians to be reimbursed for visits solely for the
purpose of administering certain vaccines;
(5) Change the outdated term “recipient” to be “participant”; and
(6) Correct a reference in Regulation .09 to the provider
participation criteria in Regulation .03.
Estimate of Economic Impact
I. Summary of Economic Impact. The proposed action
increases reimbursement rates for covered Evaluation and Management codes to
100 percent of Medicare rates beginning July 1, 2022. The estimated economic
impact is $11,944,936 in FY 2023.
|
II. Types of Economic
Impact.
|
Revenue
(R+/R-)
Expenditure
(E+/E-)
|
Magnitude
|
|
A. On Issuing agency:
|
|
|
|
Maryland Department of Health
|
(E+)
|
$11,944,936
|
|
B. On other state agencies:
|
NONE
|
|
|
C. On local governments:
|
NONE
|
|
|
|
Benefit (+)
Cost (-)
|
Magnitude
|
|
D. On regulated industries or
trade groups:
|
|
|
|
Maryland Medicaid providers
|
(+)
|
$11,944,936
|
|
E. On other industries or
trade groups:
|
NONE
|
|
|
F. Direct and indirect
effects on public:
|
NONE
|
|
III. Assumptions. (Identified by Impact Letter and Number
from Section II.)
A and D. This amount assumes:
(1) For dates of service beginning July 1, 2022, Maryland Medical
Assistance reimbursement rates for covered Evaluation and Management codes will
increase to 100 percent of Medicare rates.
(2) This amount is subject to a 65.29 percent federal match
($7,798,849 federal and $4,146,087 general funds). It does not reflect the
enhanced FMAP for non-ACA expansion participants due to the public health
emergency.
Economic Impact on Small Businesses
The proposed action has a meaningful economic impact on small
businesses. An analysis of this economic impact follows:
Maryland Medicaid providers who qualify as small businesses and
render evaluation and management services will incur a portion of the
collective benefit of increased reimbursement rates.
Impact on Individuals with Disabilities
The proposed action has no impact on individuals with
disabilities.
Opportunity for Public Comment
Comments may be sent to Jourdan Green, Director, Office of
Regulation and Policy Coordination, Maryland Department of Health, 201 West
Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499, or email
to mdh.regs@maryland.gov. Comments will be accepted through February 13, 2023.
A public hearing has not been scheduled.
Editor’s Note on Incorporation by Reference
Pursuant to State Government
Article, §7-207, Annotated Code of Maryland, the 2022 Maryland Medical
Assistance Program Professional Services Provider Manual Effective July 2022
has been declared a document generally available to the public and appropriate
for incorporation by reference. For this reason, it will not be printed in the
Maryland Register or the Code of Maryland Regulations (COMAR). Copies of this
document are filed in special public depositories located throughout the State.
A list of these depositories can be found on page 7 of this issue of the
Maryland Register, and is available online at www.dsd.state.md.us. The document
may also be inspected at the office of the Division of State Documents, 16
Francis Street, Annapolis, Maryland 21401.
.01 Definitions.
A. (text unchanged)
B. Terms Defined.
(1)—(15) (text unchanged)
(16) “Participant” means an individual who is certified as
eligible for, and is receiving, Medical Assistance benefits.
[(16)] (17)—[(23)] (24) (text unchanged)
[(24) “Recipient” means
a person who is certified as eligible for, and is receiving, Medical Assistance
benefits.]
(25)—(27) (text unchanged)
.03 Conditions for Participation.
A. General requirements for participation in the Program are that a
provider shall [meet all conditions
for participation as set forth in COMAR 10.09.36.03.]:
(1) Meet all the conditions for participation as set forth in
COMAR 10.09.36; and
(2) If delivering services via telehealth, comply with COMAR
10.09.49 and any subregulatory guidance issued by the Department.
B. Specific requirements for participation in the Program as a
physicians’ services provider require that the provider:
(1) (text unchanged)
(2) May not place a restriction on a [recipient’s] participant’s right to select providers
of his or her choice;
(3) May not knowingly employ or contract with a person,
partnership, or corporation which has been disqualified from the Program to
provide or supply services to Medical Assistance [recipients] participants unless prior written
approval has been received from the Department;
(4)—(7) (text unchanged)
.04 Covered Services.
The Program covers the following medically necessary services
rendered to [recipients] participants:
A. Physicians’ services rendered in the physician’s office, the [recipient’s] participant’s home, a
hospital, a skilled or intermediate care nursing facility, a freestanding
clinic, or elsewhere when these services are:
(1) (text unchanged)
(2) Clearly related to the [recipient’s] participant’s
individual medical needs as diagnostic, curative, palliative, or rehabilitative
services;
(3) Adequately described in the [recipient’s] participant’s medical record;
B.—F. (text unchanged)
G. Abortions performed in accordance with the Health-General
Article, Title 20, Subtitles 1 and 2, Annotated Code of Maryland; [upon
certification by the physician performing the procedure that the procedure is
necessary, based upon the physician’s professional judgment, and that one of
the following conditions exists:
(1) If continuation of pregnancy is likely to result in the death
of the woman;
(2) If the woman is a victim of rape, sexual offense, or incest
which has been reported to a law enforcement agency or a public health or
social agency;
(3) If it can be ascertained by the physician within a reasonable
degree of medical certainty that the fetus is affected by genetic defect or
serious deformity or abnormality;
(4) If it can be ascertained by the physician within a reasonable
degree of medical certainty that termination of the pregnancy is medically
necessary because there is substantial risk that continuation of the pregnancy
could have a serious and adverse effect on the woman’s present or future
physical health;
(5) That there exists medical evidence that continuation of the
pregnancy is creating a serious effect on the woman’s present mental health and
if carried to term there is substantial risk of a serious or long lasting
effect on the woman’s future mental health;]
H. (text unchanged)
I. Vaccine administrations when the
vaccines [are]:
(1) Meet the following
conditions for coverage under the Vaccines for Children Program:
[(1)] (a)
(text unchanged)
[(2)] (b)
Administered to [recipients] participants
eligible for the Vaccines for Children program; and
[(3)] (c)
Administered by providers eligible to be reimbursed for vaccine administration
under the Vaccines for Children program[.]; or
(2) Are supplied to
providers by the federal government at no charge, including but not limited to
the administration of COVID-19 vaccinations.
.05 Limitations.
A. Services which are not covered are:
(1)—(8) (text unchanged)
(9) Immunizations required
solely for travel outside the continental United States;
(10) [Injections]
Injectable medications, and visits solely for the administration of [injections]
injectable medications, unless medical necessity and the patient’s
inability to take appropriate oral medications are documented in the patient’s
medical records;
(11) Vaccine
administration unless covered under Regulation .04 of this chapter;
[(11)]
(12)—[(17)] (18) (text unchanged)
[(18)] (19) Services which do not
involve direct [(face-to-face)] patient contact;
[(19)] (20)
(text unchanged)
[(20)] (21) Prescriptions for drugs
written on prescription pads that do not prevent copying, modification, or
counterfeiting; [and]
[(21)] (22) Physician-administered drugs from manufacturers that do
not participate in the Federal Drug Rebate Program[.]; and
(21) Any covered service that requires a preauthorization,
including physician-administered drugs and injectable medications, that is
rendered without an approved preauthorization from the Program.
B.—H. (text unchanged)
I. Services not rendered in-person shall comply with the
telehealth requirements established in COMAR 10.09.49 and any other
subregulatory guidance issued by the Department.
.07 Payment Procedures.
A.—B. (text unchanged)
C. [The] Except as provided in §F of this
regulation, the Provider shall charge the Program the provider’s customary
charge to the general public for similar services[, except for
injectable drugs, the provision of diagnostic or therapeutic radiopharmaceuticals,
and dispensed medical supplies, in which case, the provider shall charge the
Program the provider’s acquisition cost]. If the service is free to
individuals not covered by Medicaid:
(1)—(2) (text unchanged)
D. The Maryland Medical Assistance Program’s procedures for payment
are contained in the following documents, the provisions of which are
incorporated by reference:
(1) The Professional Services Provider Manual and Fee Schedule
(Effective [January 2020] July
2022); and
(2) (text unchanged)
E. Except as provided in §F of this regulation, [The]
the Department will pay for covered services at the lesser of:
(1)—(2) (text unchanged)
F. The Program shall reimburse providers up to the acquisition
cost for diagnostic and therapeutic radiopharmaceuticals, contraceptive
products and devices, and injectable medications when the provider submits
documentation indicating that the acquisition cost of the product, device, or
drug is greater than the reimbursement allowed in §E of this regulation.
[F.] G.—[H.] I. (text
unchanged)
[I.] J. The provider may not bill the
Department or the [recipient] participant
for:
(1)—(2) (text unchanged)
(3) Professional services rendered by mail [or telephone]; or
(4) Providing a copy of a [recipient’s] participant’s
medical record when requested by another licensed provider on behalf of the [recipient] participant.
[J.] K. The Program will make no direct
payment to [recipients] participants.
[K.] L. (text unchanged)
[L. The program will reimburse the provider for injectable
drugs at rates promulgated by the fee schedule under §D of this regulation.]
M.—P. (text
unchanged)
[Q. The Program will reimburse the provider for the
provision of diagnostic and therapeutic radiopharmaceuticals at actual cost.]
.08 Recovery and Reimbursement.
A. If the [recipient] participant
has insurance or other coverage, or if any other person is obligated, either
legally or contractually, to pay for, or to reimburse the [recipient] participant for, services covered by
this chapter, the provider shall seek payment from that source first. If an
insurance carrier rejects the claim or pays less than the amount allowed by the
Medical Assistance Program, the provider may submit a claim to the Program. The
provider shall submit a copy of the insurance carrier’s notice or remittance
advice with the invoice. If payment is made by both the Program and the
insurance or other source for the same service, the provider shall refund to
the Department, within 60 days of receipt, the amount paid by the Program or
the insurance or other source, whichever is less.
B. (text unchanged)
.09 Cause for Suspension or Removal and Imposition of Sanctions.
A.—D. (text unchanged)
E. A provider who voluntarily withdraws from the Program, or is
removed or suspended from the Program according to this regulation, shall
notify [recipients] participants,
before rendering additional services, that the provider no longer honors
Medical Assistance cards.
F. If the Department determines that a provider participating in
the Program as a case manager has violated any provision of the agreement
executed under the terms of Regulation [.03A(2)] .03B of
this chapter, the Program may suspend or disqualify the provider from
participating as a case manager without otherwise restricting the provider’s
participation as a physician.
.11 Interpretive Regulation.
Except when the language of a specific regulation indicates an
intent by the Department to provide reimbursement for covered services to
Program [recipients] participants
without regard to the availability of federal financial participation, State
regulations shall be interpreted in conformity with applicable federal statutes
and regulations.
DENNIS R. SCHRADER
Secretary of Health
Subtitle 09 MEDICAL CARE PROGRAMS
Notice of Proposed Action
[22-292-P]
The Secretary of Health proposes to:
(1) Amend Regulations .01—.06
under COMAR 10.09.40 Early Intervention
Service Coordination;
(2) Amend Regulations .01—.06
and adopt new Regulation .03-1 under
COMAR 10.09.52 Service Coordination for
Children with an IEP or Enrolled in
the Autism Waiver; and
(3) Amend Regulations .01,
.03, and .05 under COMAR 10.09.76 School-Based Health Centers (SBHC).
Statement of Purpose
The purpose of this action is to:
(1) Update terminology throughout the Early Intervention Services
Case Management chapter to align regulations with current industry practices;
(2) Update language as it relates to children with disabilities,
and provide further clarification on the differences between service
coordination provided for Autism Waiver and IEP/IFSP participants; and
(3) Align regulations with the provisions of Ch. 606 (S.B. 830),
Acts of 2021, “Secretary of Health — School Based Health Centers — Guidelines
and Administration of Grants” which shifted approval authority of school-based
health centers from Maryland State Department of Education (MSDE) to Maryland
Department of Health (MDH), effective July 1, 2022.
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 an impact on individuals with disabilities
as follows:
The proposed action provides clarification on the differences
between service coordination provided for Autism Waiver and IEP/IFSP
participants.
Opportunity for Public Comment
Comments may be sent to Jourdan Green, Director, Office of
Regulation and Policy Coordination, Maryland Department of Health, 01 West
Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY
800-735-2258), or email to mdh.regs@maryland.gov, or fax to 410-767-6483.
Comments will be accepted through February 13, 2023. A public hearing has not
been scheduled.
10.09.40 Early Intervention [Services Case Management] Service
Coordination
Authority: Health-General Article,
§§2-104(b), 15-103, and 15-105, Annotated Code of Maryland
.01 Definitions.
A. (text unchanged)
B. Terms Defined.
[(1) “Case management” means
services which will assist participants in gaining access to the full range of
Medical Assistance services, as well as to any additional needed medical,
social, mental health, financial assistance, counseling, educational, and other
support services.
(2) “Case manager” means an
individual who:
(a) Is used by the provider chosen
by the participant’s parent;
(b) Meets the requirements in
Regulation .03C of this chapter; and
(c) Provides the covered services
specified in Regulation .04 of this chapter.
(3) “Children’s Medical Services”
means the State agency administering a program of services for children with
special health care needs, as authorized by Title V of the Social Security Act
and COMAR 10.22.08.]
[(4)] (1)—[(5)] (2) (text unchanged)
[(6)] (3) “Developmental
delay” [means that a child is
functioning at least 25 percent below chronological age in at least one of the
five developmental areas, as measured and verified by diagnostic instruments
and procedures approved by the Maryland Infants and Toddlers Program]
has the meaning stated in COMAR 13A.13.01.03B.
[(7)] (4) “Early intervention
services” means services defined in COMAR
13A.13.01.03B(15) that:
(a)—(c) (text unchanged)
[(8)] (5) “Early intervention
[services case management] service
coordination” means the [case management] coordination of services covered under
this chapter.
[(9) “Early intervention
services case management provider” means a provider of services covered under
Regulation .04 of this chapter, which meets the requirements in Regulation .03
of this chapter and is chosen as the provider by a participant’s parent.]
[(10)] (6)—[(12)] (8) (text unchanged)
[(13)] (9) “Maryland Infants
and Toddlers Program” means the program designated by the Governor under
Executive Order 01.01.1988.15 to plan, develop, and implement a Statewide,
coordinated, comprehensive, multidisciplinary, interagency plan for early
intervention services in Maryland[,
with the Office for Children, Youth, and Families designated as the lead agency
for this program under Article 49D, Annotated Code of Maryland].
[(14)] (10)—[(16)] (12) (text unchanged)
[(17)] (13) “Multidisciplinary
team” means [a group convened and
conducted by a participant’s case manager to perform the multidisciplinary
assessment or reassessment and develop or revise the participant’s IFSP, and
which is comprised of the case manager, the participant’s family, and relevant
service providers] the involvement of two or more disciplines
or professions in the provision of integrated and coordinated services,
including evaluation and assessment activities and the development of the IFSP.
[(18)] (14) “Parent” [means a biological or adoptive parent,
a legal guardian, another person responsible for a child’s welfare, or a
surrogate parent for those cases when:
(a) A public agency, after
reasonable efforts, cannot discover the whereabouts of a biological or adoptive
parent;
(b) A person cannot be identified
with responsibility for a child’s welfare; or
(c) The child is a ward of the State] has the meaning stated in
COMAR 13A.13.01.03B.
[(19)] (15) “Participant”
means a federally qualified recipient [who
is]:
[(a) A child between birth and 3
years old;
(b) Admitted to early intervention services case management through an
election statement, signed by the participant’s parent and filed with the
provider chosen by the parent;]
(a) Who is aged birth to the
beginning of the school year following the child’s fourth birthday;
(b) Whose parents have provided
written consent for the use of public benefits consistent with COMAR
13A.13.01.12;
(c) [Not] Who is
not receiving the same [case
management] service coordination services under another Program authority; and
(d) [Determined by a multidisciplinary team to be eligible for early
intervention services case management because the child:] Who is defined as a child
with a developmental delay as defined in COMAR 13A.13.01.03.
[(i) Is experiencing
developmental delays,
(ii) Has a diagnosed physical or
mental condition that has a high probability of resulting in developmental
delay, or
(iii) Demonstrates atypical
development or behavior, which is demonstrated by abnormal quality of
performance and function in at least one of the five developmental areas,
interferes with current development, and is likely to result in future
developmental delay.]
[(20)] (16) (text unchanged)
[(21)] (17) “Provider” means
an early intervention [services case
management] service coordination provider.
[(22) “Recipient” means a
recipient as defined in COMAR 10.09.36.01.]
(18) “Service coordination” means
the services provided, as part of the Maryland Infants and Toddlers Program,
which assists participants in gaining access to the full range of Medical
Assistance services, as well as to any additional needed medical, social,
mental health, financial assistance, counseling, educational, and other support
services.
(19) “Service coordinator” means
an individual who:
(a) Is utilized by the provider
and chosen by the participant’s parent;
(b) Is designated to carry out
the IFSP service coordination activities;
(c) Meets the requirements in
Regulation .03C of this chapter; and
(d) Provides the services
specified in Regulation .04 of this chapter.
(20) “Telehealth” has the meaning
as stated in COMAR 10.09.49.02.
.02 Licensing Requirements.
A. Social workers participating as [case managers] service coordinators
shall be licensed pursuant to Health Occupations Article, Title 18, Annotated
Code of Maryland, or meet the social worker licensure and regulatory
requirements of the state in which the services are provided.
B. Registered nurses participating
as [case managers] service
coordinators shall be licensed pursuant to Health Occupations Article,
Title 7, Annotated Code of Maryland, or meet the registered nurse licensure and
regulatory requirements of the state in which the services are provided.
C. Audiologists participating as [case managers] service coordinators
shall be licensed pursuant to [COMAR
13A.07.01.07K or] COMAR 10.41.03.03,
or meet the audiologist licensure and regulatory requirements of the state in
which the services are provided.
D. Nutritionists or dietitians participating as [case managers] service coordinators
shall be licensed pursuant to Health Occupations Article, Title 4, Annotated
Code of Maryland, or meet the [nutritionist] corresponding
licensure and regulatory requirements of the state in which the services are
provided.
E. Occupational therapists
participating as [case managers] service
coordinators shall be licensed pursuant to Health Occupations Article,
Title 9, Annotated Code of Maryland, or meet the occupational therapist
licensure and regulatory requirements of the state in which the services are
provided.
F. Physical therapists participating
as [case managers] service
coordinators shall be licensed pursuant to Health Occupations Article,
Title 13, Annotated Code of Maryland, or meet the physical therapist licensure
and regulatory requirements of the state in which the services are provided.
G. Clinical psychologists
participating as [case managers] service
coordinators shall be licensed pursuant to Health Occupations Article,
Title 16, Annotated Code of Maryland, or meet the clinical psychologist
licensure and regulatory requirements of the state in which the services are
provided.
H. School psychologists
participating as [case managers] service
coordinators shall be certified pursuant to COMAR [13A.07.07.07]
13A.12.03.08, or meet the school psychologist regulatory requirements of
the state in which the services are provided.
I. Special educators participating
as [case managers] service
coordinators shall be certified pursuant to COMAR [13A.07.01.02]
13A.12.01.04, or meet the special educator regulatory requirements of
the state in which services are provided.
J. Speech language pathologists
participating as [case managers] service
coordinators shall be licensed pursuant to Health Occupations Article,
Title 19, Annotated Code of Maryland[,
be certified pursuant to COMAR 13A.07.01.07K], or meet the speech language pathologist licensure or
certification and regulatory requirements of the state in which the services
are provided.
K. Professional counselors
participating as [case managers] service
coordinators shall be licensed pursuant to Health Occupations Article,
Title 15, Annotated Code of Maryland, or meet the professional counselor
licensure and regulatory requirements of the state in which services are
provided.
L. Physicians participating as [case managers] service coordinators
shall be licensed pursuant to Health Occupations Article, Title 14, Annotated
Code of Maryland, or meet the physicians’ licensure and regulatory requirements
of the state in which the services are provided.
.03 Conditions for Participation.
A. General requirements for participation
in the Program are that providers shall do the following, either directly
through staff or by agreement:
(1) (text unchanged)
(2) Maintain a file on each
participant which meets the Program’s requirements and which includes for each
contact made by the [case manager] service
coordinator:
(a)—(c) (text unchanged)
(d) Nature, content, and unit or
units of service provided[and];
(e) Place of service[.]; and
(f) Signature and printed name of
the service coordinator.
B. Specific requirements for
participation in the Program as an early intervention [services case management provider] service
coordinator are that the provider
shall do the following, either directly or indirectly by agreement:
[(1) Be the State agency, that
is, Children’s Medical Services, administering a program of services for
children with special health care needs, authorized under Title V of the Social
Security Act, acting in conjunction with its local health department designees;]
[(2)] (1) Use qualified
individuals as [case managers] service
coordinators;
[(3)] (2) (text unchanged)
[(4) Be selected by the
participant’s parent from among the local health department designees;
(5) Contact the participant’s family
within 2 working days of the receipt of a referral for early intervention
services case management, unless client-related extenuating circumstances are
documented;]
[(6)] (3) Develop the IFSP
within 45 working days of referral, unless client-related extenuating
circumstances are documented in
accordance with COMAR 13A.13.01.07B.
[(7)] (4) Have formal
written policies and procedures, approved by the Department, which specifically
address the provision of early intervention [services case management]
service coordination to participants
in accordance with the requirements of this chapter;
[(8) Be available to
participants and their families for at least 8 hours a day, 5 days a week,
except on State holidays;]
[(9)] (5) Designate specific
qualified individuals as early intervention [services case managers] service coordinators;
[(10)] (6)—[(13)] (9) (text unchanged)
C. A [case manager] service coordinator shall meet the
following requirements:
(1) Be a professional who:
(a) Has a current license or
certification, according to Regulation .02 of this chapter, in the profession
most immediately relevant to a participant’s needs; and
(b) Has demonstrated training or
experience in providing [case
management] service coordination or other early intervention services to
infants and toddlers with disabilities;
or
[(c) Meets by October 1, 1995
the personnel standards for early intervention services case managers issued by
the Maryland Infants and Toddlers Program; and
(d) Participates in ongoing training
offerings, as specified in the interagency training plan for early intervention
services; or]
(2) Be a nonprofessional who:
(a) Has a high school diploma or its
equivalency who meets Personnel Standards described in COMAR 13A.07.01.02[,];
(b) Has demonstrated training or
experience in providing [case
management] service coordination or other early intervention services to
infants and toddlers with disabilities; and
(c) (text unchanged)
.04 Covered Services.
A. (text unchanged)
B. Initial [Case Management Services] Service Coordination.
(1) A unit of service is defined as
a completed initial Individualized Family Service Plan (IFSP) and at least one
contact with the participant or the participant’s family, [in] on the participant’s behalf.
(2) The covered services include
convening and conducting a multidisciplinary team to:
(a) (text unchanged)
(b) Develop an initial IFSP for a
participant that identifies the:
(i) Participant’s needs for early
intervention, medical, mental and
behavioral health, social, educational, financial assistance, counseling,
and other support services;
(ii)—(iv) (text unchanged)
(3) Administrative, supervisory, and
monitoring services associated with the initial [case management] service coordination are included as a part of the service.
C. Ongoing [Case Management Services] Service Coordination.
(1) Ongoing [case management]
service coordination is provided
following the initial [case
management services] service coordination.
(2) A unit of service includes [a monthly telephone call to,
or visit with, the participant’s family, in the participant’s behalf, and] all
[other] necessary covered services[.] and at least one
monthly contact with the participant’s family on the participant’s behalf via:
(a) Telephone call;
(b) Telehealth or in-person
visit; or
(c) Written communication.
(3)—(4) (text unchanged)
D. Annual IFSP Review.
(1) A unit of service is defined as a completed annual IFSP review
and at least one contact with the participant or the participant’s family, [in]
on the participant’s behalf.
(2) (text unchanged)
.05 Limitations.
A. Early intervention [services
case management] service coordination is advisory in
nature.
B. A restriction may not be placed on a qualified [recipient’s] participant’s option to
receive early intervention [services
case management] service coordination.
C. Early intervention [services
case management] service coordination does not restrict or otherwise affect:
(1)—(4) (text unchanged)
D. Early intervention [services
case management] service coordination may not be:
(1)—(4) (text unchanged)
E. Reimbursement may not be made for early intervention [services case management]
service coordination if a participant is receiving a comparable case
management service under another Program authority.
F. A participant’s [case
manager] service coordinator may not be the participant’s parent.
.06 Payment Procedures.
A. Request for Payment.
(1) Requests for payment of early intervention [services case management] service coordination shall be submitted
by an approved provider according to procedures established by the Department.
The Department reserves the right to return to the provider, before payment,
all [invoices] claims not properly
signed and completed.
(2) A provider shall submit a request for payment on the [invoice] claim form designated
by the Department. A separate [invoice] claim
shall be submitted for each participant.
(3) The completed [invoice] claim
form in §A(2)B[,] of this regulation[,] shall indicate the:
(a)—(d) (text unchanged)
(4) (text unchanged)
(5) The Program may not make direct payment to [recipients] participants.
B. (text unchanged)
C. Payment shall be made:
(1) (text unchanged)
(2) Only to one provider of early intervention [services case management] service coordination rendered to a
participant during a billing period; and
(3) According to the following fee-for-service schedule for early
intervention [services case
management] service coordination:
[Description Fee Per Unit of Service]
(a) Initial [case
management] service coordination (only one unit of service may be reimbursed
per participant) ... $500;
(b) Ongoing [case
management] service coordination (only one unit of service per month may be
reimbursed for a participant after completion of initial [case management] service coordination or the annual IFSP
review) ... $150;
(c) Annual IFSP review [(only
one unit of service may be reimbursed for a participant annually, for a total
of two units per participant)] ... $275
per review.
10.09.52 Service Coordination for Children with [Disabilities] an
IEP or Enrolled in the Autism Waiver
Authority: Health-General Article, §§2-104(b), 15-103, and 15-105,
Annotated Code of Maryland
.01 Definitions.
A. (text unchanged)
B. Terms Defined.
(1) (text unchanged)
(2) “Autism Waiver” or “Waiver” means the Home and Community-Based Services Waiver for Children
with Autism Spectrum Disorder.
[(3) “Children with
disabilities” means those children who are waiver participants or:
(a) Who have been determined through appropriate assessment
pursuant to COMAR 13A.05.01 as having temporary or long-term special education
needs arising from cognitive, emotional, or physical factors, or any
combination of these; and
(b) Whose ability to meet general education objectives is impaired
to a degree that the services available in the general education program are
inadequate in preparing them to achieve their education potential.]
(3) “Autism Waiver Service Coordination” means the coordination
of waiver services covered under this chapter.
(4) “Autism Waiver Service Coordinator” means an individual who
meets the requirements specified in Regulation .03-1 of this chapter and
provides the autism waiver services specified in Regulations .04-1—04.2 of this
chapter to a waiver participant.
[(4)] (5)—[(5)] (6) (text unchanged)
(7) “IEP service coordination” means the coordination of
services which assists a participant in gaining access to the services
recommended in the participant’s IEP.
(8) “IEP service coordinator” means an individual who meets the
requirements in Regulation .03C of this chapter.
[(6)] (9) “Individualized Education Program
(IEP)” means a written, individualized plan of care for a participant, that:
(a)—(b) (text unchanged)
(c) Conforms with the requirements in COMAR 13A.05.01 and
34 CFR §§300.320—300-324.
[(7)] (10) “Individualized
education program (IEP) team” means the multidisciplinary team convened by a
provider in accordance with COMAR 13A.05.01 to review a participant’s needs, [and] develop the participant’s IEP[.], and determine the placement of the
participant in the least restrictive environment.
[(8)] (11) “Individualized
family service plan (IFSP)” means a written, individualized plan for providing early intervention and other
services for an infant, [or]
toddler, or preschool-age child, in
accordance with COMAR [10.09.40,
10.09.50, and] 13A.13.01.
[(9)] (12) (text unchanged)
[(10)] (13)
“Local school system (LSS)” means [the public local education agency for
each jurisdiction.] any public school system in Maryland
responsible for providing public elementary or secondary education.
[(11)] (14)
“Maryland Medicaid Managed Care Program” has the meaning stated in COMAR [10.09.62.01] 10.67.01.01.
[(12)]
(15)—[(12-1)] (16) (text unchanged)
[(13) Parent.
(a) “Parent” means the parent of a participant.
(b) “Parent” includes:
(i) A natural parent;
(ii) A guardian;
(iii) An individual acting as a parent such as a relative or a
stepparent with whom a child lives, including those relatives or stepparents
who are foster parents;
(iv) Any other individual who is legally responsible for a child’s
welfare; or
(v) A person appointed as the parent surrogate in accordance with
COMAR 13A.05.01.]
(17) “Parent” has the meaning stated in COMAR 13A.13.01.03.
[(14)] (18)—[17)] (21) (text unchanged)
[(18)] (22) “Rare and expensive case
management (REM)” has the meaning
stated in [COMAR 10.09.62.01] COMAR 10.09.69.02.
[(19) “Recipient” has
the meaning stated in COMAR 10.09.36.01.
(20) “Service coordination” means case management services which
assist participants in gaining access to the services recommended in a
participant’s IEP or waiver plan of care.
(21) “Service Coordination for Children with Disabilities” means
the case management services covered under this chapter.
(22) “Service coordinator” means an individual who:
(a) Meets the requirements in Regulation .03C of this chapter; and
(b) Provides the covered services specified in Regulation .04 of
this chapter, as well as Regulations .04-1 and .04-2 for a waiver participant.]
(23) “Telehealth” has the meaning as stated in COMAR
10.09.49.02.
[(23)] (24)—[(24)] (25) (text unchanged)
[(25)] (26)
“Waiver participant” means a [waiver
eligible person who is enrolled in the Autism Waiver] child whose enrollment
meets the requirements set forth in COMAR 10.09.56.
[(26)] (27) (text unchanged)
.02 Participant Eligibility.
A [recipient] participant
is eligible [to participate in] for
Service Coordination [for Children
with Disabilities] if:
A. (text unchanged)
B. The following requirements are met:
(1) The [recipient] participant,
for whom free and appropriate education is provided under the Individuals with
Disabilities Education Act, is [2] aged
3 through 20 years old;
(2) An IEP team determines that the [recipient] participant is a child with
disabilities who:
(a)—(b) (text unchanged)
(3) The [recipient] participant
elects, or the [recipient’s]
participant’s parent elects on the [recipient’s] participant’s
behalf, to receive the services available under this chapter; and
[(4) The recipient is not receiving similar case management
services under §1915(c) or (g) of Title XIX of the Social Security Act; and]
[(5)] (4) The [recipient] participant
is not a resident of any of the facilities that receive Medicaid reimbursement
for residential services.
.03 Conditions for Participation for IEP Service Coordination
Providers.
A. General requirements for participation in the Program are that a
provider shall [meet]:
(1) Meet all the conditions for participation as set
forth in COMAR [10.09.36.03] 10.09.36; and
(2) If delivering services via telehealth, comply with COMAR
10.09.49 and any subregulatory guidance issued by the Department.
B. [Specific
requirements for participation in the Program as a provider of Service
Coordination for Children with Disabilities are that a provider] IEP
service coordination providers shall:
(1) Be an agency within the State that:
(a)—(b) (text unchanged)
(2) Convene or participate on an IEP team or teams, in accordance
with COMAR 13A.05.01[, which shall:
(a) Include individuals from at least two disciplines as specified
in COMAR 13A.05.01 and determined by the participant’s disability, and provide
the opportunity for participation to the participant’s parent or parents, and
the participant, if appropriate, pursuant to COMAR 13A.05.01;
(b) Receive referrals of recipients who are 2 through 20 years old,
or who are waiver participants, and are identified as potentially eligible for
the services covered under this chapter;
(c) Conduct an assessment of a recipient within 90 days of
receiving a written referral;
(d) Develop an IEP for a participant in accordance with COMAR
13A.05.01 within 30 calendar days of the determination of eligibility for the
services covered under this chapter;
(e) Review the IEP and progress of each participant who is
receiving the special education and related services recommended in the IEP,
upon request of the parent or parents;
(f) Meet and conduct an annual review of each participant’s IEP
and, if appropriate, revise the IEPs provisions; and
(g) Reconvene the IEP team to conduct an interim IEP review and
modify the existing IEP at any time upon request of the professionals included
on the team or the parent or parents, as considered necessary pursuant to the
participant’s progress];
(3)—(4) (text unchanged)
(5) Maintain a file on each participant which meets the Program’s
requirements [and] which shall include:
(a) (text unchanged)
(b) Written parental consent [for
the] to initiate services covered under this chapter;
(c) [A record of service
coordination encounters concerning the participant] Written parental consent prior to accessing the student’s
public benefits or insurance the first time, and annually thereafter, in
accordance with 34 CFR §300.154(d)(2);
(d) Approval from a participant’s parent of the [participant’s service coordinator and
the] participant’s IEP before
implementation of the service coordination; and
[(e) The following
documentation for a waiver participant:
(i) Diagnosis of autism spectrum disorder every 3 years or more
often as requested by MSDE, by a qualified diagnostician using an evaluation
methodology considered sufficient by the multidisciplinary team;
(ii) Form for determination of eligibility for level of care in an
intermediate care facility for the intellectually disabled and persons with
related conditions (ICF/IID) — initial determination and redetermination, at
least annually;
(iii) Consent form for autism waiver services, signed before Autism
Waiver enrollment;
(iv) Form for determination of Medicaid eligibility for autism
waiver services — initial determination and redetermination, at least annually;
(v) Waiver plan of care—initial plan, review at least annually, and
any plan revisions;
(vi) Preauthorization by MSDE of any environmental accessibility
adaptations reimbursed through the Autism Waiver; and
(vii) The waiver participant’s IEP developed in accordance with
this chapter or individualized family service plan (IFSP) developed in
accordance with COMAR 10.09.40;]
(e) A record of service coordination encounters including:
(i) A brief description of the service;
(ii) The location;
(iii) The name of the contact (parent/guardian or student);
(iv) The date of the service; and
(v) The service coordinator’s printed name and signature; and
(6) Employ or have under contract qualified personnel who convene
or participate on IEP teams, convene or participate on [waiver]
multidisciplinary teams as necessary, and
develop participants’ IEPs [or
waiver plans of care, and perform as service coordinators for participants; and
(7) Convene or participate on a waiver multidisciplinary team or
teams for waiver participants, in accordance with the requirements of COMAR
10.09.56 and this chapter].
C. IEP Service
Coordinator Requirements.
(1) [A]
An IEP service coordinator shall:
(a) (text unchanged)
(b) Be [chosen] identified
by the IEP team [or waiver
multidisciplinary team, with the approval of the participant’s parent or
parents, taking into consideration the:];
[(i) Primary disability
manifested by the participant;
(ii) Participant’s needs; and
(iii) Services recommended in the IEP or waiver plan of care;]
(c) Participate with the IEP team [or waiver multidisciplinary team] in the development or revision of a participant’s IEP [or waiver plan of care] and in the IEP [or waiver plan of care]
review;
(d) Assist the participant in gaining access to the services
recommended in the IEP [or waiver
plan of care]; and
(e) Collect and synthesize evaluation reports and other relevant
information about a participant that might be needed by an IEP team [or waiver multidisciplinary team].
(2) [A]
An IEP service coordinator shall have the following qualifications and be
a:
(a) (text unchanged)
(b) Nonprofessional who meets the requirements in §C(4) [or (5)] of this regulation.
(3) A professional who is chosen as a participant’s service
coordinator shall meet the following licensing or certification requirements,
as appropriate, and be:
(a)—(b) (text unchanged)
(c) A professional counselor licensed to practice in accordance
with Health Occupations Article, Title 17, Annotated Code of Maryland;
[(c)] (d)—[(j)] (k) (text unchanged)
(4) A nonprofessional who is chosen as a participant’s service
coordinator[, except the service
coordinator for a waiver participant,]
shall meet the following requirements:
[(a) Be a parent of a
child with disabilities, but not of the participant;]
[(b)] (a) Have at least a
high school diploma or the equivalent; [and]
(b) Have demonstrated training or experience in providing
service coordination to students with disabilities; and
[(c) Have satisfactorily
completed training in advocacy at a parent information center that is approved
by MSDE.]
(c) Participate in ongoing service coordination training
offerings as specified in the interagency plan for special education services.
[(5) A nonprofessional
who is chosen as a service coordinator for a waiver participant shall have at
least:
(a) 1 year of relevant training or experience; and
(b) A bachelor’s degree in social work or a related human services
field.
(6) Service coordinators for waiver participants shall complete at
least 5 hours of initial training on the Autism Waiver, offered by the
Department and MSDE, before rendering Autism Waiver service coordination
covered under Regulations .04-1 and .04-2 of this chapter.
(7) Service coordinators for waiver participants must attend one
statewide training for Autism Waiver service coordinators per fiscal year.]
.03-1 Conditions for Participation
for Autism Waiver Service Coordination Providers.
A. General requirements for participation in the Program are
that a provider shall:
(1) Meet all the conditions for participation as set forth in
COMAR 10.09.36; and
(2) If delivering services via telehealth, comply with COMAR
10.09.49 and any subregulatory guidance issued by the Department.
B. Specific requirements for participation in the Program as a
provider of Autism Waiver Service Coordination are that a provider shall:
(1) Be an agency within the State that employs or has under
contract qualified personnel who convene or participate on waiver
multidisciplinary teams as necessary, develop participant’s waiver plans of
care, and provide service coordination services for waiver participants;
(2) Designate specific, qualified individuals as service
coordinators and verify their credentials for providing the services covered
under this chapter;
(3) Convene or participate on a waiver multidisciplinary team or
teams for waiver participants, in accordance with the requirements of COMAR
10.09.56 and this chapter;
(4) Be knowledgeable of the eligibility requirements and
application procedures of federal, State, and local government assistance
programs that are applicable to participants; and
(5) Maintain a file on each participant that meets the Program’s
requirements and includes the waiver participant’s:
(a) Technical eligibility form approved by MSDE, reviewed and
signed at least annually;
(b) Determination of eligibility for level of care in an
intermediate care facility for the intellectually disabled and persons with
related conditions (ICF/IID) — initial determination and redetermination, at
least annually;
(c) Autism Waiver Risk Assessment pursuant to 10.09.56;
(d) Consent Form for Autism Waiver Services, signed before
Autism Waiver enrollment and annually thereafter;
(e) Form for determination of Medicaid eligibility for Autism
Waiver services — initial determination and redetermination, at least annually;
(f) Initial waiver plan of care, reviewed at least annually, and
any plan revisions;
(g) Parental Rights and Responsibilities form reviewed and
signed at least annually;
(h) Preauthorization by MSDE of any environmental accessibility
adaptations reimbursed through the Autism Waiver, if applicable;
(i) Reportable Event forms concerning the waiver participant, if
applicable;
(j) Record of ongoing service coordination encounters,
including:
(i) A description of the service;
(ii) The location of the service;
(iii) Date of contact and name of the parent/guardian or
participant;
(iv) Type of contact;
(v) Supportive documentation of the service; and
(vi) The service coordinator’s printed name and signature;
(k) Monthly tracking logs with Technical Eligibility Exemption
Request Forms as applicable; and
(l) A copy of the treatment plans for each applicable service
provided or Reportable Event form, as applicable, if a treatment plan was not
submitted.
C. Autism Waiver Service Coordinator Requirements.
(1) An Autism Waiver service coordinator shall:
(a) Be employed by or under contract with a provider;
(b) Be approved by the participant’s parent or parents;
(c) Participate with the waiver multidisciplinary team in the
development, or revision, of a participant’s waiver plan of care and in the
waiver plan of care review;
(d) Assist the participant in gaining access to the services
recommended in the waiver plan of care; and
(2) An Autism Waiver service coordinator who is chosen to
provide services for a waiver participant shall have at least:
(a) 1 year of relevant training or experience; and
(b) A bachelor’s degree.
(3) An Autism Waiver service coordinator shall complete at least
5 hours of training on the Autism Waiver, offered by the Department and MSDE,
prior to rendering Autism Waiver service coordination in accordance with
Regulations .04-1 and .04-2 of this chapter.
(4) Autism Waiver service coordinators shall attend one Statewide
training for Autism Waiver service coordinators per fiscal year.
.04 Covered Services — IEP Service Coordination.
A. (text unchanged)
B. Initial IEP.
(1) Definition. “Unit of service” means:
(a) (text unchanged)
(b) At least one contact by the participant’s service coordinator [or IEP team] in person, in writing, via
telehealth, or by telephone with the participant or the participant’s
parent, on the participant’s behalf relating to development of the IEP.
(2) (text unchanged)
C. Ongoing IEP Service
Coordination.
(1) Ongoing IEP service
coordination is provided by a participant’s service coordinator.
(2) Definition. For purposes of this section, “unit of service”
means:
(a) At least one contact per month by the service coordinator in
person, via telehealth, by telephone,
or by written progress notes or log with the participant or the participant’s
parent, on the participant’s behalf relating to the child’s ongoing IEP service coordination; and
(b) (text unchanged)
(3) As necessary, the Program shall include as covered services the
following:
(a) (text unchanged)
(b) Maintaining contact with:
(i) (text unchanged)
(ii) A participant [and]
or the participant’s parent through [home
visits, office] in-person visits, written [notes,
school visits] communication, telephone calls, telehealth,
and follow-up service as necessary;
(c)—(d) (text unchanged)
(e) Providing a participant [and] or
the participant’s parent with information and direction that will assist them
in successfully accessing and using the services recommended in the IEP;
(f) Informing a participant’s parent of the participant’s and the
family’s rights and responsibilities in regard to specific programs and
resources recommended in the IEP; and
[(g) Conducting, with a
participant’s parent at a meeting or by other means acceptable to the parent
and the service coordinator, a periodic review of the participant’s IEP every 6
months, or more frequently if warranted or the parent requests a review; and]
[(h)] (g) (text unchanged)
(4) (text unchanged)
D. IEP Review.
(1) Definition. “Unit of service” means:
(a) A completed initial 60-day, interim, or annual IEP review as
evidenced by a [signed] revised IEP or, if a revised IEP was
not done, documented by the IEP team [records documenting a meeting in which
there is participation by at least two different disciplines]; and
(b) At least one contact by the IEP
service coordinator or IEP team in person, by telephone, via telehealth, or by written [progress notes or log]
communication with the participant or the participant’s parent, on the
participant’s behalf.
(2) (text unchanged)
.04-1 Covered Services — Autism Waiver Service Coordination —
General Requirements.
A. (text unchanged)
B. Waiver Service
Coordinator. A waiver service
coordinator employed by a provider shall assist with meeting the provider’s
responsibilities specified in this regulation and Regulation .04-2 of this
chapter.
C. Waiver Multidisciplinary Team. A waiver multidisciplinary team:
(1) (text unchanged)
(2) Shall include:
(a)—(b) (text unchanged)
(c) A chairman who is the official representative of the local lead
agency or local school system; and
[(d) Other appropriate
professionals representing the local lead agency or local school system, as necessary
and consistent with the Individuals with Disabilities Education Act (IDEA); and]
[(e)] (d) (text unchanged)
D. Waiver Plan of Care.
(1) (text unchanged)
(2) A waiver participant’s waiver plan of care shall be [approved by] submitted to MSDE
before implementation.
(3) Any revisions or additions to a waiver participant’s waiver
plan of care shall be [approved by] submitted
to MSDE before
implementation.
(4) A waiver participant’s service coordinator may make minor
changes to the waiver participant’s waiver plan of care without reconvening the
waiver multidisciplinary team, if the change is approved by [the chair of the multidisciplinary
team and] the waiver participant’s
parent or parents, and MSDE is notified.
(5) A waiver participant’s initial or revised waiver plan of care
shall [be documented on the waiver
plan of care form that includes] include the:
(a) [Description of each
specific preauthorized service] Identification of Autism Waiver service or
services to be delivered;
(b) (text unchanged)
[(c) Estimated duration;
(d) Approved frequency and units of services to be delivered; and]
(c) Service stop date;
(d) Approved amount of services to be delivered; and
(e) Provider or providers.
E. (text unchanged)
.04-2 Covered Services — Autism Waiver Service Coordination —
Specific Requirements.
A. Waiver Initial Assessment.
(1) Definition. For the purposes of this section, “unit of service”
means:
(a) A completed initial waiver plan of care, [approved by] submitted to MSDE and signed by the service
coordinator, the waiver participant or the parent or parents of a minor child,
and all other members of the waiver multidisciplinary team; or
(b) The provision of all [other] necessary
services specified in §A(2) of this regulation.
(2) (text unchanged)
B. Waiver Ongoing Service Coordination.
(1) Definition. For the purposes of this section, a monthly “unit
of service” means:
(a) At least one documented monthly contact by the waiver
participant’s service coordinator in person, by telephone, via telehealth, or through written progress notes with the waiver
participant or parent;
(b) A quarterly visit to the waiver participant’s residence,
residential program, or day program
conducted in person or via telehealth, including at least one in-person visit to the waiver
participant’s residence every 12 months; and
(c) (text unchanged)
(2) The covered services shall include, as necessary:
(a)—(b) (text unchanged)
(c) Referring the waiver participant to [the] approved Autism Waiver providers
specified in the waiver plan of care;
(d) Assisting the waiver participant with gaining access to the
Autism Waiver services preauthorized in the waiver plan of care [according to the type, level, amount,
frequency, and duration];
(e) (text unchanged)
(f) Providing the waiver participant and the parent or parents with
information and direction to assist them with accessing and [using] successfully utilizing
the Autism Waiver services preauthorized in the waiver plan of care;
(g) Maintaining contact with the waiver participant’s waiver and
other service providers and with the waiver participant or parent through
documented [home visits, office
visits, school] in-person visits, telehealth
contact, telephone calls, mailings, and follow-up services as necessary;
(h)—(i) (text unchanged)
(j) Making minor changes to the waiver participant’s waiver plan of
care as necessary, without reconvening the waiver multidisciplinary team, if
the change is approved by [MSDE and] the waiver participant’s parent or
parents and submitted to MSDE;
(k) Assuring that the necessary documentation is maintained in the
waiver participant’s [case] file, as specified in Regulation [.03B(5)(e)] .03-1B(5) of this
chapter;
(l) Providing MSDE with required information in the established time
frame on waiver participants enrolled in [or
being terminated from] the Autism
Waiver; and
(m) Monitoring on an ongoing basis:
(i) The appropriateness of the type, [level,] amount, [frequency,] duration, and quality of the Autism Waiver services received by a
waiver participant;
(ii)—(iii) (text unchanged)
C. Waiver Reassessment.
[(1) Definition.] For the purposes of this section, “unit
of service” means:
[(a)] (1) A completed waiver
plan of care review at least every 12
months, with revisions as necessary, which is [approved by] submitted to MSDE and signed by the
service coordinator, the waiver participant or the parent or parents of a minor
child, and all other members of the waiver multidisciplinary team; [or
(b) The provision of all other services specified in §C(2) of this
regulation.
(2) The covered services shall include:
(a) Convening, coordinating, and participating on the waiver
multidisciplinary team at least every 12 months to review, and revise as
necessary, the waiver participant’s waiver plan of care;
(b) Assisting waiver participants with the waiver’s eligibility
redetermination process, as specified in COMAR 10.09.56;
(c) Coordinating with the Department for redetermination of the
waiver participant’s Medicaid financial and technical eligibility in a timely
fashion;
(d) Assisting the waiver participant or the parent or parents of a
minor child with completion and submission of the application forms and
accompanying documentation for the Medicaid financial and technical eligibility
redetermination, before the deadline established by the Department;
(e) Completing a risk assessment within 45 days of receiving
notification of eligibility by the Department using the Autism Waiver Risk
Assessment form;
(f) Completing a risk assessment if the participant’s status
changes, to ensure the applicant can be safely maintained in a home and
community-based setting utilizing Autism Waiver services; and
(g) Providing written notice to a MSDE representative of the
participant’s ineligibility for the Autism Waiver.]
(2) Assisting waiver participants with the waiver’s eligibility
redetermination process, as specified in COMAR 10.09.56;
(3) Assisting families with making informed choices in selecting
between a home and community-based waiver documented in the Autism Waiver
Transitioning Youth Service Delivery Option Form or other documentation as
required;
(4) Assisting the waiver participant or the parent or parents of
a minor child with completion and submission of the application forms and
accompanying documentation for the Medicaid financial and technical eligibility
redetermination, in coordination with the Department, before the deadline
established by the Department;
(5) Completing a risk assessment within 45 days of receiving notification
of eligibility by the Department using the Autism Waiver Risk Assessment form;
(6) Completing a risk assessment if the participant’s status
changes, to ensure the applicant can be safely maintained in a home and
community-based setting utilizing Autism Waiver services; or
(7) Providing written notice to a MSDE representative of the
participant’s ineligibility for the Autism Waiver.
.05 Limitations.
A. Service Coordination for Children with [Disabilities] an IEP or enrolled in the Autism Waiver
is advisory in nature except for Autism Waiver Service Coordination, covered
under Regulations .03-1, .04-1,
and .04-2 of this chapter.
B. A restriction may not be placed on a qualified [recipient’s] participant’s option to
receive the services covered under this chapter except that Autism Waiver
Service Coordination, as defined by Regulations .03-1, .04-1, and .04-2 of this chapter, is required for
waiver eligible persons who choose to enroll in the Autism Waiver.
C. (text unchanged)
D. Service Coordination for Children [with Disabilities] with an IEP or enrolled in the Autism Waiver
may not be:
(1)—(3) (text unchanged)
E.—G. (text unchanged)
.06 Payment Procedures.
A. Request for Payment.
(1) (text unchanged)
(2) A provider shall:
(a)—(b) (text unchanged)
(c) Submit a request for payment in the manner specified by the
Program, that includes the:
(i)—(ii) (text unchanged)
(iii) Provider’s name, location, and [identification] Medicaid provider number; and
(iv) (text unchanged)
(3)—(4) (text unchanged)
[(5) A waiver
participant’s provider of residential habilitation services under COMAR
10.09.56 may:
(a) Provide the waiver participant with waiver ongoing service
coordination under Regulation .04-2B of this chapter;
(b) Not provide the waiver participant with a waiver initial
assessment under Regulation .04-2A of this chapter or a waiver reassessment
under Regulation .04-2C of this chapter.]
B. (text unchanged)
C. The Program shall make payment only to one qualified provider
for covered services rendered on a particular date of service to a participant
and according to the following [fee-for-services] fee
schedule covered under this chapter:
Description Fee
Per Unit of Service
(1) (text unchanged)
(2) Ongoing IEP service
coordination: no more than one unit of service per month may be reimbursed for
a participant ... $150;
(3)—(6) (text unchanged)
D.—H. (text unchanged)
10.09.76 School-Based Health Centers (SBHC)
Authority: Health-General Article, §§2-104(b), 15-103, and 15-105,
Annotated Code of Maryland
.01 Definitions.
A. (text unchanged)
B. Terms Defined.
(1)—(11) (text unchanged)
(12) “School-based health center (SBHC)” means a health center
that:
(a)—(c) (text unchanged)
(d) Has been approved by the [Maryland State Department of
Education (MSDE)] Maryland
Department of Health.
(13) (text unchanged)
.03 Conditions for Participation.
A. General requirements for participation in the Program are that a
provider shall [meet the conditions for participation as set forth in
COMAR 10.09.36.03.]:
(1) Meet the conditions for participation as set forth in COMAR
10.09.36; and
(2) If delivering services via telehealth, comply with COMAR
10.09.49 and any subregulatory guidance issued by the Department.
B. To participate as a Maryland Medicaid SBHC, a provider shall:
(1) Be approved by the [Maryland State Department of
Education (MSDE)] Maryland
Department of Health as an SBHC;
(2)—(10) (text unchanged)
C. (text unchanged)
.05 Limitations.
The Program does not cover the following:
A.—D. (text unchanged)
[E. Services to individuals who are not enrolled in the
school system;]
[F.] E.—[K.] J. (text
unchanged)
[L.] K. Services provided outside of the
physical location of the approved SBHC, unless services are rendered via
telehealth in accordance with COMAR 10.09.49 and any subregulatory guidance
issued by the Department.
DENNIS R. SCHRADER
Secretary of Health
Subtitle 09 MEDICAL
CARE PROGRAMS
10.09.77 Urgent Care Centers
Authority: Health-General Article, §§2-104(b), 15-103, and 15-105,
Annotated Code of Maryland
Notice of Proposed Action
[22-322-P]
The Secretary of Health proposes to amend Regulations .01, .03—.07, and .10 under COMAR 10.09.77 Urgent Care Centers.
Statement of Purpose
The purpose of this action is to:
(1) Ease the condition for participation that an urgent care
center have a physician on-site during hours of operation by allowing certified
nurse practitioners and physician assistants to satisfy this requirement;
(2) Permit services rendered via telehealth to be reimbursed in
compliance with COMAR 10.09.49 Telehealth Services; and
(3) Replace outdated term ‘recipient’ with ‘participant’
throughout the chapter.
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 Jourdan Green, Director, Office of
Regulation and Policy Coordination, Maryland Department of Health, 201 West
Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499, or email
to mdh.regs@maryland.gov. Comments will be accepted through February 13, 2023.
A public hearing has not been scheduled.
.01 Definitions.
A. (text unchanged)
B. Terms Defined.
(1)—(7) (text unchanged)
(8) “Participant” means an individual who is certified as
eligible for and is receiving Medical Assistance benefits.
[(8)] (9) “Patient” means a [recipient] participant
awaiting or undergoing health care or treatment.
[(9)] (10)—[(11)] (12) (text unchanged)
[(12) “Recipient” means
an individual who is certified as eligible for, and is receiving, Medical
Assistance benefits.]
(13) (text unchanged)
.03 Conditions for Participation.
A. The general requirements for participation in the Program are
that a provider shall [meet all
conditions for participation as set forth in COMAR 10.09.36.03.]:
(1) Meet all the conditions for participation as set forth in
COMAR 10.09.36; and
(2) If delivering services via telehealth, comply with COMAR
10.09.49 and any subregulatory guidance issued by the Department.
B. The specific requirements for participation in the Program as a
free-standing urgent care center include the following:
(1)—(3) (text unchanged)
(4) During the hours of operation, have [at]:
(a) A supervising physician, available for consultation either
in-person or via telehealth; and
(b) At least one
qualified physician, certified nurse practitioner, or physician assistant
present;
(5) Maintain adequate documentation of each [recipient] participant visit as part of the
individual’s medical record, which, at a minimum, shall include:
(a) (text unchanged)
(b) [Recipient’s] Participant’s
reason for visit;
(c)—(d) (text unchanged)
(6)—(7) (text unchanged)
.04 Covered Services.
The Program covers the following medically necessary services
rendered to [recipients] participants
in a free-standing urgent care center:
A.—B. (text unchanged)
C. Diagnostic, preventive, curative, palliative, rehabilitative, or
ameliorative services, when clearly related to the [recipient’s] participant’s individual needs;
D.—E. (text unchanged)
.05 Limitations.
The Program does not cover the following:
A.—C. (text unchanged)
D. [Services which do
not involve direct patient contact (face-to-face)] Services rendered via telehealth that do not comply with the
telehealth requirements established in COMAR 10.09.49 and any other
subregulatory guidance issued by the Department;
E.—I. (text unchanged)
.06 Payment Procedures.
A.—H. (text unchanged)
I. The Program may not make a direct payment to a [recipient] participant.
J. (text unchanged)
.07 Recovery and Reimbursement.
A. If the [recipient] participant
has insurance, or other coverage, or if any other person is obligated, either
legally or contractually, to pay for, or to reimburse the [recipient] participant for, services covered by
this chapter, the provider shall seek payment from that source first. If an
insurance carrier rejects the claim or pays less than the amount allowed by the
Program, the provider may submit a claim to the Program. The provider shall
submit a copy of the insurance carrier’s notice or remittance advice with the
invoice. If payment is made by both the Program and the insurance or other
source for the same service, the provider shall refund to the Department,
within 60 days of receipt, the amount paid by the Program or the insurance or
other source, whichever is less.
B. (text unchanged)
.10 Interpretive Regulation.
Except when the language of a specific regulation indicates intent
by the Department to provide reimbursement for covered services to Program [recipients] participants without
regard to the availability of federal financial participation, State
regulations shall be interpreted in conformity with applicable federal statutes
and regulations.
DENNIS R. SCHRADER
Secretary of Health
Subtitle 38 BOARD OF PHYSICAL THERAPY
EXAMINERS
10.38.13 Telehealth
Authority: Health Occupations
Article, §§1-1001—1-1006, Annotated Code of Maryland
Notice of Proposed Action
[22-295-P]
The Secretary of Health proposes to adopt new Regulations .01—.06 under a new chapter, COMAR 10.38.13 Telehealth. This action
was considered by the Board of Physical Therapy Examiners at a public meeting
held on October 20, 2020, notice of which was given by publication on the Board’s
website at https://health.maryland.gov/bphte/Pages/index.aspx pursuant to
General Provisions Article, §3–302(c), Annotated Code of Maryland.
Statement of Purpose
The purpose of this action is to provide new guidelines for
physical therapists from which to practice telehealth pursuant to Chs. 15 and
16, Acts of 2020.
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 Jourdan Green, Director, Office of
Regulation and Policy Coordination, Maryland Department of Health, 201 West Preston
Street, Room 512, Baltimore, MD 21201, or call 410-767-6499, or email to
mdh.regs@maryland.gov. Comments will be accepted through February 13, 2023. A
public hearing has not been scheduled.
.01 Scope.
A. This chapter governs the practice of physical therapy or
limited physical therapy using telehealth as an adjunct to, or replacement for,
in-person patient visits.
B. Nothing in these regulations restricts or limits
reimbursement requirements pursuant to Health-General Article and Insurance
Article, Annotated Code of Maryland.
.02 Definitions.
A. In this chapter, the following terms have the meanings
indicated.
B. Terms Defined.
(1) “Asynchronous” means not occurring in real time.
(2) “Board” means the Maryland Board of Physical Therapy
Examiners.
(3) “In-person” means within the physical presence of the
patient.
(4) “Synchronous” means occurring in real time.
(5) “Telehealth” has the meaning stated in Health Occupations
Article, §1-1001, Annotated Code of Maryland.
(6) “Telehealth practitioner” means:
(a) A Maryland licensed physical therapist or physical therapist
assistant performing telehealth services within their respective scope of
practice; or
(b) A physical therapist or physical therapist assistant with a
compact privilege in Maryland performing telehealth services within their
respective scope of practice.
.03 Licensure.
A. Subject to the provisions of Health Occupations Article,
§13-301, Annotated Code of Maryland, a telehealth practitioner shall be
licensed in Maryland or hold a compact privilege in Maryland when providing
telehealth services to a patient located in the State.
B. Telehealth practitioners licensed in this State are subject
to the jurisdiction of the State and shall abide by the telehealth requirements
of this chapter if either the practitioner or patient is physically located in
this State.
.04 Standards of
Practice for Telehealth.
A. Before providing
telehealth services, a telehealth practitioner shall develop and follow a
procedure to:
(1) Verify the identification of the patient receiving
telehealth services within a reasonable degree of certainty through use of:
(a) A government-issued photograph identification;
(b) An insurance, Medicaid, or Medicare card; or
(c) Documentation of the patient’s:
(i) Date of birth; and
(ii) Home address;
(2) For an initial patient encounter, disclose the telehealth
practitioner’s:
(a) Name;
(b) Maryland license number and type; and
(c) Contact information;
(3) Obtain oral or written consent from a patient or patient’s
parent or guardian if State law requires the consent of a parent or guardian,
including informing patients of the risks, benefits, and side effects of the
recommended treatment plan;
(4) Securely collect and transmit a patient’s medical health information,
clinical data, clinical images, laboratory results, and self–reported medical
health and clinical history, as necessary, and prevent access to data by
unauthorized persons through encryption or other means;
(5) Notify patients in the event of a data breach;
(6) Ensure that the telehealth practitioner provides a secure
and private telehealth connection that complies with federal and state privacy
laws; and
(7) Establish safety protocols to be used in the case of an
emergency, including contact information for emergency services at the patient’s
location.
B. Except when providing asynchronous telehealth services, a
telehealth practitioner shall:
(1) Obtain or confirm an alternative method of contacting the
patient in case of a technological failure;
(2) Confirm whether the patient is in Maryland and identify the
specific practice setting in which the patient is located; and
(3) Identify all individuals present at each location and
confirm they are allowed to hear the patient’s health information.
C. A telehealth practitioner shall be held to the same standards
of practice and documentation as those applicable for in-person physical
therapy practice appointments.
.05 Patient Evaluation.
A. A physical therapist who practices telehealth shall:
(1) Perform a synchronous or asynchronous clinical patient
evaluation that is appropriate for the patient and the condition with which the
patient presents before providing a treatment plan through telehealth; and
(2) If clinically appropriate for the patient, provide or refer
a patient to:
(a) In-person treatment; or
(b) Another type of telehealth service.
B. A telehealth practitioner may not treat a patient based
solely on an online questionnaire.
.06 Telehealth
Practitioner Discipline.
A. The Board shall use the same standards of evaluating and
investigating a complaint about and in disciplining a telehealth practitioner
who practices telehealth as it would use for a licensee who does not use
telehealth technology in the licensee’s practice.
B. The failure of a telehealth practitioner to comply with this
chapter shall constitute unprofessional conduct and may be subject to
disciplinary action by the Board.
DENNIS R. SCHRADER
Secretary of Health
Subtitle 47 ALCOHOL AND DRUG ABUSE
ADMINISTRATION
10.47.07 Prescription Drug
Monitoring Program
Authority: Health-General Article, §§21-2A-01 — 21-2A-09, Annotated
Code of Maryland
Notice of Proposed Action
[22-314-P]
The Secretary of Health proposes to amend Regulations .02—.05 and .07—.09 and adopt new Regulation .05-1 under COMAR 10.47.07
Prescription Drug Monitoring Program.
Statement of Purpose
The purpose of this action is to enable the Maryland Prescription
Drug Monitoring Program (PDMP) to implement recent expansion of the types of
dispenses required to be reported to the PDMP by controlled dangerous substance
(CDS) dispensers. These guidelines are being promulgated in accordance with Ch.
224, Acts of 2022, Public Health — Prescription Drug Monitoring Program —
Naloxone Medication Data. In addition to aligning the regulations with recent
statutory changes, the purpose of this action is to align Maryland reporting
requirements with best practices by updating the required fields CDS dispensers
must report for each dispense. The purpose of this action is to allow health
licensing boards access to dispense data based on the prescription history of a
patient, not only the dispensing or prescribing practices of a specific
provider. This expanded access to data will support existing individual bono
fide investigations facilitated by Boards. This expanded access of data for
health licensing boards aligns with many other state PDMPs. Finally, the purpose
of this action is to clean discrepancies between the Maryland PDMP statute and
regulations specific to the PDMP Use Mandate.
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 Jourdan Green, Director, Office of
Regulation and Policy Coordination, Maryland Department of Health, 201 West
Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499, or email
to mdh.regs@maryland.gov. Comments will be accepted through February 13, 2023.
A public hearing has not been scheduled.
.02 Definitions.
A. (text unchanged)
B. Terms Defined.
(1)—(9) (text unchanged)
(10) Monitored
Prescription Drug.
(a) “Monitored prescription drug” means a prescription drug
that contains a Schedule II, Schedule III, Schedule IV, or Schedule V
controlled dangerous substance designated under Criminal Law Article, Title 5,
Subtitle 4, Annotated Code of Maryland.
(b) “Monitored prescription drug” does not include naloxone
medication.
(11) “Naloxone medication” means an opioid antagonist approved
by the federal Food and Drug Administration for the reversal of an opioid
overdose.
(12) “Naloxone medication data” means the information required
to be submitted to the Program when dispensing naloxone medication.
[(11)] (13)—[(24)] (26)
(text unchanged)
.03 Dispenser Reporting.
A. For each monitored prescription drug and naloxone medication dispensed, the dispenser shall report data elements required by American Society
for Automation in Pharmacy (ASAP) standards in addition to the following [prescription monitoring data to the
Department]:
(1) Identifying information for the prescription issued and drug
dispensed, including:
(a)—(g) (text unchanged)
(h) Metric quantity of drug dispensed and units; [and]
(i) Days’ supply of drug dispensed; and
(j) Date prescription was sold;
(2) Identifying information for the patient or animal owner or handler, as
appropriate, including:
(a)—(c) (text unchanged)
(d) [Sex] Gender;
(e) (text unchanged)
(f) Address, including residential house or building number,
apartment number, street name, state, and zip code; [and]
(g) A patient identification number[, which may include:
(i) A state-issued driver’s license or identification card number;
(ii) An insurance or third-party payer identification number;
(iii) A passport identification number;
(iv) An employer-issued identification card number;
(v) A student identification card number;
(vi) A United States Permanent Resident Card identification number;
or
(vii) A patient or customer identification number generated by the
dispenser’s record management system];
(h) ID qualifier; and
(i) Species indication;
(3) [Identifying information] First and Last name
for the prescriber, including:
(a) [A] For
prescription monitoring data, a
valid Drug Enforcement Administration registration number; [and] or
(b) [Last name; and] For naloxone medication data, a
valid National Provider Identifier;
(4) Identifying information for the dispenser, including a valid
Drug Enforcement Administration registration number[.]; and
(5) Additional data elements consistent with the standards
established by the ASAP.
B. Reporting Deadline.
(1) A dispenser shall report prescription monitoring data and
naloxone medication data to the Department to include zero reports
at least once every 24 hours and in accordance with procedures developed by the
Department and approved by the Advisory Board on Prescription Drug Monitoring.
(2) A dispenser that suffers a mechanical, electrical, or other
technical failure that, as a direct consequence, precludes the dispenser’s
ability to report prescription monitoring data or naloxone medication data
electronically shall:
(a) (text unchanged)
(b) Submit a report for each monitored prescription drug and
naloxone medication dispensed
during the period of technical failure as soon as possible, but no later than
24 hours following reestablishment of the means of electronic reporting.
C.—F. (text unchanged)
G. Waiver for Dispensing to Hospice Inpatients.
(1) On a form or in a manner approved by the Department, a pharmacy
may apply to the Department to be granted a waiver from reporting prescription
monitoring data
or naloxone medication data for dispensing of monitored
prescription drugs to hospice inpatients, provided that:
(a) (text unchanged)
(b) The pharmacy agrees that it will be subject to unannounced,
on-site inspections by the Department to verify its reporting of prescription
monitoring data and naloxone medication data on customers that are not hospice
inpatients.
(2) (text unchanged)
.04 Review of Prescription Monitoring Data.
A. The Program shall review prescription monitoring data and
naloxone medication data for
indications of possible:
(1)—(2) (text unchanged)
B. (text unchanged)
.05 Disclosure of Prescription Monitoring Data.
A.—C. (text unchanged)
D. Disclosure of Prescription Monitoring Data to a Licensing
Entity.
(1) (text unchanged)
(2) The licensing entity shall include in the administrative
subpoena:
(a) Information sufficient to identify the unique prescriber, [or] dispenser, or patient
about whom prescription monitoring data is requested;
(b)—(d) (text unchanged)
E. (text unchanged)
F. Disclosure of Prescription Monitoring Data to a Patient or a
Patient’s Authorized Representative.
(1) Upon request, the Program shall disclose to a patient 18 years
old or older prescription monitoring data about [that] the patient provided that the
request is submitted to the Program:
(a) [In person and is
accompanied by:
(i) A] On a completed form approved by
the Department[; and] that
contains a notarized signature of the requester; or
[(ii) Valid photo
identification issued by a government agency of any jurisdiction of the United
States verifying that the patient is 18 years old or older; or]
(b) (text unchanged)
(2)—(4) (text unchanged)
G.—O. (text unchanged)
.05-1 Disclosure of Naloxone Medication Data.
Disclosure of Naloxone Medication Data for Public Health
Surveillance, Research, Analysis, Education, and Public Reporting.
A. The Program shall disclose naloxone medication data for
research, analysis, education, and public reporting:
(1) Upon approval by the Department of a written proposal or
abstract explaining the purpose and scope of the research, analysis, education,
and public reporting; and
(2) After redaction of all information that could identify a
patient, prescriber, dispenser, or any other individual.
B. The Secretary may waive the requirement of §A(1) of this
regulation for requests from units of the Department.
C. The Program may disclose de-identified naloxone medication
data for public health surveillance purposes.
D. The Program may not disclose identifiable naloxone medication
data to any entity, including but not limited to prescribers or dispensers.
.07 Confidentiality.
A. Prescription monitoring data and naloxone medication data are
confidential, privileged, not subject to discovery, subpoena, or other means of
legal compulsion in civil litigation, and are not public records.
B. (text unchanged)
C. The Program shall periodically conduct an audit review of
prescription monitoring data and naloxone medication data and
disclosure requests to ensure compliance with §B of this regulation.
.08 Penalties and Sanctions.
A. Civil Penalties. A dispenser who knowingly fails to submit
prescription monitoring data or naloxone medication data to the
Program as required by Regulation .03 of this chapter shall be subject to a
civil penalty not exceeding $500 for each failure to submit required
information.
B. Criminal Penalties. A person who knowingly discloses, uses,
obtains, or attempts to obtain by fraud or deceit prescription monitoring data or naloxone medication data in
violation of in Health-General Article, §21-2A, Annotated Code of Maryland,
shall be guilty of a misdemeanor and on conviction is subject to imprisonment
not exceeding 1 year or a fine not exceeding $10,000 or both.
C. Administrative Sanctions. A prescriber or pharmacist who
knowingly discloses or uses prescription monitoring data or naloxone medication data
in violation of Health-General Article, §21-2A, Annotated Code of Maryland
shall be subject to disciplinary action by the appropriate licensing entity.
.09 General Provisions.
A. The Program shall make available the information technology
necessary for dispensers to report prescription monitoring data and
naloxone medication data to the Program.
B. (text unchanged)
C. A prescriber or pharmacist[:
(1) Is not required or obligated to access or use the prescription
monitoring data available under the Program; and
(2) When], when acting in good faith, is not subject to
liability or disciplinary action arising solely from:
[(a)] (1)
Requesting or receiving[, or failing
to request or receive,] prescription
monitoring data from the Program; or
[(b)] (2)
(text unchanged)
D. Redisclosure of Prescription Monitoring Data.
(1) Prescription monitoring data received under Health-General
Article, §21-2A-06, Annotated Code of Maryland, and Regulation [.04] .05
of this chapter may be redisclosed only:
(a) (text unchanged)
(b) For entities to which the Program has disclosed data [in
accordance with Regulation .05C—E and H of this chapter], in furtherance of an existing, bona fide, individual investigation
to another agency cooperating with or providing support [for] to the original data [recipient’s existing, bona fide,
individual investigation].
(2) (text unchanged)
E. Redisclosure of Naloxone Medication Data. Naloxone medication
data received under Health-General Article, §21-2A-6.1, Annotated Code of
Maryland, and Regulation .05-1 of this chapter may be redisclosed only in a
manner consistent with the Health Insurance Portability and Accountability Act
of 1996 (HIPAA), 42 U.S.C. §1320d et seq., as amended, and all other State and
federal laws and regulations governing the security and confidentiality of
protected health information and personal medical records.
[E.] F. The Program shall retain
prescription monitoring data and naloxone medication data for 5
years from the date of receipt.
[F.] G. (text unchanged)
DENNIS R. SCHRADER
Secretary of Health
Subtitle 60 BOARD OF ENVIRONMENTAL
HEALTH SPECIALISTS
Notice of Proposed Action
[22-320-P]
The Secretary of Health proposes to amend:
(1) Regulation .01
under COMAR 10.60.01 General Regulations;
(2) Regulation .06
under COMAR 10.60.02 Licensing Procedures;
(3) Regulation .01
under COMAR 10.60.03 Continuing Education; and
(4) Regulation .01
under COMAR 10.60.06 Fee Schedule.
This action was considered by the Board of Environmental Health Specialists
at a public meeting held on April 6, 2022, notice of which was given by
publication on the Board’s website at Pages - Board of Environmental Health
Specialists Home (maryland.gov) pursuant to General Provisions Article,
§3–302(c), Annotated Code of Maryland.
Statement of Purpose
The purpose of this action is to:
(1) Clarify the term “board-approved training”;
(2) Establish license expiration dates after June 30, 2023;
(3) Establish alternating biennial license renewal schedules for
licensees in odd-numbered and even-numbered years;
(4) Clarify board-approved training requirements; and
(5) Provide a one-time, one-year prorated renewal fee for licenses
expiring on June 30, 2023.
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 Jourdan Green, Director, Office of
Regulation and Policy Coordination, Maryland Department of Health, 201 West
Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 , or email
to mdh.regs@maryland.gov. Comments will be accepted through February 13, 2023.
A public hearing has not been scheduled.
10.60.01 General Regulations
Authority: Health Occupations Article, §§21-101—21-502, Annotated
Code of Maryland
.01 Definitions.
A. (text unchanged)
B. Terms Defined.
(1)—(2) (text unchanged)
(3) Approved Training.
(a) “Approved training”
means Board-approved courses of study
or programs of instruction in an area of environmental health sciences and
related subjects designed to improve, advance, or extend professional skill and
knowledge relating to the practice of an environmental health specialist [and that are approved by the Board in
accordance with the requirements of this subtitle].
(b) “Approved training” includes, for licensees applying for
renewal of a license for the first time, in-training or prior work experience as specified under COMAR
10.60.03.01C(7).
(4)—(22) (text unchanged)
10.60.02 Licensing Procedures
Authority: Health Occupations Article, §§21-101—21-502, Annotated
Code of Maryland
.06 Expiration and
Renewal of Licenses.
A. Expiration. After June 30, 2023, licenses shall expire
pursuant to the following schedule:
(1) The license of a licensee with an even-numbered birth year
shall expire on June 30 of an even-numbered year; and
(2) The license of a licensee with an odd-numbered birth year
shall expire on June 30 of an odd-numbered year.
[A.] B. Conditions for
License Renewal.
(1) [The] Except
as provided in §B(2) and (3) of this regulation, the Board shall renew a license for a 2-year period if the licensee
has:
(a)—(b) (text unchanged)
(c) Submitted satisfactory proof to the Board that the licensee has
completed at least 20 clock hours of [Board-approved] approved
training [obtained during the 2-year
period before the license expiration date]
during the license renewal period;
and
(d) (text unchanged)
(2) For licenses expiring on June 30, 2023 only, the Board shall
renew the license of a licensee with an even-numbered birth year for a 1-year
period if the licensee meets the requirements set forth under §B(1) of this
regulation.
(3) For licenses expiring on June 30, 2024 only, the Board shall
renew a license for a 2-year period if the licensee has:
(a) Submitted an application for renewal to the Board before the
expiration date of the license;
(b) Paid the renewal fee established by COMAR 10.60.06;
(c) Submitted satisfactory proof to the Board that the licensee
has completed at least 10 clock hours of approved training during the 1-year
period immediately preceding the license expiration date; and
(d) Not committed any act which, under Health Occupations
Article, §21-312, Annotated Code of Maryland, would subject the licensee to
disciplinary action by the Board.
[(2)] (4) The Board may deny
the application to renew a license if the applicant has failed to satisfy the
requirements of [§A(1)] §B
of this regulation.
[B.] C. (text unchanged)
10.60.03 Continuing Education
Authority: Health Occupations Article, §§21-101—21-502, Annotated
Code of Maryland
.01 Approval of Training.
A. The Board shall approve and credit training that meets the
requirements of this regulation.
[A.] B. [Board-approved] Approved training shall be designed to
improve, advance, or extend professional skill and knowledge relating to the
practice of an environmental health specialist.
[B. For courses for
which continuing education units (CEUs) have been assigned, one CEU is
equivalent to 10 clock or classroom hours of approved training.]
C. [Board-approved] Approved
training may consist of participation in any of the following:
(1)—(4) (text unchanged)
(5) Authoring a paper published in a professional journal requiring
peer review; [or]
(6) Instruction of approved training courses[.]; or
(7) For licensees applying for renewal for the first time:
(a) On-the-job training in an environmental health
specialist-in-training program under the supervision of an environmental health
sponsor; or
(b) Practice as an environmental health specialist or its
equivalent in another state or territory of the United States, as approved by
the Board.
[D. The Board shall
maintain a current list of all Board-approved training.
E. Assignment of Credit.
(1) The Board shall determine the hours of approved training as
follows:
(a) For courses given in educational institutions, 1 hour of
approved training is equivalent to 1 hour of classroom training;
(b) Credit hours for training such as online courses,
correspondence courses, extension studies, and authored papers shall be
determined by the Board on a case-by-case basis; and
(c) Credit hours for participation in instruction of an approved
training course shall be:
(i) Credited to the instructor as 1 hour of credit for 1 hour of
instruction;
(ii) Accepted for up to 10 hours of training per renewal period;
and
(iii) Accepted only once per renewal period for each training
course.
(2) Approved training shall be credited to the license renewal
period only if:
(a) Taken during the renewal period;
(b) Evidence of completion is submitted to the Board within 90 calendar
days of the date of completion of the training; and
(c) The training meets the requirements set forth in Regulation
.01A of this chapter.
(3) Credit shall be received for other training approved by the
Board on a case-by-case basis.
(4) Within the license renewal period, credit may not be received
for training that is substantially similar to another training as determined by
the Board.
(5) The requirement set forth under §E(2)(b) of this regulation
does not apply to an individual who is on inactive status or non-renewed status
who is seeking reactivation of a license.
(6) The Board may waive the requirement set forth under §E(2)(b) of
this regulation if the Board determines that failure to submit evidence of
completion to the Board within 90 calendar days of completion of the training
is the result of unforeseen circumstances out of the licensee’s control.]
D. Determination of Hours of Approved Training. The Board shall
determine the hours of approved training as follows:
(1) For courses for which continuing education units (CEUs) have
been assigned, 1 CEU is equivalent to 10 clock or classroom hours of approved
training;
(2) For courses given in educational institutions, 1 hour of
classroom training is equivalent to 1 hour of approved training;
(3) For training such as online courses, correspondence courses,
extension studies, authored papers, and any other approved training, the Board
shall determine the hours of approved training on a case-by-case basis;
(4) For instruction of an approved training course, the Board
shall grant:
(a) 1 hour of training for 1 hour of instruction;
(b) Up to 10 hours of training per license renewal period; and
(c) Hours as an instructor only once per license renewal period
for each training course; and
(5) For licensees applying for renewal for the first time, the
Board shall grant 5 hours of approved training for each full 6-month period
that the licensee participated in training or work experience listed in §C(7)
of this regulation within the license renewal period.
E. Assignment of Hours of Approved Training.
(1) The Board shall assign hours of approved training to a
license renewal if the licensee:
(a) Completed the hours of training during the license renewal
period, unless an extension has been granted pursuant to Regulation .04 of this chapter;
and
(b) Submitted evidence of completion to the Board within 90
calendar days of the date of completion of the training.
(2) For licensees applying for renewal for the first time, the
Board shall assign hours of approved training to the license renewal if the
licensee completed training set forth under:
(a) §C(1)—(6) of this regulation after the date the initial
license is issued and submitted evidence of completion to the Board within 90
calendar days of the date of completion of the training; or
(b) §C(7) of this regulation during the license renewal period.
(3) Within the license renewal period, credit may not be
received for training that is substantially similar to another training as
determined by the Board.
(4) The requirements set forth under §E(1) of this regulation do
not apply to an individual who is on inactive status or non-renewed status who
is seeking reactivation of a license.
(5) The Board may waive the requirement set forth under §E(1)(b)
of this regulation if the Board determines that failure to submit evidence of
completion to the Board within 90 calendar days of completion of the training
is the result of unforeseen circumstances out of the licensee’s control.
F. Procedures.
(1) The sponsor of a training
course or licensee may request of the Board approval of training on a form
provided by the Board.
(2) The Board shall maintain a list of all approved training.
10.60.06 Fee Schedule
Authority: Health Occupations Article, §§21-205, 21-206, and 21-309,
Annotated Code of Maryland
.01 Scope.
A.—C. (text unchanged)
D. The following fees apply:
(1)—(4) (text unchanged)
(5) One-time renewal fee for licenses expiring on June 30, 2023
for licensees with an even-numbered birth year whose license will be renewed
for 1 year — $100;
[(5)] (6)—[(11)] (12) (text unchanged)
DENNIS R.
SCHRADER
Secretary of Health
Title 12
DEPARTMENT OF PUBLIC SAFETY AND CORRECTIONAL SERVICES
Subtitle 04 POLICE TRAINING
AND STANDARDS COMMISSION
12.04.11 Police Complaint Mediation Program
Authority: Public Safety
Article, §§3-207 and 3-208, Annotated Code of Maryland
Notice of Proposed Action
[22-277-P]
The Police Training and Standards Commission proposes to adopt new
Regulations .01―.08 under a
new chapter, COMAR 12.04.11 Police
Complaint Mediation Program. This action was considered and approved by the
Police Training and Standards Commission at a public meeting held on November
17, 2022.
Statement of Purpose
The purpose of this action is to adopt a new chapter, COMAR
12.04.11, that fulfills the requirement mandated by Public Safety Article,
§3-207(d), Annotated Code of Maryland. During the 2016 Legislative Session,
H.B. 1016 was introduced as a police reform bill and included a requirement for
the Maryland Police Training and Standards Commission to establish a police
complaint mediation program. The inclusion of mediation as a tool for
effectively responding to and resolving police complaints is based upon a
growing body of research that shows dispute resolution through mediation is
effective in resolving procedural and interpersonal issues that are not
necessarily subject to legal determination, and it gives the participants a
greater degree of control over the outcome of the dispute, thus preserving
community relationships. H.B. 1016 was enacted as Ch. 519, Acts of 2016, and
the Commission later developed a model policy for mediation, but did not adopt
regulations to implement a program. The proposed chapter establishes the
regulations to create and maintain a police complaint mediation program as
required by Public Safety Article, §3-207, Annotated Code of Maryland.
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 Wayne Silver, Director, Police Training
and Standards Commission, Police and Correctional Training Commissions, 6852
4th Street, Sykesville, MD 21842, or call 410-875-3605, or email to wayne.silver@maryland.gov.
Comments will be accepted through February 13, 2023. A public hearing has not
been scheduled.
.01 Purpose.
A. This chapter establishes a police complaint mediation program
which provides an alternative method to address minor, nonviolent police misconduct
complaints outside of the standard complaint process.
B. A law enforcement agency may refer a nonviolent complaint made
against a police officer, subject to the agreement of the complainant and the involved
police officer, to an independent mediation provider.
.02 General Provisions.
A. Mediation is a process for
settling minor police misconduct disputes based on the voluntary participation of
the disputing parties.
B. If eligible, voluntary mediation
between community members and police officers may be used in place of the traditional
administrative complaint process and administrative charging committees (ACC).
C. The mediation process can bridge
the communication gap and create a greater understanding and appreciation between
community members, police officers, and employing law enforcement agencies.
.03 Definitions.
A. In this chapter, the following terms have the meanings indicated.
B. Terms Defined.
(1) “Confidential material” means
any communication occurring during a mediation session that may not be disclosed
outside the mediation except as allowed pursuant to Courts and Judicial Proceedings
Article, §3-1804, Annotated Code of Maryland.
(2) “Impasse” means an outcome
of a mediation session in which the parties are unable to resolve the dispute.
(3) “Independent mediation provider”
means an organization, separate and apart from a law enforcement agency, that can
provide mediators to conduct mediation sessions between complainants and law enforcement
personnel.
(4) “Letter of conclusion”
means a document signed by staff of the independent mediation provider that is delivered
to a law enforcement agency indicating that a mediation session was held between
a complainant and police officer.
(5) “Letter of consent to mediate”
means a document signed by the parties in mediation indicating each party’s
voluntarily participation in mediation, and witnessed by the mediator.
(6) “Mediation” has the
meaning stated in COMAR 12.04.10.03B.
(7) “Mediator” means a trained,
impartial third party, affiliated with an independent mediation provider, who will
facilitate a mediation session between parties to assist them in reaching a voluntary
resolution to their dispute.
(8) “Police misconduct” has the
meaning stated in Public Safety Article, §3-101, Annotated Code of Maryland.
(9) “Resolution” means a mutual
agreement resolving a conflict between two or more disputing parties.
.04 Establishing a Police Complaint
Mediation Program.
A. The Maryland Police Training and Standards Commission (MPTSC)
in collaboration with community-based mediation resources shall establish and maintain
a listing of qualified mediation providers located within the State.
B. A law enforcement agency interested in establishing a mediation
program shall contact MPTSC for referral to an appropriate mediation provider.
C. Prior to establishing a mediation process, a law enforcement agency
shall enter into a memorandum of understanding (MOU) with a local independent mediation
provider approved by MPTSC.
D. A local law enforcement agency shall establish guidelines for
mediation consistent with this regulation and any policy guidelines provided by
MPTSC.
E. A law enforcement agency that enters into an MOU with a
qualified mediation provider shall report the establishment of a program to MPTSC
and forward a copy to ensure the program meets the requirements of the regulation.
.05 Mediation Participation.
A. Participant Requirements.
(1) Participation in a mediation program is voluntary and shall be
agreed upon by the complainant, law enforcement agency, and police officer identified
in the complaint.
(2) A complainant or police officer who is the subject of a complaint
of police misconduct has the right to decline mediation.
(3) If a police officer who is the subject of a complaint declines
the offer to mediate the complaint, the decision to not participate may not be considered
during any disciplinary proceeding.
(4) A party to mediation shall sign a letter of consent to mediate
as an alternative to the formal police misconduct complaint process, outlined in
COMAR 12.04.09 and the uniform citizen complaint process.
B. Confidentiality.
(1) All parties involved in a potential mediation process shall agree
to the confidentiality requirements as set forth in Courts and Judicial Proceedings
Article, §3-1803, Annotated Code of Maryland.
(2) Except as provided in Courts and Judicial Proceedings Article,
§3-1804, Annotated Code of Maryland, statements shared during a mediation are considered
confidential material and may not be disclosed in any judicial, administrative,
or other proceeding.
C. Costs associated with participating in a mediation program are
the responsibility of the law enforcement agency employing the involved police officer.
.06 Complaints Eligible for
Mediation.
A. Complaint Eligibility.
(1) A nonviolent complaint of a minor nature is eligible for
mediation if it falls into one of the following categories:
(a) Violation category A, as
stated in COMAR 12.04.10.04D(2); or
(b) Violation category B, as
stated in COMAR 12.04.10.04D(3).
(2) A law enforcement agency shall review the nature of the complaint
and determine if mediation is appropriate, based on the following factors:
(a) Type and severity of the alleged violation;
(b) Circumstances of the alleged police misconduct; and
(c) Work history and past disciplinary record of the involved police
officer.
(3) Even if a complaint is eligible for mediation, the agency head
or designee has the authority to decide, for any reason, that a case may not be
assigned for mediation.
B. Complaints Not Eligible.
(1) A complaint of police misconduct that involves any level of force
is not eligible for mediation.
(2) A complaint is not eligible for mediation if it falls into one
of the following categories:
(a) Violation category C, as stated in COMAR 12.04.10.04D(4);
(b) Violation category D, as stated in COMAR 12.04.10.04D(5);
(c) Violation category E, as stated in COMAR 12.04.10.04E(6); or
(d) Violation category F, as stated in COMAR 12.04.10.04D(7).
C. A complaint of police misconduct not eligible for mediation
shall be handled through the process set forth in COMAR 12.04.09.
.07 Complaint Procedures.
A. When a minor complaint from a member of the public has been made
to a law enforcement agency or police accountability board, a law enforcement agency
shall review the nature of the complaint and determine if it is eligible for the
mediation program.
B. Notification to Involved Parties.
(1) If the complaint is eligible and conforms to Regulation .06 of
this chapter, the law enforcement agency shall notify the police officer who is
the subject of the complaint of the mediation option.
(2) If the police officer agrees to mediation, the law
enforcement agency shall notify the complainant of the mediation option.
C. If the police officer or a complainant decline to participate
in mediation, the matter shall be referred back to the administrative complaint
process set forth in COMAR 12.04.09.
D. If all parties to the complaint agree to the mediation process,
the law enforcement agency shall contact the independent mediation provider in which
there is a current memorandum of understanding (MOU) and proceed with the process
pursuant to the MOU.
E. When a case has been referred to the mediation service, the independent
mediation provider will manage the case through mediation and resolution.
.08 Resolution.
A. When the mediation process has concluded, the outcome shall be
determined by the independent mediation provider to be:
(1) A successful resolution if all parties agree with the resolution;
or
(2) An impasse if one or more parties to the complaint cannot agree
to a satisfactory resolution.
B. An impasse shall be referred back to the law enforcement agency
of the involved police officer for investigation and handled through the administrative
complaint process set forth in COMAR 12.04.09.
C. A successful resolution shall be documented by the
independent mediation provider in a written statement, signed by both parties and
the mediator.
D. The mediator shall send a letter of conclusion to the referring
law enforcement agency indicating the results of mediation.
E. Results of the mediation shall be tracked by the law enforcement
agency and forwarded to the local police accountability board.
F. Complaint mediation statistics shall be included in the law enforcement
agency’s annual reporting of complaints involving the public, and the statistics
shall include the:
(1) Total number of complaints handled through mediation;
(2) Number of successful resolutions; and
(3) Number of mediation impasses.
G. If the police officer fails to comply with the actions and deadlines
identified in the mediation agreement, a new complaint shall be initiated and the
actions of the original complaint of misconduct shall be considered as a potential
aggravating factor.
WOODROW W. JONES, III
Chair
Title 14
INDEPENDENT AGENCIES
Subtitle 09 WORKERS’ COMPENSATION
COMMISSION
14.09.04 Legal Representation
and Fees
Authority: Labor and Employment Article, §§9-309, 9-721, 9-731, and
9-734, Annotated Code of Maryland
Notice of Proposed Action
[22-282-P]
The Maryland Workers’ Compensation Commission proposes to amend Regulation
.02, repeal existing Regulation .03, and adopt new Regulation .03 under COMAR 14.09.04 Legal Representation and Fees. This action was
considered at a public meeting held on October 27, 2022, notice of which was
given by publication in 49:22 Md. R. 987 (October 21, 2022) pursuant to General
Provision Article, §3-302(c), Annotated Code of Maryland.
Statement of Purpose
The purpose of this action is to update the schedule of attorney’s
fees.
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 Amy S. Lackington, Administrator, Workers’
Compensation Commission, 10 E. Baltimore Street, Baltimore, MD 21202, or call
410-864-5300, or email to alackington@wcc.state.md.us. Comments will be
accepted through February 13, 2023. A public hearing has not been scheduled.
Open Meeting
Final action on the proposal will be considered by the Workers’
Compensation Commission during a public meeting to be held on March 9, 2023, at
9:30 a.m., at 10 E. Baltimore Street, Baltimore, MD 21202.
.02 Attorney’s Fee,
Medical Evaluation Fee, and Costs — Application or Petition for Approval.
A. Request for Attorney’s Fee Not in Excess of Schedule.
(1) — (8) (text unchanged)
(9) An attorney seeking approval of an attorney’s fee that does
not exceed the maximum amount set forth in Regulation .03 of this chapter
shall:
(a) Accurately calculate the
fees sought; and
(b) Include an itemization of
all attorney’s fees previously awarded by reference to the amount and date of
the Commission’s orders.
(10) Failure to comply with this regulation may result in the
reduction or denial of the attorney’s fee sought.
B. Petition for Attorney’s Fee in Excess of Schedule.
(1) — (3) (text unchanged)
(4) The Commission, at its discretion, may schedule a hearing on
the petition for an attorney’s fee in excess of the schedule.
C. (text unchanged)
.03 Schedule of Attorney’s Fees.
A. The Commission
shall approve attorney’s fees in accordance with the schedule of fees
established by the Commission and set forth in §C of this regulation.
B. Definitions.
(1) In this regulation, the following terms have the meanings
indicated.
(2) Terms Defined.
(a) “Award of compensation” means the amount of indemnity benefits
actually paid or payable to the claimant after any credit or offset or
reduction of the percentage of permanent partial disability following a
stipulation, appeal, or other modification approved by the Commission.
(b) “Final award” means the award of compensation determined by the
Commission after exhaustion of all applicable appeals, regardless of whether
the award is increased or decreased because of any appeal.
(c) “Formal set-aside allocation” means a document reflecting a comprehensive
analysis and projection of future injury-related medical needs and associated
costs.
(d) “State average weekly wage” means the State average weekly wage in
effect on the date of the accident or date of disablement.
C. Schedule of
Fees.
(1) Amounts
Excluded from Calculation. In calculating the attorney’s fee, an attorney may
not include in the calculation any amounts paid or payable for medical services
and prescription drugs, including but not limited to:
(a) Any monies
allocated to future medical expenses through a formal set-aside allocation;
(b) Any monies
apportioned to future medical benefits;
(c) Any monies
already paid or owing for medical services and prescription drugs; or
(d) Any monies
charged or to be charged for the administration of a formal set-aside
allocation.
(2) Fee in Excess
of Limits — Exceptional Circumstances. The Commission may approve an attorney’s
fee in excess of the limits set forth in this regulation only if exceptional
circumstances are shown under Regulation .02B of this chapter.
(3) Permanent
Partial Disability.
(a) General.
Except as otherwise provided in §C(3)(b) of this regulation, in a case in which
a final award of compensation is made for permanent partial disability, the
Commission may approve an attorney’s fee in a total amount not to exceed 60
times the State average weekly wage and computed as follows:
(i) Up to 20
percent of the first $50,000 of the total award of compensation;
(ii) Up to 15
percent of the next $50,000 of the total award of compensation; and
(iii) Up to 5
percent of the total award of compensation in excess of $100,000.
(b) Disability Due
to Amputation or Loss of Vision — Generally. Except as provided in §C(3)(c) of
this regulation, in a case in which the rate of compensation is set for permanent
partial disability due to the amputation of an arm, leg, hand, or foot, or
total loss of vision in one eye, and the sole issue before the Commission is
the nature and extent of disability, the Commission may approve an attorney’s
fee in an amount up to 5 percent of the compensation awarded, but not exceeding
7.5 times the State average weekly wage.
(c) Disability Due
to Amputation or Loss of Vision — Worsening. In a case of worsening of a
permanent partial disability due to the amputation of an arm, leg, hand, or
foot, or total loss of vision in one eye, takes place or is discovered after
the rate of compensation is set or compensation is terminated, the Commission
may approve an attorney’s fee computed under §C(8) of this regulation on the
increased award.
(4) Permanent
Total Disability.
(a) General.
Except as otherwise provided in this regulation, in a case in which an initial
determination of permanent disability produces a final award of compensation
for permanent total disability, the Commission may approve an attorney’s fee in
an amount not exceeding 25 times the State average weekly wage.
(b) Special Cases.
The Commission may approve an attorney’s fee in an amount not exceeding 15
times the State average weekly wage in a case in which compensability is not an
issue and an award of compensation is made for permanent total disability
established pursuant to either:
(i) Labor and
Employment Article, §9-636(b), Annotated Code of Maryland, for the loss of two
or more scheduled members; or
(ii) The stipulation
on the extent of disability.
(5) Temporary
Total and Temporary Partial Disability. The Commission may not approve an
attorney’s fee in a case in which final award of compensation is made for
temporary total or temporary partial disability or temporary total disability
paid while a claimant is receiving vocational rehabilitation services unless
the claimant’s right to the compensation is contested, and the issue is
resolved by evidentiary hearing or by stipulation. In such a contested case,
the fee may be in an amount not exceeding 10 percent of the compensation that
has accrued as of the date of the award.
(6) Dependency
Claims.
(a) In a case
involving a claim of dependency where compensability is not contested, but the
extent of dependency, partial or total, or the identity of a dependent, or both
is contested, the Commission may approve a total attorney’s fee for attorneys
representing all dependents:
(i) In an amount
not exceeding 6.25 times the State average weekly wage in a case of partial
dependency under Labor and Employment Article, §9-682, Annotated Code of
Maryland; or
(ii) In an amount
not exceeding 15 times the State average weekly wage in a case of total
dependency under Labor and Employment Article, §9-681 or 9-683.3, Annotated
Code of Maryland.
(b) In a case
involving a claim of dependency where neither compensability nor dependency is
contested and a record is being made solely to determine to whom payments of
compensation shall be made, the Commission may approve an attorney’s fee in an amount
not exceeding 2.5 times the State average weekly wage.
(c) In a case
involving a claim of dependency where compensability and dependency are
contested, the Commission may approve an attorney’s fee:
(i) In an amount
calculated under §C(3)(a) of this regulation in a case involving a claim of
partial dependency under Labor and Employment Article, §9-682 or 9-683.3,
Annotated Code of Maryland; or
(ii) In an amount
calculated under §C(4)(a) of this regulation in a case of total dependency
under Labor and Employment Article, §9-681, Annotated Code of Maryland.
(7) Settlement
Agreements. In a case in which an agreement of final
compromise and settlement is approved, and upon the filing of an
application or petition for an attorney’s fee in accordance with Regulation .02
of this chapter, the Commission may approve an attorney’s fee not exceeding 60
times the State average weekly wage and computed in accordance with §B(3)(a) of
this regulation.
(8) Increase in
Last Award of Compensation.
(a) Permanent Partial Disability. If the claimant is entitled to additional compensation as a
result of an increase in a permanent partial disability award under §C(3) of
this regulation the Commission may approve an additional attorney’s fee in an
amount not exceeding the difference between the fee approved for all prior
permanent partial disability awards and the fee computed under §C(3) or (4)(a)
of this regulation on the increased award.
(b) Agreement of
Final Compromise and Settlement. If the claimant is entitled to additional
compensation as a result of an agreement of final compromise and settlement
approved under §C(7) of this regulation following a prior award of permanent
partial disability, the Commission may approve an additional attorney’s fee in
an amount not exceeding the difference between the fee approved for all prior
awards and the fee computed under §C(3) or (4) of this regulation on the
increased award.
(c) In a case in
which a determination of permanent disability made pursuant to Labor and
Employment Article, §9-736(a), Annotated Code of Maryland, produces a final
award of compensation for permanent total disability, the Commission may
approve an additional attorney’s fee in an amount as follows:
(i) 20 percent of
the first 200 weeks of permanent total disability benefits, excluding any
cost-of-living increase as provided in Labor and Employment Article, §9-638 or
§9-638.1, Annotated Code of Maryland, minus a fee or fees approved for all
prior permanent disability awards; and
(ii) Not exceeding
15 times the State average weekly wage.
(9) Additional
Fees for Appeals of Compensation Awards.
(a) When a
compensation award of the Commission is appealed to a circuit court and the
case is tried on appeal, the Commission may approve an additional attorney’s
fee in an amount up to 5 percent of the first final indemnity award issued
following the circuit court action, but not exceeding 7.5 times the State
average weekly wage.
(b) When a
decision of a circuit court on an appeal from a compensation award of the
Commission is appealed to a higher appellate court and the appeal is briefed
and decided on its merits, the Commission may approve an additional attorney’s
fee for each appeal in an amount up to 5 percent of the first final indemnity
award issued following the appellate action, but not exceeding 7.5 times the
State average weekly wage.
(c) When an appeal
from a compensation award of the Commission to a circuit court is not tried, or
an appeal to a higher appellate court is not briefed and decided on its merits,
the Commission may approve an additional attorney’s fee in an amount up to 2.5
percent of the first final indemnity award issued following the appellate
action or circuit court action, but not exceeding 3.75 times the State average
weekly wage.
(d) When a decision
of the Commission on the issue of compensability of a claim is appealed to a
circuit court, if the claim is determined on appeal to be compensable, the
Commission, upon remand, may approve an additional attorney’s fee in an amount
up to 5 percent of the first final indemnity award issued following the remand,
but not exceeding 7.5 times the State average weekly wage.
(e) An attorney
may be awarded an appeal fee under only one of paragraphs (a) — (d) of this
subsection for a circuit court action or appellate court action.
(f) Once an appeal
fee has been awarded for a circuit court action or appellate action, the
Commission may not award an additional appeal fee based on the same circuit
court action or appellate action.
D. Attorney’s Fee
Allowed — Exceptional Circumstances.
(1) In exceptional
circumstances as shown under Regulation .02B of this chapter, the Commission
may approve an attorney’s fee in a case in which it is determined that the
claimant is not entitled to any compensation or benefits. Nothing in this regulation
prohibits the Commission from awarding an attorney’s fee under Regulation .02C
of this chapter.
(2) In exceptional
circumstances as shown under Regulation .02B of this chapter, the Commission
may approve an attorney’s fee in a case involving issues such as medical care
and treatment, or vocational rehabilitation, in which the claimant does not
receive any monetary award. Nothing in this regulation prohibits the Commission
from awarding an attorney’s fee under Regulation .02C of this chapter.
R. KARL AUMANN
Chairman
Subtitle 22 COMMISSION ON CRIMINAL
SENTENCING POLICY
Notice of Proposed Action
[22-303-P]
The Maryland State Commission on Criminal Sentencing Policy
proposes to amend:
(1) Regulations .09—.11 under COMAR 14.22.01 General Regulations; and
(2) Regulation .02 under COMAR 14.22.02 Criminal Offenses and Seriousness
Categories.
Statement of Purpose
The purpose of this action is to modify Regulation .09 under COMAR
14.22.01 General Regulations to clarify the definition of “explosive” as it
pertains to the assignment of weapon presence points in part C of the offense score.
Additionally, the purpose of this action is to modify Regulations .10 and .11
under COMAR 14.22.01 General Regulations and Regulation .02 under COMAR
14.22.02 Criminal Offenses and Seriousness Categories to account for recent
cannabis legislation enacted by Ch. 26 (H.B. 837), Acts of 2022. The
legislation, as it impacts the noted regulations, substitutes the term
marijuana with cannabis, legalizes the use or possession of a personal amount
of cannabis, and reduces the maximum penalty from 5 years to 3 years for
unlawfully possess with intent to distribute, manufacture, possess production
equipment—cannabis.
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 David Soule, Executive Director, Maryland
State Commission on Criminal Sentencing Policy, University of Maryland, 4511
Knox Rd., Suite 309, College Park, MD 20742, or call 301-403-4165, or email to
dsoule@umd.edu. Comments will be accepted through February 13, 2023. A public
hearing has not been scheduled.
14.22.01 General Regulations
Authority: Criminal Procedure Article, §6-211, Annotated Code of
Maryland
.09 Offense Score.
A. (text unchanged)
B. Elements of the Offense Score.
(1)—(3) (text unchanged)
(4) Weapon Presence.
(a)—(b) (text unchanged)
(c) The individual completing the
worksheet shall assign a score of 2 if a firearm or explosive material was present.
(d) (text unchanged)
(5) (text unchanged)
C. (text unchanged)
.10 Computation of the Offender Score.
A. (text unchanged)
B. Four Components of the Offender Score.
(1)—(2) (text unchanged)
(3) Prior Adult Criminal Record.
(a) In General.
(i) Except as noted in this paragraph,
the prior adult criminal record includes all adjudications preceding the
current sentencing event, whether the offense was committed before, during, or
after the instant offense(s). The prior adult criminal record shall not
include: adjudications that were expunged from the record or proven by the
defense to have been eligible for expungement as a matter of right prior to the
date of offense pursuant to Subtitle 1 (Expungement of Police and Court
Records) of Title 10 (Criminal Records) of the Criminal Procedure Article,
Annotated Code of Maryland; violations of public local laws; municipal
infractions; contempt; criminal nonsupport; [marijuana possession or marijuana paraphernalia possession
adjudications that qualify for a non-incarceration penalty due to evidence of
medical necessity;] adjudications
based on acts that are no longer crimes (e.g.,
cannabis possession); non-incarcerable traffic offenses; military
adjudications imposed by an Article 15 proceeding or summary court-martial;
findings of guilt by general or special courts-martial, if the elements of the
offense require the defendant’s service in a military force, including but not
limited to desertion, absence without leave (AWOL), and conduct unbecoming an
officer and a gentleman, or do not constitute an offense under Maryland law; or
more than one adjudication arising from a single criminal event.
(ii)—(iv) (text unchanged)
(b)—(c) (text unchanged)
(d) Convictions Out of Jurisdiction. If
an offender has been convicted in another jurisdiction, excluding military
adjudications (see §B(3)(e) of this regulation for instructions for scoring
military adjudications), the individual completing the worksheet shall match
the offense as closely as possible to the closest analogous Maryland offense.
If no Maryland analogous offense exists, the individual completing the
worksheet shall count the offense in the lowest seriousness category (VII), and
shall inform the judge and parties. If the out of jurisdiction conviction is
based on act that is not a criminal violation in Maryland (e.g., [marijuana] cannabis possession [less than 10 grams]), then the out of jurisdiction conviction shall be excluded from
the prior adult criminal record. If there is a question as to the analogous
guidelines offense for an out-of-State conviction, that question shall be
brought to the attention of the judge at sentencing.
(e)—(h) (text unchanged)
(4) (text unchanged)
C. (text unchanged)
.11 Determining the Guidelines Sentence.
A.—C. (text unchanged)
D. Drug Offenses.
(1) (text unchanged)
(2) Sentencing Matrix for Drug Offenses.
|
|
SENTENCING MATRIX FOR DRUG
OFFENSES
OFFENDER SCORE
|
|
OFFENSE
SERIOUSNESS
CATEGORY
|
0
|
1
|
2
|
3
|
4
|
5
|
6
|
7+
|
|
VII
|
P
|
P
|
P-1M
|
P-3M
|
P-4M
|
P-6M
|
P-9M
|
P-1Y
|
|
VI
|
Row VI
is available for future use. There
are currently no seriousness category VI drug offenses.
|
|
V
|
P-1M
|
P-3M
|
P-4M
|
P-6M
|
P-9M
|
P-1Y
|
1M-18M
|
2M-2Y
|
|
IV
|
P-3M
|
P-4M
|
P-6M
|
P-9M
|
P-1Y
|
1M-18M
|
2M-2Y
|
3M-3Y
|
|
III-A
[Marijuana] Cannabis import 45
kilograms or more, and MDMA 750 grams or more
|
P-6M
|
P-9M
|
P-18M
|
1M-2Y
|
3M-3Y
|
6M-5Y
|
1Y-6Y
|
2Y-8Y
|
|
III-B
[Non-marijuana] Non-cannabis and
non-MDMA, Except Import
|
P-9M
|
P-18M
|
1M-2Y
|
3M-3Y
|
6M-5Y
|
1Y-6Y
|
2Y-8Y
|
4Y-12Y
|
|
III-C
[Non-marijuana] Non-cannabis and
non-MDMA, Import
|
P-18M
|
1M-2Y
|
3M-3Y
|
6M-5Y
|
1Y-6Y
|
2Y-8Y
|
4Y-12Y
|
6Y-14Y
|
|
II
|
16Y-20Y
|
18Y-22Y
|
20Y-24Y
|
22Y-26Y
|
24Y-28Y
|
26Y-30Y
|
28Y-32Y
|
30Y-36Y
|
Note: (text unchanged)
E. (text unchanged)
14.22.02 Criminal Offenses and Seriousness Categories
Authority: Criminal Procedure Article, §6-211, Annotated Code of Maryland
.02 Seriousness Categories.
|
|
Offense Literal
|
CJIS
Code
|
Source
|
Felony or
Misd.
|
Max
Term
|
Min
Term
|
Offense Type
|
Ser.
Category
|
Fine
|
|
1—49 (text unchanged)
|
|
50
|
CDS and Paraphernalia
Controlled dangerous substance importation into State, [non-marijuana] non-cannabis
|
3-3550
|
CR, §5-614(a)
|
Felony
|
25Y
|
|
Drug
|
IIIC
|
$50,000
|
|
50-1
|
CDS and Paraphernalia
Controlled dangerous substance importation into State, [marijuana] cannabis (45 kilograms or more)
|
3-3550
|
CR, §5-614(a)
|
Felony
|
25Y
|
|
Drug
|
IIIA
|
$50,000
|
|
51 (text unchanged)
|
|
52
|
CDS and Paraphernalia
[Unlawful distribution,
manufacture, etc.; counterfeiting, etc., manufacture, possession, etc., of
certain equipment for illegal use; keeping common nuisance,] Unlawfully distribute, PWID,
manufacture, possess production equipment, distribute counterfeit, PWID
counterfeit, possess counterfeiting equipment, keep common nuisance, possess
false prescription—narcotics and hallucinogenics (e.g.,
PCP, heroin, cocaine, LSD, oxycodone, fentanyl, and methadone)
|
1-1118
1-1119
1-1120
1-1121
1-1122
1-1123
1-1124
1-1125
1-1126
1-1127
1-1128
1-1129
1-1131
1-1132
1-1133
1-1556
1-1557
1-1558
|
CR, §5-602(a)
CR, §5-603(a)
CR, §5-604
CR, §5-605
CR, §5-606
CR, §5-608(a)
CR, §5-609(a)
(penalty)
|
Felony
|
20Y
|
|
Drug
|
IIIB
|
$15,000
|
|
53
|
CDS and Paraphernalia
[Unlawful distribution,
manufacture, etc.; counterfeiting, etc., manufacture, possession, etc., of
certain equipment for illegal use; keeping common nuisance,] Unlawfully distribute, PWID,
manufacture, possess production equipment, distribute counterfeit, PWID
counterfeit, possess counterfeiting equipment, keep common nuisance, possess
false prescription—narcotics and hallucinogenics
(e.g., PCP, heroin, cocaine, LSD, oxycodone, fentanyl, and methadone), subsequent
|
|
CR, §5-602(a)
CR, §5-603(a)
CR, §5-604
CR, §5-605
CR, §5-606
CR, §5-608(b)
CR, §5-609(b)
CR, §5-608(c)
CR, §5-609(c)
CR, §5-608(d)
CR, §5-609(d)
(penalty)
|
Felony
|
20Y
25Y
40Y
|
|
Drug
|
IIIB
|
$15,000
$25,000
$25,000
|
|
53-1—54 (text unchanged)
|
|
54-1
|
CDS and Paraphernalia
[Unlawful distribution,
manufacture, etc.; counterfeiting, etc., manufacture, possession, etc., of
certain equipment for illegal use; keeping common nuisance,] Unlawfully distribute, PWID,
manufacture, possess production equipment, distribute counterfeit, PWID
counterfeit, possess counterfeiting equipment, keep common nuisance, possess
false prescription—MDMA
(methylenedioxymethamphetamine), 750 grams or more
|
1-1127
1-1128
1-1129
1-1131
1-1132
1-1133
1-1556
1-1557
1-1558
|
CR, §5-602(a)
CR, §5-603(a)
CR, §5-604
CR, §5-605
CR, §5-606
CR, §5-609(a)
(penalty)
|
Felony
|
20Y
|
|
Drug
|
IIIA
|
$15,000
|
|
54-2
|
CDS and Paraphernalia
[Unlawful distribution,
manufacture, etc.; counterfeiting, etc., manufacture, possession, etc., of
certain equipment for illegal use; keeping common nuisance,] Unlawfully distribute, PWID,
manufacture, possess production equipment, distribute counterfeit, PWID
counterfeit, possess counterfeiting equipment, keep common nuisance, possess
false prescription—MDMA
(methylenedioxymethamphetamine), 750 grams or more, subsequent
|
|
CR, §5-602(a)
CR, §5-603(a)
CR, §5-604
CR, §5-605
CR, §5-606
CR, §5-609(b)
CR, §5-609(c)
CR, §5-609(d)
(penalty)
|
Felony
|
20Y
25Y
40Y
|
|
Drug
|
IIIA
|
$15,000
$25,000
$25,000
|
|
55—56 (text unchanged)
|
|
57
|
CDS and Paraphernalia
Controlled dangerous substance importation into State, [marijuana] cannabis (5 to less than 45 kilos)
|
1-0730
|
CR, §5-614(b)
|
Felony
|
10Y
|
|
Drug
|
IV
|
$10,000
|
|
58—58-1 (text unchanged)
|
|
58-2
|
CDS and Paraphernalia
Unlawfully PWID, manufacture, possess production equipment—cannabis
|
1-1692
1-1693
1-1694
|
CR, §5-602(b)(1)
CR, §5-603(b)
CR, §5-607(a)(2)
(penalty)
|
Misd.
|
3Y
|
|
Drug
|
V
|
$5,000
|
|
58-3
|
CDS and
Paraphernalia
Unlawfully distribute, distribute counterfeit, PWID counterfeit,
possess counterfeiting equipment, keep common nuisance, possess false
prescription—cannabis
|
1-0234
1-0235
1-0236
1-0238
1-0239
1-0728
2-3550
|
CR, §5-602(a)(1)
CR, §5-604
CR, §5-605
CR, §5-606
CR, §5-607(a)(1)
(penalty)
|
Felony
|
5Y
|
|
Drug
|
IV
|
$15,000
|
|
59
|
CDS and Paraphernalia
[Unlawful distribution,
manufacture, etc.; counterfeiting, etc.; manufacture, possession, etc., of
certain equipment for illegal use; keeping common nuisance,] Unlawfully distribute, PWID,
manufacture, possess production equipment, distribute counterfeit, PWID
counterfeit, possess counterfeiting equipment, keep common nuisance, possess
false prescription—Schedules I through V
non-narcotics (e.g., amphetamines, methamphetamine, [marijuana,] synthetic
marijuana, diazepam, MDMA under 750 grams, and Valium) and buprenorphine
|
1-0233
1-0234
1-0235
1-0236
1-0237
1-0238
1-0239
1-0660
1-0728
2-3550
|
[CR, §5-607(a)]
CR, §5-602(a)
CR, §5-603(a)
CR, §5-604
CR, §5-605
CR, §5-606
CR, §5-607(a)(1)
(penalty)
|
Felony
|
5Y
|
|
Drug
|
IV
|
$15,000
|
|
60—63 (text unchanged)
|
|
64 Vacant
|
[CDS and Paraphernalia
Paraphernalia—possess or distribute controlled paraphernalia—marijuana]
|
[1-0566]
[1-1287]
|
[CR, §5-620(d)(2)]
|
[Misd.]
|
[1Y]
|
|
[Drug]
|
[VII]
|
[$1,000]
|
|
65
|
CDS and Paraphernalia
Paraphernalia—possess or distribute controlled paraphernalia—[non-marijuana] non-cannabis
|
1-0255
1-0256
1-0257
|
[CR, §5-620(d)(1)]
CR, §5-620(d)
|
Misd.
|
4Y
|
|
Drug
|
V
|
$25,000
|
|
66—66-1 (text unchanged)
|
|
67
|
CDS and Paraphernalia
Paraphernalia—use or possess with intent to use drug paraphernalia—[non-marijuana] non-cannabis, subsequent
|
5-3555
|
[CR, §5-619(c)(3)(ii)]
CR, §5-619(c)(2)(ii)
|
Misd.
|
2Y
|
|
Drug
|
VII
|
$2,000
|
|
68 (text unchanged)
|
|
69
|
CDS and Paraphernalia
Possession—unlawful possession or administering to another, obtaining, etc.,
substance by fraud, forgery, misrepresentation, etc.; affixing forged labels;
altering etc., label—[marijuana] cannabis
|
1-1559
1-1560
1-1561
1-1562
1-1563
1-1564
|
CR, §5-601(c)(2)(i)
|
Misd.
|
6M
|
|
Drug
|
VII
|
$1,000
|
|
69-1
|
CDS and Paraphernalia
Possession—unlawful possession or administering to another; obtaining, etc.,
substance by fraud, forgery, misrepresentation, etc.; affixing forged labels;
altering etc., label—[non-marijuana] non-cannabis,
1st offense
|
1-1110
1-1111
1-1112
1-1113
1-1114
1-1115
1-1117
|
CR, §5-601(c)(1)(i)
|
Misd.
|
1Y
|
|
Drug
|
VII
|
$5,000
|
|
69-2
|
CDS and Paraphernalia
Possession—unlawful possession or administering to another; obtaining, etc.,
substance by fraud, forgery, misrepresentation, etc.; affixing forged labels;
altering etc., label—[non-marijuana] non-cannabis,
2nd or 3rd offense
|
|
CR, §5-601(c)(1)(ii)
|
Misd.
|
18M
|
|
Drug
|
VII
|
$5,000
|
|
69-3
|
CDS and Paraphernalia
Possession—unlawful possession or administering to another; obtaining, etc.,
substance by fraud, forgery, misrepresentation, etc.; affixing forged labels;
altering etc., label—[non-marijuana] non-cannabis,
4th or subsequent offense
|
|
CR, §5-601(c)(1)(iii)
|
Misd.
|
2Y
|
|
Drug
|
VII
|
$5,000
|
|
70—421 (text unchanged)
|
Footnotes (text unchanged)
General Rules:
(a)—(b) (text unchanged)
(c) For Prior Record calculations involving offenses in which the
offender has been convicted in another jurisdiction, the individual completing
the worksheet shall match the offense as closely as possible to the closest
analogous Maryland offense. If no Maryland analogous offense exists, the
individual completing the worksheet shall count the offense in the lowest
seriousness category (VII), and shall inform the judge and parties. If the out
of jurisdiction conviction is based on act that is not a criminal violation in
Maryland (e.g., [marijuana] cannabis
possession [less than 10 grams]), then the out of jurisdiction
conviction shall be excluded from the prior adult criminal record. If there is
a question as to the analogous guidelines offense for an out-of-State
conviction, that question should be brought to the attention of the judge at
sentencing.
DAVID SOULE
Executive Director
