Capitol Building Maryland Register

Issue Date:  June 30, 2023

Volume 50 •  Issue 13  • Pages 499 — 550

IN THIS ISSUE

Judiciary

Regulations

Special Documents

General Notices

Pursuant to State Government Article, §7-206, Annotated Code of Maryland, this issue contains all previously unpublished documents required to be published, and filed on or before June 12, 2023 5 p.m.
 
Pursuant to State Government Article, §7-206, Annotated Code of Maryland, I hereby certify that this issue contains all documents required to be codified as of June 12, 2023.
 
Gail S. Klakring
Acting Administrator, Division of State Documents
Office of the Secretary of State

Seal

Information About the Maryland Register and COMAR

MARYLAND REGISTER

   The Maryland Register is an official State publication published every other week throughout the year. A cumulative index is published quarterly.

   The Maryland Register is the temporary supplement to the Code of Maryland Regulations. Any change to the text of regulations published  in COMAR, whether by adoption, amendment, repeal, or emergency action, must first be published in the Register.

   The following information is also published regularly in the Register:

   • Governor’s Executive Orders

   • Attorney General’s Opinions in full text

   • Open Meetings Compliance Board Opinions in full text

   • State Ethics Commission Opinions in full text

   • Court Rules

   • District Court Administrative Memoranda

   • Courts of Appeal Hearing Calendars

   • Agency Hearing and Meeting Notices

   • Synopses of Bills Introduced and Enacted by the General Assembly

   • Other documents considered to be in the public interest

CITATION TO THE MARYLAND REGISTER

   The Maryland Register is cited by volume, issue, page number, and date. Example:

• 19:8 Md. R. 815—817 (April 17, 1992) refers to Volume 19, Issue 8, pages 815—817 of the Maryland Register issued on April 17, 1992.

CODE OF MARYLAND REGULATIONS (COMAR)

   COMAR is the official compilation of all regulations issued by agencies of the State of Maryland. The Maryland Register is COMAR’s temporary supplement, printing all changes to regulations as soon as they occur. At least once annually, the changes to regulations printed in the Maryland Register are incorporated into COMAR by means of permanent supplements.

CITATION TO COMAR REGULATIONS

   COMAR regulations are cited by title number, subtitle number, chapter number, and regulation number. Example: COMAR 10.08.01.03 refers to Title 10, Subtitle 08, Chapter 01, Regulation 03.

DOCUMENTS INCORPORATED BY REFERENCE

   Incorporation by reference is a legal device by which a document is made part of COMAR simply by referring to it. While the text of an incorporated document does not appear in COMAR, the provisions of the incorporated document are as fully enforceable as any other COMAR regulation. Each regulation that proposes to incorporate a document is identified in the Maryland Register by an Editor’s Note. The Cumulative Table of COMAR Regulations Adopted, Amended or Repealed, found online, also identifies each regulation incorporating a document. Documents incorporated by reference are available for inspection in various depository libraries located throughout the State and at the Division of State Documents. These depositories are listed in the first issue of the Maryland Register published each year. For further information, call 410-974-2486.


HOW TO RESEARCH REGULATIONS

An Administrative History at the end of every COMAR chapter gives information about past changes to regulations. To determine if there have been any subsequent changes, check the ‘‘Cumulative Table of COMAR Regulations Adopted, Amended, or Repealed’’ which is found online at http://www.dsd.state.md.us/PDF/CumulativeTable.pdf. This table lists the regulations in numerical order, by their COMAR number, followed by the citation to the Maryland Register in which the change occurred. The Maryland Register serves as a temporary supplement to COMAR, and the two publications must always be used together. A Research Guide for Maryland Regulations is available. For further information, call 410-260-3876.

SUBSCRIPTION INFORMATION

   For subscription forms for the Maryland Register and COMAR, see the back pages of the Maryland Register. Single issues of the Maryland Register are $15.00 per issue.

CITIZEN PARTICIPATION IN
THE REGULATION-MAKING PROCESS

   Maryland citizens and other interested persons may participate in the process by which administrative regulations are adopted, amended, or repealed, and may also initiate the process by which the validity and applicability of regulations is determined. Listed below are some of the ways in which citizens may participate (references are to State Government Article (SG),

Annotated Code of Maryland):

   • By submitting data or views on proposed regulations either orally or in writing, to the proposing agency (see ‘‘Opportunity for Public Comment’’ at the beginning of all regulations appearing in the Proposed Action on Regulations section of the Maryland Register). (See SG, §10-112)

   • By petitioning an agency to adopt, amend, or repeal regulations. The agency must respond to the petition. (See SG §10-123)

   • By petitioning an agency to issue a declaratory ruling with respect to how any regulation, order, or statute enforced by the agency applies. (SG, Title 10, Subtitle 3)

   • By petitioning the circuit court for a declaratory judgment

on the validity of a regulation when it appears that the regulation interferes with or impairs the legal rights or privileges of the petitioner. (SG, §10-125)

   • By inspecting a certified copy of any document filed with the Division of State Documents for publication in the Maryland Register. (See SG, §7-213)

 

Maryland Register (ISSN 0360-2834). Postmaster: Send address changes
and other mail to: Maryland Register, State House, Annapolis, Maryland
21401. Tel. 410-260-3876. Published biweekly, with cumulative indexes published quarterly, by the State of Maryland, Division of State Documents, State House, Annapolis, Maryland 21401. The subscription rate for the Maryland Register is $225 per year (first class mail). All subscriptions post-paid to points in the U.S. periodicals postage paid at Annapolis, Maryland and additional mailing offices.

Wes Moore, Governor; Susan C. Lee, Secretary of State; Gail S. Klakring, Administrator; Mary D. MacDonald, Senior Editor, Maryland Register and COMAR; Elizabeth Ramsey, Editor, COMAR Online, and Subscription Manager; Tami Cathell, Help Desk, COMAR and Maryland Register Online.

Front cover: State House, Annapolis, MD, built 1772—79.

Illustrations by Carolyn Anderson, Dept. of General Services


 

     Note: All products purchased are for individual use only. Resale or other compensated transfer of the information in printed or electronic form is a prohibited commercial purpose (see State Government Article, §7-206.2, Annotated Code of Maryland). By purchasing a product, the buyer agrees that the purchase is for individual use only and will not sell or give the product to another individual or entity.


 


Closing Dates for the Maryland Register

Schedule of Closing Dates and Issue Dates for the
Maryland Register .....................................................................  503

 

COMAR Research Aids

Table of Pending Proposals ...........................................................  504

 

Index of COMAR Titles Affected in This Issue

COMAR Title Number and Name                                                  Page

03        Comptroller of the Treasury ..............................................  511

08        Department of Natural Resources .............................  511, 515

10        Maryland Department of Health ................................  512, 520

14        Independent Agencies ...............................................  513, 534

20        Public Service Commission ...............................................  513

21        State Procurement Regulations .........................................  539

30        Maryland Institute for Emergency Medical Services
Systems (MIEMSS) .......................................................  541

31        Maryland Insurance Administration ..................................  514

33        State Board of Elections ............................................  514, 542

 

PERSONS WITH DISABILITIES

Individuals with disabilities who desire assistance in using the publications and services of the Division of State Documents are encouraged to call (410) 974-2486, or (800) 633-9657, or FAX to (410) 974-2546, or through Maryland Relay.

 

The Attorney General

CONSUMER PROTECTION DIVISION

REQUEST FOR PUBLIC COMMENT ...........................  507

 

The Judiciary

SUPREME COURT OF MARYLAND

DISCIPLINARY PROCEEDINGS ..................................  510

 

Final Action on Regulations

03 COMPTROLLER OF THE TREASURY

ALCOHOL AND TOBACCO TAX

Alcoholic Beverages .  511

Tobacco Tax .  511

Administration .........................................................................  511

08 DEPARTMENT OF NATURAL RESOURCES

FISHERIES SERVICE

Blue Crabs .  511

Blue Crabs .  511

BOATING—SPEED LIMITS AND OPERATION OF
   VESSELS

Chesapeake Bay .  511

10 MARYLAND DEPARTMENT OF HEALTH

MEDICAL CARE PROGRAMS

Physicians’ Services .  512

Dental Services .  512

Physician Assistants .  512

Urgent Care Centers .  512

14 INDEPENDENT AGENCIES

MARYLAND HEALTH BENEFIT EXCHANGE

Appeals from Determinations Regarding Producer
   Authorization or Individual Exchange Navigator
   Certification .  513


20 PUBLIC SERVICE COMMISSION

ELECTRICITY SUPPLIERS

General Provisions .  513

Administrative Provisions .  513

COMPETITIVE ELECTRICITY SUPPLY

General  513

Pre-Enrollment Information .  513

Transfers of Service .  513

Residential Customer Protection .  513

GAS SUPPLIERS

General Provisions .  513

Administrative Provisions .  513

COMPETITIVE GAS SUPPLY

General  513

Pre-Enrollment Information .  513

Transfers of Service .  513

Residential Customer Protection .  513

RENEWABLE ENERGY PORTFOLIO STANDARD
   PROGRAM

General  514

Certifiable Renewable Energy Facilities .  514

Maryland Strategic Energy Investment Fund .  514

Offshore Wind .  514

31 MARYLAND INSURANCE ADMINISTRATION

INSURANCE PRODUCERS AND OTHER INSURANCE
   PROFESSIONALS

Insurance Producers—Continuing Education
   Requirements .  514

33 STATE BOARD OF ELECTIONS

DEFINITIONS; GENERAL PROVISIONS

Administrative Complaint Procedure .  514

RECORDS MANAGEMENT

Copies of Registration Lists .  514

VOTING SYSTEMS—SYSTEM REQUIREMENTS AND
   PROCEDURES

System Requirements and Procedures — EVS Voting
   Solution .  514

RECOUNTS

Initiation of Recounts .  514

PROVISIONAL VOTING

Provisional Voting Documents and Supplies .  514

Pre-Canvass Procedures .  514

Canvass of Ballots—Procedures .  514

EARLY VOTING

Early Voting Centers ................................................................  514

SPECIAL ELECTIONS BY MAIL

Definitions; General Provisions ...............................................  514

Issuance and Return .  514

Voting Centers .  514

 

Proposed Action on Regulations

08 DEPARTMENT OF NATURAL RESOURCES

WILDLIFE

Open Seasons, Bag Limits for Game Birds and Game
   Animals .................................................................................  515

Furbearer Wildlife .  517

Irreplaceable Natural Areas .....................................................  517

10 MARYLAND DEPARTMENT OF HEALTH

MEDICAL CARE PROGRAMS

Freestanding Clinics .  520

Applied Behavior Analysis Services .  522

General Medical Assistance Provider Participation
   Criteria ..................................................................................  524

Community Violence Prevention Services ..............................  526

MARYLAND HEALTHCHOICE PROGRAM

Maryland Medicaid Managed Care Program: Benefits .  526

CANCER CONTROL

Professional and Volunteer Firefighter Innovative Cancer
   Screening Technologies Program ..  528

DANGEROUS DEVICES AND SUBSTANCES

Prohibition of Child Care Products Containing TCEP or
   TDCPP .  530

Prohibition of Consumer Products Containing Flame-
   Retardant Chemicals .  530

BOARD OF NURSING

Examination and Licensure .  532

BOARD OF PHARMACY

Pharmacy Technicians .  533

14 INDEPENDENT AGENCIES

COMMISSION ON CRIMINAL SENTENCING POLICY

General Regulations .  534

MARYLAND HEALTH BENEFIT EXCHANGE

Eligibility Standards for Enrollment in a Qualified Health
   Plan, Eligibility Standards for APTC and CSR, and
   Eligibility Standards for Enrollment in a Catastrophic
   Qualified Health Plan in the Individual Exchange .  535

Hearings by the Board of Trustees .  536

21 STATE PROCUREMENT REGULATIONS

PROCUREMENT METHODS AND PROJECT DELIVERY
   METHODS

Procurement by Competitive Sealed Bidding .  539

Procurement by Competitive Sealed Proposals .  539

SOCIOECONOMIC POLICIES

Minority Business Enterprise Policies .  539

30 MARYLAND INSTITUTE FOR EMERGENCY
   MEDICAL SERVICES SYSTEMS (MIEMSS)

COMMERCIAL AMBULANCE SERVICES

Neonatal Ambulance Service and Infant Transport  541

Specialty Care Transport Services .  541

33 STATE BOARD OF ELECTIONS

MEETINGS AND TRAINING

Judges’ Manuals and Training .  542

RECOUNTS

Initiation of Recounts .  542

EARLY VOTING

Early Voting Center Equipment and Materials .  542

Election Judges .  542

Non-Voting Hours Procedures .  542

SAME DAY REGISTRATION AND ADDRESS CHANGES

Definitions; General Provisions .  542

Public Notice .  542

 

Special Documents

DEPARTMENT OF THE ENVIRONMENT

SUSQUEHANNA RIVER BASIN COMMISSION

Projects Approved for Consumptive Uses of Water  545

Projects Approved for Minor Modifications .  546

DEPARTMENT OF STATE POLICE

HANDGUN ROSTER BOARD

Proposed Additions to Handgun Roster and Notice of Right
   to Object or Petition
.  546

 


General Notices

STATE COLLECTION AGENCY LICENSING BOARD
   (SCALB)

Public Meeting .  549

DEPARTMENT OF THE ENVIRONMENT

Public Hearing .  549

FIRE PREVENTION COMMISSION

Public Meeting .  549

MARYLAND HEALTH BENEFIT EXCHANGE

Public Meeting .  549

MARYLAND DEPARTMENT OF HEALTH

Public Meeting .  549

Receipt of Application .  549

MARYLAND HEALTH CARE COMMISSION

Public Meeting .  550

Receipt of Application .  550

MARYLAND DEPARTMENT OF TRANSPORTATION/
   OFFICE OF MINORITY BUSINESS ENTERPRISE

Public Meeting .  550

 

 

COMAR Online

        The Code of Maryland Regulations is available at www.dsd.state.md.us as a free service of the Office of the Secretary of State, Division of State Documents. The full text of regulations is available and searchable. Note, however, that the printed COMAR continues to be the only official and enforceable version of COMAR.

        The Maryland Register is also available at www.dsd.state.md.us.

        For additional information, visit www.dsd.maryland.gov, Division of State Documents, or call us at (410) 974-2486 or 1 (800) 633-9657.

 

 

Availability of Monthly List of
Maryland Documents

        The Maryland Department of Legislative Services receives copies of all publications issued by State officers and agencies. The Department prepares and distributes, for a fee, a list of these publications under the title ‘‘Maryland Documents’’. This list is published monthly, and contains bibliographic information concerning regular and special reports, bulletins, serials, periodicals, catalogues, and a variety of other State publications. ‘‘Maryland Documents’’ also includes local publications.

        Anyone wishing to receive ‘‘Maryland Documents’’ should write to: Legislative Sales, Maryland Department of Legislative Services, 90 State Circle, Annapolis, MD 21401.

 


CLOSING DATES AND ISSUE DATES THROUGH
DECEMBER 2023

Issue
Date

Emergency

and Proposed

Regulations

5 p.m.*

Notices, etc.

10:30 a.m.

Final

Regulations

10:30 a.m.

2023

July 14

June 26

July 3

July 5

July 28

July 10

July 17

July 19

August 11

July 24

July 31

August 2

August 25

August 7

August 14

August 16

September 8

August 21

August 28

August 30

September 22

September 1**

September 11

September 13

October 6

September 18

September 25

September 27

October 20

October 2

October 6**

October 11

November 3

October 16

October 23

October 25

November 17

October 30

November 6

November 8

December 1

November 13

November 20

November 22

December 15

November 27

December 4

December 6

December 29

December 11

December 18

December 20

 

   Please note that this table is provided for planning purposes and that the Division of State Documents (DSD) cannot guarantee submissions will be published in an agency’s desired issue. Although DSD strives to publish according to the schedule above, there may be times when workload pressures prevent adherence to it.

*   Also note that proposal deadlines are for submissions to DSD for publication in the Maryland Register and do not take into account the 15-day AELR review period. The due date for documents containing 8 to 18 pages is 48 hours before the date listed; the due date for documents exceeding 18 pages is 1 week before the date listed.

NOTE:  ALL DOCUMENTS MUST BE SUBMITTED IN TIMES NEW ROMAN, 9-POINT, SINGLE-SPACED FORMAT. THE PAGE COUNT REFLECTS THIS FORMATTING.

** Note closing date changes.

The regular closing date for Proposals and Emergencies is Monday.

 


RegCodificationSystem


Cumulative Table of COMAR Regulations
Adopted, Amended, or Repealed

   This table, previously printed in the Maryland Register lists the regulations, by COMAR title, that have been adopted, amended, or repealed in the Maryland Register since the regulations were originally published or last supplemented in the Code of Maryland Regulations (COMAR). The table is no longer printed here but may be found on the Division of State Documents website at www.dsd.state.md.us.

Table of Pending Proposals

   The table below lists proposed changes to COMAR regulations. The proposed changes are listed by their COMAR number, followed by a citation to that issue of the Maryland Register in which the proposal appeared. Errata and corrections pertaining to proposed regulations are listed, followed by “(err)” or “(corr),” respectively. Regulations referencing a document incorporated by reference are followed by “(ibr)”. None of the proposals listed in this table have been adopted. A list of adopted proposals appears in the Cumulative Table of COMAR Regulations Adopted, Amended, or Repealed.

 


03 COMPTROLLER OF THE TREASURY

 

03.06.01.47 • 50:12 Md. R. 478 (6-16-23)

03.06.03.02,.03 • 50:12 Md. R. 478 (6-16-23)

 

05 DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT

 

05.03.09.01—.11 • 50:7 Md. R. 304 (4-7-23)

05.20.05.01—.12 • 49:25 Md. R. 1054 (12-2-22)

 

08 DEPARTMENT OF NATURAL RESOURCES

 

08.02.11.01 • 50:8 Md. R. 344 (4-21-23)

08.02.11.02,.04 • 50:8 Md. R. 345 (4-21-23)

08.02.20.01,.03 • 50:8 Md. R. 349 (4-21-23)

08.03.03.01 • 50:13 Md. R. 515 (6-30-23)

08.03.06.03 • 50:13 Md. R. 517 (6-30-23)

08.03.17.01,.02 • 50:13 Md. R. 517 (6-30-23) (ibr)

 

09 MARYLAND DEPARTMENT OF LABOR

 

09.03.14.01—.18 • 50:4 Md. R. 125 (2-24-23)

                                50:7 Md. R. 307 (4-7-23) (corr)

09.12.32.01—06 • 49:21 Md. R. 953 (10-7-22)

09.12.81.02 • 50:1 Md. R. 11 (1-13-23) (ibr)

09.22.01.13 • 50:3 Md. R. 92 (2-10-23)

09.28.04.01—.06,.08 • 50:9 Md. R. 382 (5-5-23)

 

10 MARYLAND DEPARTMENT OF HEALTH

 

     Subtitle 09 (2nd volume)

 

10.09.01.03,.06 • 50:4 Md. R. 135 (2-24-23)

10.09.04.01,.03,.04,.07 • 50:7 Md. R. 307 (4-7-23)


10.09.06.02,.04,.06,.07,.09 • 50:11 Md. R. 448 (6-2-23)

10.09.07.08 • 50:7 Md. R. 309 (4-7-23)

10.09.08.01—.06,.09,.10 • 50:13 Md. R. 520 (6-30-23)

10.09.09.01,.03—.07 • 50:6 Md. R. 220 (3-24-23) (ibr)

10.09.10.07,.08 • 50:6 Md. R. 221 (3-24-23)

10.09.12.06,.07 • 50:6 Md. R. 222 (3-24-23)

10.09.15.03,.07 • 50:4 Md. R. 136 (2-24-23)

10.09.16.01—.13 • 50:4 Md. R. 136 (2-24-23)

10.09.17.03,.04 • 50:4 Md. R. 139 (2-24-23)

10.09.23.01,.01-1,.03—.05,.07,.08 • 50:6 Md. R. 224 (3-24-23) (ibr)

10.09.27.01,.03—.06 • 50:6 Md. R. 225 (3-24-23)

10.09.28.01,.02,.04,.06 • 50:13 Md. R. 522 (6-30-23)

10.09.29.07 • 50:7 Md. R. 310 (4-7-23)

10.09.31.01,.03—.06 • 49:22 Md. R. 982 (10-21-22)

10.09.33.01,.02,.06,.07,.09 • 50:6 Md. R. 227 (3-24-23)

10.09.34.06 • 50:6 Md. R. 228 (3-24-23)

10.09.36.01—.03,.07,.09—.11 • 50:13 Md. R. 524 (6-30-23)

10.09.40.01—.06 • 50:1 Md. R. 13 (1-13-23)

10.09.41.04,.07 • 49:16 Md. R. 762 (7-29-22)

10.09.48.08 • 50:6 Md. R. 229 (3-24-23)

10.09.49.03—.10 • 49:24 Md. R. 1028 (11-18-22)

10.09.52.01—.06 • 50:1 Md. R. 13 (1-13-23)

10.09.53.01,.07 • 50:7 Md. R. 311 (4-7-23)

10.09.54.01,.04,.14,.16,.17,.22 • 50:3 Md. R. 94 (2-10-23)

10.09.56.22 • 50:4 Md. R. 140 (2-24-23)

10.09.63.01—.06 • 50:13 Md. R. 527 (6-30-23)

10.09.76.01,.03,.05 • 50:1 Md. R. 13 (1-13-23)

10.09.89.09—.12,.14 • 50:6 Md. R. 230 (3-24-23)

10.09.96.01,.02,.05,.06 • 49:24 Md. R. 1028 (11-18-22)

 

     Subtitles 10—22 (3rd volume)

 

10.14.08.01—.08 • 50:13 Md. R. 528 (6-30-23)

10.15.07.01 • 49:27 Md. R. 1116 (12-30-22) (ibr)

10.19.07.02 • 50:13 Md. R. 530 (6-30-23)

10.19.08.01—.06 • 50:13 Md. R. 530 (6-30-23)

10.21.01.04,.08 • 49:23 Md. R. 1000 (11-4-22)

     Subtitles 23—36 (4th volume)

 

10.27.01.05 • 50:13 Md. R. 532 (6-30-23)

10.28.01.01—.06 • 49:26 Md. R. 1084 (12-16-22)

10.32.01.03 • 49:16 Md. R. 768 (7-29-22)

10.32.02.03 • 49:16 Md. R. 768 (7-29-22)

10.32.02.10 • 49:16 Md. R. 769 (7-29-22)

10.34.34.02—.12 • 50:13 Md. R. 533 (6-30-23)

 

     Subtitles 37—52 (5th volume)

 

10.37.10.26 • 49:18 Md. R. 822 (8-26-22)

10.38.13.01—.06 • 50:1 Md. R. 22 (1-13-23)

10.40.12.01—.06 • 49:26 Md. R. 1085 (12-16-22)

10.41.06.01—.06 • 49:26 Md. R. 1087 (12-16-22)

10.42.10.01—.06 • 49:26 Md. R. 1088 (12-16-22)

10.43.17.01—.06 • 50:2 Md. R. 68 (1-27-23)

10.46.08.01—.06 • 49:27 Md. R. 1116 (12-30-22)

 

     Subtitles 53—68 (6th volume)

 

10.56.10.01—.06 • 49:27 Md. R. 1117 (12-30-22)

10.58.06.01—.06 • 49:26 Md. R. 1090 (12-16-22)

10.58.16.02,.13—.19 • 49:26 Md. R. 1090 (12-16-22)

10.63.01.02,.05 • 50:4 Md. R. 143 (2-24-23)

10.63.02.02 • 50:4 Md. R. 143 (2-24-23)

10.63.03.20,.21 • 50:4 Md. R. 143 (2-24-23)

10.65.10.01—.06 • 50:2 Md. R. 69 (1-27-23)

10.67.06.26-6 • 49:22 Md. R. 982 (10-21-22)

10.67.06.26-7 • 50:13 Md. R. 526 (6-30-23)

 

11 DEPARTMENT OF TRANSPORTATION

 

     Subtitles 11—23 (MVA)

 

11.15.22.17 • 50:12 Md. R. 479 (6-16-23)

11.17.13.02 • 50:10 Md. R. 408 (5-19-23)

 

12 DEPARTMENT OF PUBLIC SAFETY AND CORRECTIONAL SERVICES

 

12.04.01.09,.14 • 50:10 Md. R. 409 (5-19-23)

 

13A STATE BOARD OF EDUCATION

 

13A.01.08.01—16 • 50:7 Md. R. 313 (4-7-23)

13A.01.09.01—11 • 50:7 Md. R. 315 (4-7-23)

13A.03.02.02,.04,.06,.07,.09,.09-1 • 50:11 Md. R. 449 (6-2-23)

13A.03.04.01,.02 • 50:11 Md. R. 449 (6-2-23)

13A.06.07.06—.08,.11,.12,.18,.19 • 50:8 Md. R. 351 (4-21-23)

13A.08.01.03 • 50:7 Md. R. 317 (4-7-23)

13A.15.01.02 • 49:24 Md. R. 1032 (11-18-22)

13A.15.04.03 • 49:24 Md. R. 1032 (11-18-22)

13A.15.13.01—.10 • 49:24 Md. R. 1032 (11-18-22)

13A.15.14.01—.09 • 49:24 Md. R. 1032 (11-18-22)

13A.15.15.01—.08 • 49:24 Md. R. 1032 (11-18-22)

13A.15.16.01—.04 • 49:24 Md. R. 1032 (11-18-22)

 

13B MARYLAND HIGHER EDUCATION COMMISSION

 

13B.01.01.17 • 50:4 Md. R. 153 (2-24-23)

13B.02.06.01,.06,.11,.14 • 50:4 Md. R. 153 (2-24-23)

13B.03.01.03,.13 • 50:4 Md. R. 155 (2-24-23)

13B.07.02.03 • 50:4 Md. R. 156 (2-24-23)


13B.08.01.02 • 49:16 Md. R. 772 (7-29-22)

13B.08.12.01—.08 • 50:4 Md. R. 156 (2-24-23)

13B.08.13.03 • 49:17 Md. R. 802 (8-12-22)

13B.08.14.02,.06,.07 • 49:17 Md. R. 803 (8-12-22)

13B.08.20.02—.13 • 50:4 Md. R. 158 (2-24-23)

 

14 INDEPENDENT AGENCIES

 

14.04.09.01—.04 • 49:9 Md. R. 536 (4-22-22)

14.22.01.12,.14 • 50:13 Md. R. 534 (6-30-23)

14.35.07.22 • 50:13 Md. R. 535 (6-30-23)

14.35.20.01—.12 • 50:13 Md. R. 536 (6-30-23)

 

15 MARYLAND DEPARTMENT OF AGRICULTURE

 

15.01.17.02,.04,.08,.10—.20 • 50:11 Md. R. 452 (6-2-23)

 

20 PUBLIC SERVICE COMMISSION

 

20.50.01.03 • 50:10 Md. R. 410 (5-19-23)

20.50.02.02 • 50:10 Md. R. 410 (5-19-23)

20.50.03.04 • 50:10 Md. R. 410 (5-19-23)

20.50.11.01 • 50:10 Md. R. 410 (5-19-23)

20.50.12.01,.02,.04,.05,.08—18 • 50:10 Md. R. 410 (5-19-23)

20.85.03.09 • 50:10 Md. R. 417 (5-19-23)

                      50:11 Md. R. 455 (6-2-23) (corr)

 

21 STATE PROCUREMENT REGULATIONS

 

21.01.02.01 • 50:12 Md. R. 480 (6-16-23)

21.01.03.01,.01-1,.03 • 50:12 Md. R. 480 (6-16-23)

21.02.01.04 • 50:12 Md. R. 480 (6-16-23)

21.03.05.01 • 50:12 Md. R. 480 (6-16-23)

21.05.01.01 • 50:12 Md. R. 480 (6-16-23)

21.05.02.01 • 50:12 Md. R. 480 (6-16-23)

21.05.02.14 • 50:13 Md. R. 539 (6-30-23)

21.05.03.02 • 50:12 Md. R. 480 (6-16-23)

21.05.03.03 • 50:13 Md. R. 539 (6-30-23)

21.05.06.01 • 50:12 Md. R. 480 (6-16-23)

21.05.07.06 • 50:12 Md. R. 480 (6-16-23)

21.05.08.05 • 50:12 Md. R. 480 (6-16-23)

21.05.09.08 • 50:12 Md. R. 480 (6-16-23)

21.05.13.01,.03,.05 • 50:12 Md. R. 480 (6-16-23)

21.05.14.01—.06 • 50:12 Md. R. 480 (6-16-23)

21.05.15.01—.05 • 50:12 Md. R. 480 (6-16-23)

21.06.09.01 • 50:12 Md. R. 480 (6-16-23)

21.07.01.31 • 50:12 Md. R. 480 (6-16-23)

21.07.02.05-2 • 50:12 Md. R. 480 (6-16-23)

21.07.03.27 • 50:12 Md. R. 480 (6-16-23)

21.08.03.03 • 50:12 Md. R. 480 (6-16-23)

21.10.08.01,.02,.06 • 50:12 Md. R. 480 (6-16-23)

21.11.01.02,.06 • 50:12 Md. R. 480 (6-16-23)

21.11.03.03,.09,.17 • 50:12 Md. R. 480 (6-16-23)

21.11.03.10 • 50:13 Md. R. 539 (6-30-23)

21.11.05.01—.07 • 50:12 Md. R. 480 (6-16-23)

21.11.14.04 • 50:12 Md. R. 480 (6-16-23)

21.13.01.08,.14,.18 • 50:12 Md. R. 480 (6-16-23)

 

26 DEPARTMENT OF THE ENVIRONMENT

 

     Subtitles 01—07 (Part 1)

 

26.04.01.01,.01-1,.20,.37 • 50:3 Md. R. 106 (2-10-23) (ibr)

26.04.12.01—.07 • 50:2 Md. R. 73 (1-27-23)

 

     Subtitles 08—12 (Part 2)

 

26.11.17.01,.04 • 50:11 Md. R. 455 (6-2-23)

26.11.34.02 • 50:10 Md. R. 417 (5-19-23)

26.12.01.01 • 50:9 Md. R. 384 (5-5-23) (ibr)

 

30 MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS)

 

30.08.08.01—.22 • 50:5 Md. R. 184 (3-10-23)

30.09.12.04 • 50:13 Md. R. 541 (6-30-23)

30.09.14.04 • 50:13 Md. R. 541 (6-30-23)

 

31 MARYLAND INSURANCE ADMINISTRATION

 

31.04.22.02—.07 • 50:12 Md. R. 491 (6-16-23)

31.10.06.06 • 50:9 Md. R. 385 (5-5-23)

 

33 STATE BOARD OF ELECTIONS

 

33.01.07.01—.06 • 49:9 Md. R. 537 (4-22-22)

33.02.03.01—.05 • 50:13 Md. R. 542 (6-30-23)

33.12.02.01 • 50:13 Md. R. 542 (6-30-23)

33.13.10.05 • 50:12 Md. R. 492 (6-16-23)

33.13.13.06 • 50:12 Md. R. 492 (6-16-23)

33.17.04.06 • 50:13 Md. R. 542 (6-30-23)

33.17.05.03 • 50:13 Md. R. 542 (6-30-23)

33.17.07.01 • 50:13 Md. R. 542 (6-30-23)

33.19.01.01 • 50:13 Md. R. 542 (6-30-23)

33.19.02.01 • 50:13 Md. R. 542 (6-30-23)

 


The Attorney General


CONSUMER PROTECTION DIVISION

REQUEST FOR PUBLIC COMMENT:

Implementation of Reporting Requirements for Assisted Living Programs Serving as Representative Payees (Subtitle 4B of the Consumer Protection Act), and Protection of Assisted Living Residents from Unfair, Abusive, or Deceptive Trade Practices

 

June 30, 2023

 

     The Consumer Protection Division of the Office of the Attorney General (CPD) requests public comment concerning its potential adoption of regulations to implement certain requirements established for assisted living programs by the General Assembly during the 2021 legislative session.  The legislation, enacted at Chapters 471 and 472 of the 2021 Laws of Maryland, seeks to protect residents of “assisted living program facilities” who are entitled to receive Social Security and other public benefit payments, but whose benefits are paid to the assisted living program as the resident’s “representative payee,” rather than directly to the beneficiary.  Among other things, the legislation requires an assisted living program serving as a representative payee to report annually to CPD on its use of such benefits.  See Md. Code Ann., Com. Law § 13-4B-01.  The legislation also directs the Office of Health Care Quality to refer to CPD any “allegation of an unfair, abusive or deceptive trade practice by an assisted living program.”  See Health-Gen. § 19-1814. 

As further discussed below, CPD requests public comment on its potential adoption of regulations to implement the reporting requirement established in the 2021 legislation and to protect residents of assisted living program facilities from unfair, deceptive or abusive trade practices.

 

Background

The federal Social Security Act and the Social Security Administration (SSA) use the term “representative payee” to refer to an individual or organization that SSA has appointed to receive Social Security or Supplemental Security Income (SSI) payments for the use and benefit of a beneficiary.  See, e.g., 42 U.S.C. §§ 405(j), 1383(a). SSA will appoint a representative payee when it determines that it would be “in the interest of the beneficiary” to do so.  See 20 CFR §§ 404.2001, 416.601.  SSA bases its determination whether to appoint a representative payee on its assessment of the beneficiary’s “ability to manage or direct the management of benefit payments,” and SSA may appoint a representative payee “even if the beneficiary is a legally competent individual.”  Id.

In appointing representative payees, SSA gives preference to legal guardians, spouses, and “friend[s] who . . . demonstrate[] strong concern for the personal welfare of the beneficiary,” but an organization or institution may also be appointed, including a “private institution operated for profit.”  See 20 CFR §§ 404.2021, 416.621.  Creditors of a beneficiary are ordinarily prohibited from serving as the beneficiary’s representative payee.  See id. §§ 404.2022, 416.622.  This prohibition does not apply, however, to a “licensed or certified care facility,” or to an “administrator, owner or employee of the facility in which [the beneficiary] live[s],” if the facility or person “poses no risk” to the beneficiary, and if the facility or person’s financial relationship with the beneficiary “presents no substantial conflict of interest.”  Id. 

It is CPD’s understanding that many long term care facilities in Maryland may serve as the representative payee for certain of their residents, notwithstanding their status as a creditor of the resident.  As of December 2021, 1,034,041 Marylanders were Social Security beneficiaries and received more than $20.5 billion in annual benefit payments; while 117,202 Marylanders were SSI beneficiaries and received more than $880 million in annual benefit payments.  Nationally, as of December 2021, 2.2% of adult Social Security beneficiaries and 26.6% of adult SSI beneficiaries received their benefit payments through a representative payee.  A 2015 study found that, during 2013, SSA made payments to 5.9 million representative payees for the benefit of 8.2 million beneficiaries, and benefit payments made to representative payees totaled approximately $74 billion.  See Chris E. Anguelov et al., “Adult OASDI Beneficiaries and SSI Recipients Who Need Representative Payees:  Projections for 2025 and 2035,” Social Security Bulletin, Vol. 75, No. 2 (2015).  For 143,232 Social Security beneficiaries and 109,848 SSI beneficiaries receiving benefits through a representative payee as of December 2021, SSA characterized the representative payee as a “nonmental institution,” a category that appears to consist principally of long term care facilities and group homes.

     The SSA’s representative payee regulations include provisions specifying how payments made to a representative payee are to be “used for the use and benefit of the beneficiary,” 20 CFR §§ 404.2040, 416.640, and prohibiting a representative payee from misusing the benefits, see id. §§ 404.2041, 416.641.  SSA requires most representative payees, including all organizational representative payees, to submit a report on an annual basis to account for the use of the benefits.  See 20 CFR §§ 404.2065, 416.665.  SSA has developed forms (including Form SSA-6234-F6) for assisted living programs, nursing facilities and other organizations serving as representative payees to submit the required reporting on their use of beneficiaries’ Social Security and SSI benefits.

     It appears that other federal, state and local government public benefit programs and public employee pension programs have also adopted policies under which, in certain circumstances, they may make benefit payments to a representative of the beneficiary, rather than directly to the beneficiary.   Some agencies administering such programs, like SSA, utilize the term “representative payee” to refer to this status.  For example, the Family Investment Administration of Maryland’s Department of Human Services (“FIA”), in administering both the Temporary Disability Assistance and Public Assistance for Adults programs established under Maryland law, will make benefit payments to a “representative payee.”  See COMAR 07.03.05.11, 07.03.07.09.  FIA’s standards for the appointment of a representative payee, however, differ from those utilized by SSA and appear to exclude the appointment of any for-profit assisted living program.  See COMAR 07.03.07.09(E) (excluding any “individual whose selection would create a conflict of interest, including  . . . [a]n entity that deals with the recipient for profit, such as an assisted living home operator or other vendor”); COMAR 07.03.05.11(C)(3)(c)(iii) (excluding “an entity which deals with eligible individuals for profit, which would create a conflict of interest”).

     In Chapters 471 and 472 of the 2021 Laws of Maryland, the General Assembly enacted legislation intended to confer new protections on residents of assisted living program facilities who receive public benefit payments intended for the support of seniors and people with disabilities, and whose assisted living program is serving as their representative payee.  The 2021 legislation added to the Consumer Protection Act a new Subtitle 4B, which requires assisted living programs serving as representative payees to report annually to CPD on their use of such benefits.  (The General Assembly then slightly amended Subtitle 4B during its 2022 session to refer to the State Board of Long-Term Care Administrators.  See 2022 Laws of Maryland, chs. 689 & 690.) 

 

Subtitle 4B now provides as follows:

 

§ 13-4B-01.  Reporting Requirements for Assisted Living Programs

(a)  In this section, “assisted living program has the meaning stated in § 19-1801 of the Health-General Article.

(b)  On or before June 1 of each year, each assisted living program that was appointed as a representative payee for residents of the assisted living program facility at any point during the reporting period shall report to the Division on the use of:

(1)     Social Security benefits by residents of the assisted living program facility during the immediately preceding year; and

(2)     Other federal, State, or local government funds by residents of the assisted living program facility during the immediately preceding year that are allocated for the purpose of assisting individuals who are aged, disabled, or blind.

(c)  The Office of Health Care Quality shall notify the Division and, beginning October 1, 2024, the State Board of Long-Term Care Administrators of the appointment of an assisted living program as a resident’s representative payee within a reasonable time after being made aware of the appointment.

 

Com. Law § 13-4B-01.

 

     Chapters 471 and 472 of the 2021 Laws of Maryland also amended the subtitle of the Health-General Article governing assisted living programs.  The 2021 legislation directs the Office of Health Care Quality within the Department of Health, which serves as the principal regulator of Maryland assisted living programs, to “refer an allegation of an unfair, abusive, or deceptive trade practice by an assisted living program to the Division of Consumer Protection of the Office of the Attorney General and to the Office of the Inspector General within the Department.”  Health-Gen. § 19-1814. 

The Consumer Protection Act generally prohibits engagement in “any unfair, abusive, or deceptive trade practice” in a number of broad categories of consumer transactions, including in the “sale” and “offer for sale” of any “consumer services.”  Com. Law § 13-303.  The Consumer Protection Act also contains a non-exhaustive list of types of “unfair, abusive, or deceptive trade practices.”  Id. § 13-301.  CPD is charged with administering and enforcing the Consumer Protection Act, and CPD has authority to adopt regulations to implement the Act.  Id. §§ 13-201, 13-204, 13-205.

 

Request for Public Comment

     CPD requests comment from the public, including from assisted living programs, long term care trade organizations, residents of assisted living programs and their family members, and advocates for residents of long term care facilities, on CPD’s potential adoption of regulations to implement the reporting requirement established in the 2021 legislation and to protect residents of assisted living programs from unfair, deceptive or abusive trade practices.  CPD welcomes any comment on the need for, value of, or substance of such potential regulations.

     In addition, CPD requests comment from the public on any of the following questions:

1.        How commonly do assisted living programs and operators and employees of such programs serve as the representative payee for their residents’ public benefits and pension benefits?

2.        Does it benefit residents of assisted living facilities for assisted living programs and operators and employees of such programs to serve as their representative payee, and, if so, how are residents benefited?  What are the actual or potential risks/downsides?

3.        What are the best practices for assisted living programs and other long term care facilities in obtaining consent to serve as a resident’s representative payee?

4.        Do assisted living programs require that potential residents, as a condition of admission to the assisted living program, consent to the program or one of its employees serving as their representative payee?  If so, (a) under what circumstances do they do so, and (b) is this an unfair or abusive trade practice?  See Md. Code Ann., Com. Law §§ 13-301, 13-303.  Is this practice inconsistent with SSA regulations and/or with best practices of respect for resident autonomy, dignity and privacy? 

5.        Do the SSA’s current annual reporting forms for organizational representative payees (such as Form SSA-6234-F6), capture all of the information that would be necessary for the CPD to monitor for the misuse of funds by an assisted living program serving as a representative payee?  If not, what other information should be requested and why?

6.        In addition to the information required by the SSA in its annual reporting form for organizational representative payees, should CPD, in implementing the reporting requirement set forth in Subtitle 4B of the Consumer Protection Act, also require assisted living programs to state whether, during the reporting period, they were the subject of allegations, charges or judicial or administrative findings of fraudulent or deceptive practices or other misconduct?  If so, what types of allegations, charges or findings should CPD require assisted living programs to report?

7.        What other types of federal, state and local public benefit payments and public employee pension benefit payments do assisted living programs and other long term care facilities in Maryland receive on behalf of, or as the representative payee for, their residents?

8.        What types of reporting methods or systems should CPD employ to reduce any reporting burden on assisted living programs associated with the reporting requirement set forth in Subtitle 4B of the Consumer Protection Act?

9.        What are the best practices for assisted living programs and other long term care facilities serving as representative payees to account to residents for the use of their benefits and to be accessible to residents to answer their questions about the status of benefit payments and the availability of funds for their other personal needs? 

10.     Where assisted living programs and other long term care facilities serve as the representative payee for their residents, how do they handle the funds and for what purposes do they use the funds?  Do facilities apply amounts received for the resident to debts (a) assertedly owed to them by the resident and (b) incurred prior to the period for which the benefits were received?  If so, is this an unfair or abusive trade practice?  See Md. Code Ann., Com. Law §§ 13-301, 13-303.  Is this practice of collecting past-due debts inconsistent with SSA regulations and/or with best practices for the protection of residents from fraud and financial exploitation?

11.      Are there particular practices or patterns of conduct that could be characterized as unfair, abusive, or deceptive in which certain assisted living programs or other long term care facilities have engaged in connection with serving as the representative payee for their residents?

12.     What actions should CPD take, whether in adopting regulations or otherwise enforcing the Consumer Protection Act, to protect residents of assisted living program facilities from unfair, abusive or deceptive practices?

 

 

How to Submit Comments

     Comments may be submitted via email at RepPayeeComments@oag.state.md.us.

 

     Comments may also be submitted via regular mail at:

                   Consumer Protection Division

                   Attention:  Representative Payee Comments

                   Office of the Attorney General

                   200 Saint Paul Place

                   Baltimore, Maryland 21202

 

     CPD requests the submission of comments by August 25, 2023.

     Please note that comments submitted to CPD will be subject to public inspection under the Maryland Public Information Act.

[23-13-15]


The Judiciary


 


SUPREME COURT OF MARYLAND

DISCIPLINARY PROCEEDINGS

     This is to certify that by an Order of this Court dated April 21, 2023, PHILLIP WAYNE WRIGHT (CPF# 8812160362), as of June 7, 2023, Phillip Wayne Wright has been disbarred by consent, effective June 7, 2023, and his name has been stricken from the register of attorneys in this Court. Notice of this action is given in accordance with Maryland Rule 19-761(b).

 

[23-13-10]

 

 


Final Action on Regulations

 

Symbol Key

   Roman type indicates text already existing at the time of the proposed action.

   Italic type indicates new text added at the time of proposed action.

   Single underline, italic indicates new text added at the time of final action.

   Single underline, roman indicates existing text added at the time of final action.

   [[Double brackets]] indicate text deleted at the time of final action.

 

 


Title 03
COMPTROLLER OF THE TREASURY

Subtitle 02 ALCOHOL AND TOBACCO TAX

Notice of Final Action

[23-018-F]

On June 6, 2023, the Comptroller of Maryland adopted:

(1) Amendments to Regulation .01 under COMAR 03.02.01 Alcoholic Beverages;

(2) Amendments to Regulations .05—.07 under COMAR 03.02.02 Tobacco Tax;

(3) Amendments to Regulation .01 and the repeal of Regulation .02 under COMAR 03.02.04 Administration.

This action, which was proposed for adoption in 50:8 Md. R. 340—341 (April 21, 2023), has been adopted as proposed.

Effective Date: July 10, 2023.

BROOKE E. LIERMAN
Comptroller of Maryland

 

Title 08
DEPARTMENT OF NATURAL RESOURCES

Subtitle 02 FISHERIES SERVICE

08.02.03 Blue Crabs

Authority: Natural Resources Article, §§4-215 and 4-803, Annotated Code of Maryland

Notice of Final Action

[23-055-F]

On June 16, 2023, the Secretary of Natural Resources adopted amendments to Regulations .11 and .12 under COMAR 08.02.03 Blue Crabs. This action, which was proposed for adoption in 50:8 Md. R. 341—342 (April 21, 2023), has been adopted as proposed.

Effective Date: July 10, 2023.

JOSH KURTZ
Secretary of Natural Resources

 


Subtitle 02 FISHERIES SERVICE

08.02.03 Blue Crabs

Authority: Natural Resources Article, §§4-215 and 4-803, Annotated Code of Maryland

Notice of Final Action

[23-068-F]

On June 20, 2023, the Secretary of Natural Resources adopted amendments to Regulation .14 under COMAR 08.02.03 Blue Crabs. This action, which was proposed for adoption in 50:9 Md. R. 381—382 (May 5, 2023), has been adopted as proposed.

Effective Date: July 10, 2023.

JOSH KURTZ
Secretary of Natural Resources

 

Subtitle 18 BOATING—SPEED LIMITS AND OPERATION OF VESSELS

08.18.07 Chesapeake Bay

Authority: Natural Resources Article, §§8-703 and 8-704, Annotated Code of Maryland

Notice of Final Action

[23-067-F]

On June 21, 2023, the Secretary of Natural Resources adopted amendments to Regulation .01 under COMAR 08.18.07 Chesapeake Bay. This action, which was proposed for adoption in 50:9 Md. R. 382 (May 5, 2023), has been adopted as proposed.

Effective Date: July 10, 2023.

JOSH KURTZ
Secretary of Natural Resources

 


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 Final Action

[22-323-F-I]

On May 19, 2023, the Secretary of Health adopted amendments to Regulations .01, .03—.05, .07—.09, and .11 under COMAR 10.09.02 Physicians’ Services. This action, which was proposed for adoption in 50:1 Md. R. 11—13 (January 13, 2023), has been adopted as proposed.

Effective Date: July 10, 2023.

LAURA HERRERA SCOTT
Secretary of Health

 

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.05 Dental Services

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

Notice of Final Action

[22-276-F]

On May 19, 2023, the Secretary of Health adopted amendments to Regulations .01 and .03—.07 under COMAR 10.09.05 Dental Services. This action, which was proposed for adoption in 49:27 Md. R. 1113—1115 (December 30, 2022), has been adopted with the nonsubstantive changes shown below.

Effective Date: July 10, 2023.

Attorney General’s Certification

In accordance with State Government Article, §10-113, Annotated Code of Maryland, the Attorney General certifies that the following changes do not differ substantively from the proposed text. The nature of the changes and the basis for this conclusion are as follows:

Regulation .01B: To reflect the Adult Dental Pilot that has sunset, the Maryland Department of Health (the Department) removes the definition of dual-eligible.

Regulation .04C: To align with the DSD style manual, the Department adjusts the language to use gender-neutral terminology instead of “his”.

.01 Definitions.

A. (proposed text unchanged)

B. Terms Defined.

(1)—(10) (proposed text unchanged)

[[(11) Dual Eligible.

(a) “Dual eligible” means an individual who is enrolled in both the Maryland Medical Assistance Program and Medicare.

(b) “Dual eligible” does not include Medicaid participants who only receive assistance with their Medicare premiums, deductibles, or copayments.]]

[[(12)]] (11)[[(32)]] (31) (proposed text unchanged)

.04 Covered Services.

A.—B. (proposed text unchanged)

C. The Program shall reimburse for covered services in §§A and B of this regulation if:

(1) (proposed text unchanged)

(2) The services are provided by the dentist or one of the following:

(a) Another licensed dentist in [[his]] the dentist’s employ;

(b) A dental hygienist or dental assistant, provided that the individual rendering the service is:

(i)—(ii) (proposed text unchanged)

(iii) Within the scope of [[his]] the individual’s training or certification for the purpose of assisting in the provision of dental services; or

(c) (proposed text unchanged)

(3)—(4) (proposed text unchanged)

LAURA HERRERA SCOTT
Secretary of Health

 

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.55 Physician Assistants

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

Notice of Final Action

[22-290-F]

On May 19, 2023, the Secretary of Health adopted amendments to Regulations .03 and .06 under COMAR 10.09.55 Physician Assistants. This action, which was proposed for adoption in 49:27 Md. R. 1115—1116 (December 30, 2022), has been adopted as proposed.

Effective Date: July 10, 2023.

LAURA HERRERA SCOTT
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 Final Action

[22-322-F]

On May 19, 2023, the Secretary of Health adopted amendments to Regulations .01, .03—.07, and .10 under COMAR 10.09.77 Urgent Care Centers. This action, which was proposed for adoption in 50:1 Md. R. 21—22 (January 13, 2023), has been adopted as proposed.

Effective Date: July 10, 2023.

LAURA HERRERA SCOTT
Secretary of Health

 


Title 14
INDEPENDENT AGENCIES

Subtitle 35 MARYLAND HEALTH BENEFIT EXCHANGE

14.35.10 Appeals from Determinations Regarding Producer Authorization or Individual Exchange Navigator Certification

Authority: Insurance Article, §§31-106(c)(1)(iv), 31-112, and 31-113; State Government Article, Title 10, Subtitle 2; Annotated Code of Maryland

Notice of Final Action

[23-039-F]

On June 20, 2023, the Maryland Health Benefit Exchange adopted amendments to Regulations .01—.05, the repeal of Regulations .06—.09 and .15, amendments to and the recodification of existing Regulations .10—.14 and .16 to be Regulations .06—.10 and .11, respectively, and new Regulation .12 under COMAR 14.35.10 Appeals from Determinations Regarding Producer Authorization or Individual Exchange Navigator Certification. This action, which was proposed for adoption in 50:8 Md. R. 353—355 (April 21, 2023), has been adopted as proposed.

Effective Date: July 10, 2023.

MICHELE EBERLE
Executive Director

 

Title 20
PUBLIC SERVICE COMMISSION

Subtitle 51 ELECTRICITY SUPPLIERS

Notice of Final Action

[22-354-F]

On May 31, 2023, the Maryland Public Service Commission adopted:

(1) Amendments to Regulation .02 under COMAR 20.51.01 General Provisions; and

(2) Amendments to Regulation .03 and new Regulation .10 under COMAR 20.51.02 Administrative Provisions.

This action, which was proposed for adoption in 50:6 Md. R. 232—233 (March 24, 2023), has been adopted as proposed.

Effective Date: July 10, 2023.

ANDREW S. JOHNSTON
Executive Secretary

 


Subtitle 53 COMPETITIVE ELECTRICITY SUPPLY

Notice of Final Action

[22-357-F]

On May 31, 2023, the Maryland Public Service Commission adopted:

(1) Amendments to Regulation .02 under COMAR 20.53.01 General;

(2) Amendments to Regulation .02 under COMAR 20.53.03 Pre-Enrollment Information;

(3) Amendments to Regulation .02 under COMAR 20.53.04 Transfers of Service; and

(4) Amendments to Regulations .02, .05, .07, .08, .10, .12, and .13 and new Regulation .14 under COMAR 20.53.07 Residential Customer Protection.

This action, which was proposed for adoption in 50:6 Md. R. 234—237 (March 24, 2023), has been adopted as proposed.

Effective Date: July 10, 2023.

ANDREW S. JOHNSTON
Executive Secretary

 

Subtitle 54 GAS SUPPLIERS

Notice of Final Action

[22-359-F]

On May 31, 2023, the Maryland Public Service Commission adopted:

(1) Amendments to Regulation .02 under COMAR 20.54.01 General Provisions; and

(2) Amendments to Regulation .03 and new Regulation .10 under COMAR 20.54.02 Administrative Provisions.

This action, which was proposed for adoption in 50:6 Md. R. 237—238 (March 24, 2023), has been adopted as proposed.

Effective Date: July 10, 2023.

ANDREW S. JOHNSTON
Executive Secretary

 

Subtitle 59 COMPETITIVE GAS SUPPLY

Notice of Final Action

[22-365-F]

On May 31, 2023, the Maryland Public Service Commission adopted:

(1) Amendments to Regulation .02 under COMAR 20.59.01 General;

(2) Amendments to Regulation .02 under COMAR 20.59.03 Pre-Enrollment Information;

(3) Amendments to Regulation .02 under COMAR 20.59.04 Transfers of Service; and

(4) Amendments to Regulations .02, .05, .07, .08, .10, .12, and .13 and new Regulation .14 under COMAR 20.59.07 Residential Customer Protection.

This action, which was proposed for adoption in 50:6 Md. R. 238—241 (March 24, 2023), has been adopted as proposed.

Effective Date: July 10, 2023.

ANDREW S. JOHNSTON
Executive Secretary

 

Subtitle 61 RENEWABLE ENERGY PORTFOLIO STANDARD PROGRAM

Notice of Final Action

[22-310-F]

On May 31, 2023, the Maryland Public Service Commission adopted amendments to:

(1) Regulation .03 under COMAR 20.61.01 General;

(2) Regulations .01 and .03 under COMAR 20.61.02 Certifiable Renewable Energy Facilities;

(3) Regulation .01 under COMAR 20.61.05 Maryland Strategic Energy Investment Fund; and

(4) Regulations .01—.03, .06, .12, and .18 under COMAR 20.61.06 Offshore Wind.

This action, which was proposed for adoption in 50:6 Md. R. 241—245 (March 24, 2023), has been adopted as proposed.

Effective Date: July 10, 2023.

ANDREW S. JOHNSTON
Executive Secretary

 

Title 31
MARYLAND INSURANCE ADMINISTRATION

Subtitle 03 INSURANCE PRODUCERS AND OTHER INSURANCE PROFESSIONALS

31.03.02 Insurance Producers—Continuing Education Requirements

Authority: Insurance Article, §§2-109,10-115, and 10-116, Annotated Code of Maryland

Notice of Final Action

[23-044-F]

On June 6, 2023, the Insurance Commissioner adopted amendments to Regulation .03 under COMAR 31.03.02 Insurance Producers—Continuing Education Requirements. This action, which was proposed for adoption in 50:8 Md. R. 355 (April 21, 2023), has been adopted as proposed.

Effective Date: October 1, 2023.

KATHLEEN A. BIRRANE
Insurance Commissioner

 


Title 33
STATE BOARD OF ELECTIONS

Notice of Final Action

[23-054-F]

On June 20, 2023, the State Board of Elections adopted:

 (1) Amendments to Regulation .06 under COMAR 33.01.05 Administrative Complaint Procedure;

(2) Amendments to Regulations .01, .03, and .04 under COMAR 33.03.02 Copies of Registration Lists;

(3) Amendments to Regulation .18 under COMAR 33.10.01 System Requirements and Procedures — EVS Voting Solution;

(4) Amendments to Regulation .05 under COMAR 33.12.02 Initiation of Recounts;

(5) Amendments to Regulation .01, the repeal of existing Regulation .03, and the recodification of existing Regulations .04—.06 to be Regulations .03—.05 under COMAR 33.16.02 Provisional Voting Documents and Supplies;

(6) Amendments to Regulation .02 under COMAR 33.16.04 Pre-Canvass Procedures;

(7) Amendments to Regulation .04 under COMAR 33.16.05 Canvass of Ballots — Procedures;

(8) Amendments to Regulations .02 and .04 under COMAR 33.17.02 Early Voting Centers;

(9) Amendments to Regulation .02 under COMAR 33.21.01 Definitions; General Provisions;

(10) Amendments to Regulations .02 and .03 under COMAR 33.21.03 Issuance and Return; and

(11) Amendments to Regulation .06 under COMAR 33.21.04 Voting Centers.

This action, which was proposed for adoption in 50:7 Md. R. 317—320 (April 7, 2023), has been adopted as proposed.

Effective Date: July 10, 2023.

LINDA H. LAMONE
State Administrator of Elections

 


Proposed Action on Regulations

 

 



Title 08
DEPARTMENT OF NATURAL RESOURCES

Subtitle 03 WILDLIFE

08.03.03 Open Seasons, Bag Limits for Game Birds and Game Animals

Authority: Natural Resources Article, §10-410, Annotated Code of Maryland

Notice of Proposed Action

[23-063-P]

The Secretary of Natural Resources proposes to amend Regulation .01 under COMAR 08.03.03 Open Seasons, Bag Limits for Game Birds and Game Animals.

Statement of Purpose

The purpose of this action is to provide additional Sunday hunting opportunities for game birds and game mammals (excluding waterfowl) on certain Sundays in Wicomico and Worcester counties. The added Sunday hunting opportunities include private and designated public lands and will have legal shooting hours of 30 minutes before sunrise to 10:30 am.

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 Brian Eyler, Associate Director, Department of Natural Resources, 14038 Blairs Valley Road
Clear Spring, MD 21722, or call 301-842-0332, or email to brian.eyler@maryland.gov. Comments will be accepted through July 31, 2023. A public hearing has not been scheduled.

.01 Bag Limits and Possession Limits.

A.—C. (text unchanged)

D. Hunting on Sunday.

(1) (text unchanged)

(2) An individual may hunt on Sunday, if the individual is:

(a)—(d) (text unchanged)

(e) Hunting white-tailed or sika deer on private property as described in Regulations .07 and .08 of this chapter:

(i) (text unchanged)

(ii) On the last three Sundays in October and the first two Sundays in November during the deer bow season and all Sundays during the deer firearms season in Harford [and Worcester counties] County;

(iii) (text unchanged)

(iv) 16 years of age or younger when participating in the Junior Deer Hunt on private lands only in Anne Arundel, Calvert, Caroline, Carroll, Charles, Dorchester, Harford, Kent, Montgomery, Queen Anne’s, Somerset, and Talbot[, Wicomico, and Worcester] counties;

(f) 16 years of age or younger when participating in the Junior Deer Hunt on private property in Allegany, Frederick, Cecil, Garrett, St. Mary’s, [and] Washington, Wicomico, and Worcester counties or a designated Natural Heritage Area, Wildlife Management Area, [or] State Forest, or Fishery Management Area  listed in §G of this regulation;

(g) Hunting deer on private property or a designated Natural Heritage Area, Wildlife Management Area, State Forest, or Fishery Management Area listed in §G of this regulation on all Sundays in September, October, November, and January during the deer bow season, the last Sunday in December during the deer bow season, all Sundays in December during the deer muzzleloader season, and all Sundays in the deer firearms season in Allegany, Cecil, Garrett, St. Mary’s, and Washington counties;

(h) Hunting deer on private property or a designated Natural Heritage Area, Wildlife Management Area, State Forest, or Fishery Management Area listed in §G of this regulation on all Sundays during the deer bow season in October and November, the last Sunday in December during the deer bow season, the first two Sundays in January during the deer bow season, all Sundays in December during the deer muzzleloader season, and all Sundays in the deer firearms season in Frederick County;

(i) Hunting deer on private property in Kent County:

(i) From 30 minutes before sunrise to 30 minutes after sunset on all Sundays in September, October, November, and January during the deer bow season, the last Sunday in December during the deer bow season, all Sundays in December during the deer muzzleloader season, and the first Sunday in the deer firearms season; and

(ii) (text unchanged)

(j) Hunting deer on private property in Montgomery County:

(i) (text unchanged)

(ii) Except as provided in §D(2)(j)(i) of this regulation, from 30 minutes before sunrise to 10:30 a.m. on all Sundays in September, October, November, and January during the deer bow season, the last Sunday in December during the deer bow season, all Sundays in December during the deer muzzleloader season, and the second and any subsequent Sunday during the deer firearms season;

(k) Hunting deer on private property or a designated Natural Heritage Area, Wildlife Management Area, State Forest, or Fishery Management Area listed in §G of this regulation in Wicomico County:

(i) (text unchanged)

(ii) Except as provided in §D(2)(k)(i) of this regulation, from 30 minutes before sunrise to 10:30 a.m. on [the second Sunday during the deer firearms season] all Sundays in September, October, November, and January during the deer bow season, the last Sunday in December during the deer bow season, all Sundays in December during the deer muzzleloader season, and the second and any subsequent Sunday during the deer firearms season;

(l) Hunting deer on private property in Talbot County:

(i) (text unchanged)

(ii) Except as provided in §D(2)(l)(i) of this regulation, from 30 minutes before sunrise to 10:30 a.m. on all Sundays in September, October, November, and January during the deer bow season, the last Sunday in December during the deer bow season, all Sundays in December during the deer muzzleloader season, and the second and any subsequent Sunday during the deer firearms season;

(m) Hunting deer on private property in Calvert, Caroline, Charles, and Queen Anne’s counties:

(i) (text unchanged)

(ii) Except as provided in §D(2)(m)(i) of this regulation, from 30 minutes before sunrise to 10:30 a.m. on all Sundays in September, October, November, and January during the deer bow season, the last Sunday in December during the deer bow season, and all Sundays in December during the deer muzzleloader season;

(n) (text unchanged)

(o) Hunting deer on private property or public land leased to hunt clubs in Somerset County:

(i) (text unchanged)

(ii) Except as provided in §D(2)(o)(i) of this regulation, from 30 minutes before sunrise to 10:30 a.m. on all Sundays in September, October, November, and January during the deer bow season, the last Sunday in December during the deer bow season, and all Sundays in December during the deer muzzleloader season;

(p) Hunting deer on private property or a designated Natural Heritage Area, Wildlife Management Area, State Forest, or Fishery Management Area listed in §G of this regulation in Worcester County:

(i) From 30 minutes before sunrise to 30 minutes after sunset on the last three Sundays in October and the first two Sundays in November during the deer bow season and all Sundays during the deer firearms season; and

(ii) Except as provided in §D(2)(p)(i) of this regulation, from 30 minutes before sunrise to 10:30 a.m. on all Sundays in September, October, November, and January during the deer bow season, the last Sunday in December during the deer bow season, and all Sundays in December during the deer muzzleloader season;

[(p)] (q) (text unchanged)

[(q)] (r) Hunting wild turkeys as described in Regulation .03 of this chapter on private property or a designated Natural Heritage Area, Wildlife Management Area, [or] State Forest, or Fishery Management Area  listed in §G of this regulation on any Sunday during the Junior Hunt and spring season in Dorchester County;

[(r)] (s) Hunting any game mammal or any game bird, except deer, migratory game birds or wetland game birds, in Allegany, Cecil, Garrett, St. Mary’s, and Washington counties on private property or a designated Natural Heritage Area, Wildlife Management Area, [or] State Forest, or Fishery Management Area  listed in §G of this regulation during the open seasons for those game animals;

[(s)] (t) (text unchanged)

[(t)] (u) Hunting any game mammal or any game bird, except deer, migratory game birds or wetland game birds, in Somerset County on private property or public land leased to hunt clubs from 30 minutes before sunrise to 10:30 a.m. during the open seasons for those game animals; [and]

(v) Hunting any game mammal or any game bird, except deer, migratory game birds or wetland game birds, in Wicomico and Worcester counties on private property or a designated Natural Heritage Area, Wildlife Management Area, State Forest, or Fishery Management Area listed in §G of this regulation from 30 minutes before sunrise to 10:30 a.m. during the open seasons for those game animals; and

[(u)] (w) (text unchanged)

E.—F. (text unchanged)

G. The Natural Heritage Areas, Wildlife Management Areas, State Forests, and Fishery Management Areas designated for Sunday hunting in accordance with §D of this regulation are as follows:

(1) (text unchanged)

(2) Chesapeake Forest Lands;

[(2)] (3)[(3)] (4) (text unchanged)

(5) E. A. Vaughn WMA;

[(4)] (6) (text unchanged)

(7) Ellis Bay WMA;

[(5)] (8)[(7)] (10) (text unchanged)

(11) Hickory Point Natural Heritage Area;

[(8)] (12) (text unchanged)

(13) Isle of Wight WMA;

(14) Johnson WMA;

[(9)] (15)[(10)] (16) (text unchanged)

(17) Nanticoke WMA;

[(11)] (18) (text unchanged)

(19) Pocomoke State Forest;

(20) Pocomoke River WMA;

[(12)] (21)[(17)] (26) Sideling Hill WMA; [and]

(27) Sinepuxent Islands WMA;

[(18)] (28) Warrior Mountain WMA[.]; and

(29) Wetipquin WMA.

JOSH KURTZ
Secretary of Natural Resources

 


Subtitle 03 WILDLIFE

08.03.06 Furbearer Wildlife

Authority: Natural Resources Article, §10-408, Annotated Code of Maryland

Notice of Proposed Action

[23-111-P]

The Secretary of Natural Resources proposes to amend Regulation .03 under COMAR 08.03.06 Furbearer Wildlife.

Statement of Purpose

The purpose of this action is to require traps, snares and similar devices to be marked with the user’s DNRid number. The DNRid number may be either stamped on the device or affixed to the device with a metal tag. Marking is not required if the device is being used on private property that is owned or rented by the person placing the device.

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 Brian Eyler, Associate Director, Department of Natural Resources, 14038 Blairs Valley Road, Clear Spring, MD 21722, or call 301-842-0332, or email to brian.eyler@maryland.gov. Comments will be accepted through July 31, 2023. A public hearing has not been scheduled.

.03 Trapping.

A. Except as otherwise expressly permitted or prohibited by law, trapping shall conform to the conditions in §§B—[G] H of this regulation.

B.—G. (text unchanged)

H. A person who uses a snare, a trap, or another similar device to capture wildlife shall stamp their DNRid number on each device, or affix a metal tag with their DNRid number to each device, unless the device is being used on private property that is owned or rented by the person placing the device.

JOSH KURTZ
Secretary of Natural Resources

 

Subtitle 03 WILDLIFE

08.03.17 Irreplaceable Natural Areas

Authority: Natural Resources Article, §3-503, Annotated Code of Maryland

Notice of Proposed Action

[23-091-P-I]

The Secretary of Natural Resources proposes to adopt new Regulations .01 and .02 under a new chapter, COMAR 08.03.17 Irreplaceable Natural Areas.

Statement of Purpose

The purpose of this action is to identify and describe Irreplaceable Natural Areas in Maryland. Irreplaceable Natural Areas are those areas that provide habitat necessary to support a unique natural community or threatened and endangered species. These areas are important for preserving and enhancing biodiversity within the State.

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 Jonathan McKnight, Associate Director, Department of Natural Resources, Tawes State Office Building E-1, 580, Taylor Avenue, Annapolis, MD  21401, or call 410-260-8539, or email to jonathan.mcknight@maryland.gov. Comments will be accepted through July 31, 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 Irreplaceable Natural Areas Portfolio (Maryland Department of Natural Resources, Wildlife and Heritage Service, March 2023) 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 was published in 50:1 Md. R. 7 (January 13, 2023), 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 Incorporation by Reference.

The Irreplaceable Natural Areas Portfolio (Maryland Department of Natural Resources, Wildlife and Heritage Service, March 2023), establishing management objectives for irreplaceable natural areas, including: a map depicting boundaries for each area; a description of the unique features and threats for each area; and compatible and incompatible activities for each area, is incorporated by reference.

.02 Sites Designated as Irreplaceable Natural Areas.

A. Allegany County.

(1) Bells Hill Shale Glade.

(2) Big Run — Green Ridge.

(3) Black Sulphur Run.

(4) Boyer Knob.

(5) Carroll Road Barrens.

(6) Dans Mountain.

(7) Deep Run.

(8) East Gilpin Shale Cliff.

(9) East Pratt Hollow Slope.

(10) Fifteenmile Creek and Tributaries.

(11) Fifteenmile Creek North Complex.

(12) Fifteenmile Creek South Complex.

(13) Fort Hill.

(14) Fossil Run.

(15) Georges Creek Tributaries.

(16) Green Ridge North.

(17) Hanging Prairie Shale Glade.

(18) High Germany Shale Barrens.

(19) Indian Lick Woods.

(20) Indigo Cedars.

(21) Jacobs Road Woods.

(22) Kasecamp Neck.

(23) Line Run Shale Barren.

(24) Little Pine Lick Hollow.

(25) Lower Town Creek Shale Glade.

(26) Maniford Shale Slopes.

(27) Maple Run.

(28) Martin Mountain South.

(29) Mertens Avenue Woods.

(30) Mountain Road South Woods.

(31) Mountain Road Woods.

(32) North Bells Hill Cliff.

(33) North Branch Potomac — Dans Mountain Tributaries.

(34) Oldtown Road Shale Glade.

(35) Outdoor Club Barrens.

(36) Paw Bends.

(37) Peters Run Woods.

(38) Possum Hollow.

(39) Rocky Gap.

(40) Rocky Gap Glade.

(41) Rocky Gap Run.

(42) Sideling Hill Creek.

(43) Stafford Slope Woods.

(44) Straus Barren and Floodplain.

(45) Sugar Hollow Shale Glades.

(46) Sulphur Run.

(47) Terrapin Run South.

(48) The Narrows.

(49) Town Creek — Pumpkin Center.

(50) Town Creek — Turkey Camp.

(51) Town Creek and Tributaries.

(52) Town Hill East Woods.

(53) Town Hill South.

(54) Town Hill West Woods.

(55) Turkey Camp Shale Complex.

(56) Warrior Mountain Hillside.

(57) Warrior Mountain Sandstone Glade.

(58) West Boyer Knob.

(59) Whittaker Ridge South.

(60) Williams Road Shale Glade.

(61) Wills Mountain Outcrop.

(62) Yonkers Bottom Shale Barren.

B. Anne Arundel County.

(1) Benfield Bottomland.

(2) Deep Run — Elkridge.

(3) Gumbottom Wetland.

(4) Little Patuxent Oxbow.

(5) Patapsco River and Tributaries.

(6) Patuxent River — Bowie.

(7) Severn Run East.

(8) Upper Patuxent Marshes.

C. Baltimore County.

(1) Alberton Slopes.

(2) Beetree Run.

(3) Black Marsh.

(4) Days Cove.

(5) Forks-of-the-Patapsco.

(6) Gunpowder Falls — Central.

(7) Gunpowder Falls — Hereford.

(8) Ilchester Powerline and Woods.

(9) Little Falls.

(10) Little Gunpowder Falls.

(11) Patapsco River and Tributaries.

(12) Prettyboy Cove Springs.

(13) Soldiers Delight.

D. Calvert County.

(1) Calvert Cliffs.

(2) Middle Patuxent Marshes.

(3) Parkers Creek.

(4) Patuxent — Yellow Bank Marsh.

(5) Patuxent Highlands.

E. Caroline County.

(1) Bridgetown Ponds.

(2) Hollingsworth Ponds.

(3) Marshyhope Creek and Tributaries.

(4) Marshyhope Creek North.

(5) Tuckahoe Creek.

F. Carroll County.

(1) Forks-of-the-Patapsco.

(2) Morgan Run and Tributaries.

(3) Morgan Run East.

(4) South Branch Patapsco River.

G. Cecil County.

(1) Big Elk Creek.

(2) Big Elk Creek Springs.

(3) Gramies Run.

(4) Grove Neck.

(5) Horseshoe Point Wetlands.

(6) North Grove Point.

(7) Plum Creek.

(8) Susquehanna Islands.

H. Charles County.

(1) Allen's Fresh.

(2) Chapman's Forest.

(3) Chicamuxen Creek.

(4) Mallows Bay.

(5) Mallows Bay Tributaries.

(6) Marbury Creek.

(7) Mattawoman Creek.

(8) Nanjemoy Creek.

(9) Persimmon Point Creek.

(10) Piney Branch Bog.

(11) Popes Creek.

(12) Purse Uplands and Ravines.

(13) Reeder Run.

(14) Smallwood Creek.

(15) Thorne Gut.

(16) Wards Run.

(17) Zekiah Swamp.

I. Dorchester County.

(1) Barnes Landing Marsh.

(2) Becker Island Marsh.

(3) Bestpitch Marsh.

(4) Brookview Ponds.

(5) Cedar Creek Marsh.

(6) Centennial Ponds.

(7) Chicone Woods.

(8) Doctors Creek Marsh.

(9) Fishing Bay Wetlands.

(10) Guinea Island.

(11) Little Creek Marsh.

(12) Maple Dam Marsh.

(13) Marshyhope Sand Ridge Complex.

(14) McCreadys Creek Marsh.

(15) Steels Neck Woods.

(16) Thorofare Creek Marsh.

(17) Town Point Neck Woods.

(18) Upper Nanticoke River.

J. Frederick County.

(1) Bells Chapel Woods.

(2) Big Hunting Creek.

(3) Boundary Rocks.

(4) Buzzard Branch.

(5) Cat Rock.

(6) Chick Road Springs.

(7) Cunningham Falls Hollow.

(8) High Run.

(9) Little Hunting Creek.

(10) Lower Monocacy River.

(11) Potomac Islands.

(12) Ridenour Swamp.

(13) Weverton Cliffs.

K. Garrett County.

(1) Amish Road Wetlands.

(2) Ashton's Woods.

(3) Backbone Mountain Northeast.

(4) Bear Creek.

(5) Bear Creek Springs.

(6) Bear Pen Headwaters.

(7) Big Laurel Run Swamp.

(8) Big Run — Savage.

(9) Big Savage — Mt. Zion.

(10) Bucks Run.

(11) Callahan Swamp.

(12) Casselman River — Grantsville.

(13) Casselman River and Tributaries.

(14) Chisolm Run Swamp.

(15) Coleman Hollow — South Savage.

(16) Crabtree Cave.

(17) Crabtree Creek Cliffs.

(18) Crabtree Slopes.

(19) Crooked — Laurel Runs.

(20) Cucumber Hollow.

(21) Cunningham Swamp.

(22) Discovery Woods.

(23) Eagle Rock Sandstone Glades.

(24) East Piney Mountain.

(25) Folly Run.

(26) Foxtown Bog Complex.

(27) Georges Creek Tributaries.

(28) Herrington Lake Wetlands.

(29) Herrington Run.

(30) High Rock.

(31) Huckleberry Rocks Wetlands and Glades.

(32) Hutton Switch Bog.

(33) Little Bear Creek.

(34) Little Laurel Run.

(35) Lostland Run.

(36) Lower Deep Creek Complex.

(37) Maple Lick Run.

(38) Mechem Bog.

(39) Mellott Springs.

(40) Middle Fork Headwaters.

(41) Mill Run Rocks.

(42) Monroe Run.

(43) Mount Nebo Wetlands.

(44) Muddy Creek — Piney Run.

(45) Mudlick Run.

(46) Murley Run.

(47) North Branch Potomac — Backbone Mountain Tributaries.

(48) North Chisolm Run.

(49) North Piney Mountain.

(50) North Prong.

(51) Pine Swamp East.

(52) Piney Run Bog.

(53) Poplar Lick Run.

(54) Poplar Lick Swamp.

(55) Pronghorn Swamp.

(56) Puzzley Run.

(57) Russell Road Meadow.

(58) Russell Road Pool.

(59) Savage Ravines.

(60) Savage River — Warnick Run.

(61) Savage River and Tributaries.

(62) Southeast Savage Reservoir Woods.

(63) Spring Lick Run.

(64) Toliver Run.

(65) Turkey Lodge Ridge Woods.

(66) Upper Cucumber Hollow.

(67) Upper White Rock Run.

(68) Upperman Road Bog.

(69) Walnut Bottom Vernal Pond.

(70) Warnick Point Southwest.

(71) Warnick Run Hilltop.

(72) West Piney Run.

(73) Wolf Swamp.

(74) Youghiogheny River.

(75) Youghiogheny River and Tributaries.

L. Harford County.

(1) Days Cove.

(2) Deer Creek and Tributaries.

(3) Falling Branch Woods.

(4) Herring Run.

(5) Hopkins Branch.

(6) Little Gunpowder Falls.

(7) Lower Deer Creek.

(8) Rocks Woods.

(9) Susquehanna Islands.

(10) Upper Deer Creek.

(11) Upper Deer Creek Hemlock Forest.

M. Howard County.

(1) Deep Run — Elkridge.

(2) Forks-of-the-Patapsco.

(3) Hawlings River.

(4) Patapsco River and Tributaries.

(5) Patuxent River.

(6) South Branch Patapsco River.

(7) Upper Patuxent Woods.

N. Kent County.

(1) Big Stone Ponds.

(2) Cypress Branch.

(3) Cypress Branch Ponds.

(4) Golts Ponds.

(5) Massey Ponds Complex.

(6) Millington Central Wetlands.

(7) Sassafras Shores.

O. Montgomery County.

(1) Hawlings River.

(2) Patuxent River.

(3) Potomac Islands.

(4) Sycamore Landing Wetlands.

(5) Upper Patuxent Woods.

P. Prince George’s County.

(1) Belt Woods.

(2) Mataponi Creek.

(3) Middle Patuxent Marshes.

(4) Patuxent Maple Swamp.

(5) Patuxent River — Bowie.

(6) Upper Patuxent Marshes.

(7) Zekiah Swamp.

Q. Queen Anne’s County.

(1) Andover Flatwoods.

(2) Browns Branch.

(3) Schoolhouse Woods.

(4) Tall Oaks.

(5) Tuckahoe Creek.

(6) Wye Island Hemlocks.

R. Somerset County.

(1) Cedar Island.

(2) Chance Marsh.

(3) Dames Quarter Marsh.

(4) Dividing Creek and Tributaries.

(5) Dublin Swamp.

(6) Fairmount Marsh.

(7) Hazard Island.

(8) Hickory Point Cypress Swamp.

(9) Janes Island.

(10) Manokin River Tributaries.

(11) Upper Fairmount Marsh.

S. St. Mary’s County.

(1) Elms Seeps.

(2) McIntosh Run.

(3) Moll Dyers Run.

(4) Point Lookout Creek.

(5) St. Mary's Lake Woods.

(6) St. Mary's River Bottomland.

T. Talbot County.

(1) Seth Forest.

U. Washington County.

(1) Beaver Creek.

(2) Black Rock Creek.

(3) Boyd Mountain Pond.

(4) Ernstville Stream.

(5) Fort Frederick Floodplain.

(6) Greenbrier Ponds.

(7) Hanging Rock Ridges.

(8) Hickory Ridge Ponds.

(9) Jugtown Cave.

(10) Kuhns Ridge Shale Barrens.

(11) Licking Creek.

(12) Potomac River — Long Ridge.

(13) Prathers Neck.

(14) Rabble Run Wetlands.

(15) Roundtop Hill.

(16) Sideling Hill Creek.

(17) Warner Gap Wetlands.

(18) Weverton Cliffs.

V. Wicomico County.

(1) Campbell Branch.

(2) Campbell Complex.

(3) Dividing Creek and Tributaries.

(4) Nutters Neck.

(5) Powell Road Wetlands.

(6) Sharptown Dunes.

(7) Stump Gut Complex.

(8) Sturges Creek.

(9) Taylors Trail Sand Ridges.

(10) Wango Pines.

(11) Widow Hawkins Meadow.

W. Worcester County.

(1) Assateague Island.

(2) Bachelors Branch.

(3) Blades Ponds.

(4) Chandler Woods.

(5) Corbin Canyon.

(6) Corkers Creek.

(7) Cottingham Mill Run.

(8) Disharoon Glades.

(9) Dividing Creek and Tributaries.

(10) Dividing Creek Ponds.

(11) Forest Road Dunes.

(12) Foster Woods.

(13) Furnace Dunes.

(14) Furnace Road Meadows.

(15) George Island Landing Marsh.

(16) Great Cypress Swamp.

(17) Hickory Point Cypress Swamp.

(18) Little Mill Run.

(19) Mattaponi.

(20) Nassawango Central.

(21) Nassawango Creek and Tributaries.

(22) Pikes Creek.

(23) Porters Crossing.

(24) Pusey Branch.

(25) Reedy Island.

(26) St. Lukes Wet Woods.

(27) Scarboro Creek Marsh.

(28) Scarboro Creek Woods.

(29) Shad Landing Cypress Swamp.

(30) Sinepuxent Sandflats.

(31) Skimmer Island Sandflats.

(32) South Point Island.

(33) Sturges Creek.

JOSH KURTZ
Secretary of Natural Resources

 

Title 10
MARYLAND DEPARTMENT OF HEALTH

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.08 Freestanding Clinics

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

Notice of Proposed Action

[23-095-P]

The Secretary of Health proposes to amend Regulations .01—.06, .09, and .10 under COMAR 10.09.08 Freestanding Clinics.

Statement of Purpose

The purpose of this action is to:

(1) Allow reimbursement for services rendered via telehealth in compliance with COMAR 10.09.49;

(2) In accordance with Ch. 56 (H.B. 937), Acts of 2022, permit nurse midwives, nurse practitioners, and physician assistants to provide abortions when appropriate; and

(3) Clarify and update language throughout the chapter to align regulations with current practice and terminology, for example, replace outdated “recipient” language with “participant”.

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 (TTY 800-735-2258), or email to mdh.regs@maryland.gov. Comments will be accepted through July 31, 2023. A public hearing has not been scheduled.

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

(1) (text unchanged)

(2) “Clinic services” means preventive, diagnostic, therapeutic, rehabilitative, or palliative items or services furnished by or under the direction of a licensed physician or dentist either in a freestanding clinic, or outside the clinic if the:

(a) [Recipient] Participant does not reside in a permanent dwelling or have a fixed home or mailing address; and

(b) (text unchanged)

(3)—(7) (text unchanged)

(8) Freestanding Clinic.

(a) (text unchanged)

(b) “Freestanding clinic” does not include a clinic or clinic site located in a [recipient’s] participant’s home.

(9) Home.

(a) “Home” means the house, apartment, trailer, licensed health care facility, or other dwelling in which a [recipient] participant resides.

(b) (text unchanged)

(10)—(11) (text unchanged)

(12) “Mental health services” means those services described in COMAR [10.09.70.10C] 10.67.08.02 that are rendered to treat an individual for a diagnosis as set forth in COMAR [10.09.70.10A] 10.67.08.02M and N.

(13)—(20) (text unchanged)

(21) “Qualified provider” means an individual who is licensed, certified, or otherwise authorized by law to practice in the State and for whom the performance of an abortion is within the scope of the individual’s license or certification.

[(21)] (22)[(22)] (23) (text unchanged)

.02 License Requirements.

A.—D. (text unchanged)

E. When applicable, abortion clinics shall be licensed in accordance with [10.21.01] 10.12.01.

.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 freestanding clinic provider require that the provider:

(1)—(3) (text unchanged)

(4) Maintain adequate documentation of each contact with each [recipient] participant as part of the plan of care, which, at a minimum, shall include:

(a) (text unchanged)

(b) [Recipient’s] Participant’s chief medical complaint or reason for visit;

(c)—(d) (text unchanged)

(5)—(8) (text unchanged)

C. In the absence of specifically applicable regulations, a freestanding clinic [may participate in the Program by] shall:

(1) [Complying] Comply with §A of this regulation;

(2) [Complying] Comply with specific conditions, which may be included in the written agreement; and

(3) [Accepting] Accept reimbursement according to COMAR 10.09.02 Physicians’ Services.

D. (text unchanged)

.04 Covered Services.

A.—C. (text unchanged)

D. Abortion Clinic [Services] Care.

(1) To participate in the Program as an abortion clinic, the provider shall meet the requirements of Regulations .02 and .03 of this chapter and §B of this regulation and shall:

(a) (text unchanged)

(b) [Perform] Ensure abortions [upon certification] are performed by [the physician performing the procedure that the procedure is necessary, based upon his or her professional judgment,] a qualified provider and in compliance with [COMAR 10.09.02 Physicians’ Services] all applicable Program regulations; and

(c) (text unchanged)

(2) (text unchanged)

E. (text unchanged)

.05 Federally Qualified Health Center Services.

A. To participate as a federally qualified health center, the provider shall meet the requirements of Regulations .03 and .04B of this chapter and shall:

(1) (text unchanged)

(2) Be enrolled in the EPSDT/Healthy Kids Program as provided in COMAR 10.09.23 and provide EPSDT/Healthy Kids services to [recipients] participants who are eligible to receive them;

(3)—(6) (text unchanged)

B.—E. (text unchanged)

.06 Limitations.

The Program does not cover the following:

A.—E. (text unchanged)

F. Freestanding clinic services for inpatient [recipients] participants in State-operated facilities serving individuals with intellectual disabilities;

G—I. (text unchanged)

J. [Injections and] Office visits solely for the administration of [injections] injectable medications, unless medical necessity and the [recipient’s] patient’s inability to take appropriate oral medications are documented in the [patient’s] medical record;

K.—L. (text unchanged)

M. Immunizations required solely for travel outside the continental United States;

N.—O. (text unchanged)

P. Separate reimbursement to a [physician] practitioner for services provided in a freestanding clinic in addition to the freestanding clinic reimbursement;

Q.—T. (text unchanged)

.09 Preauthorization Requirements.

A.—B. (text unchanged)

C. Preauthorization is valid only for services rendered or initiated within 60 days of the date preauthorization was issued. The patient shall be an eligible [recipient] participant at the time the service is rendered.

D. (text unchanged)

.10 Payment Procedures.

A.—E. (text unchanged)


F. The provider may not bill the Program for:

(1)—(2) (text unchanged)

(3) Professional services rendered by mail [or telephone];

(4)—(6) (text unchanged)

G. The Program may not make direct payment to [recipients] participants.

H.—I. (text unchanged)

LAURA HERRERA SCOTT
Secretary of Health

 

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.28 Applied Behavior Analysis Services

Authority: Health-General Article, §§2-104(b), 2-105(b), 15-103, and 15-105, Annotated Code of Maryland

Notice of Proposed Action

[23-116-P]

The Secretary of Health proposes to amend Regulations .01, .02, .04, and .06 under COMAR 10.09.28 Applied Behavior Analysis Services.

Statement of Purpose

The purpose of the proposed action is to:

(1) Update reimbursement rates for Applied Behavioral Analysis (ABA) services in accordance with Ch. 484 (S.B. 290), Acts of 2022, FY23 Budget Bill, and the Governor’s supplemental budget; and

(2) Update definitions, provider qualifications, and covered services to reflect the Department’s decision to allow behavior technicians (BTs) to provide ABA services to eligible participants.

Estimate of Economic Impact

I. Summary of Economic Impact. The Fiscal Year (FY) 2023 budget includes a rate increase of 7.25 percent for Applied behavioral analysis (ABA) providers effective July 1, 2022. The total impact of this change for FY 2023 is $3,811,947.

II. Types of Economic Impact.

Impacted Entity

Revenue (R+/R-)

Expenditure

(E+/E-)

Magnitude

A. On issuing agency:

 

 

Maryland Department of
Health

(E+)

$3,811,947

B. On other state agencies:

NONE

 

C. On local governments:

NONE

 

 

 

 

 

Benefit (+)

Cost (-)

Magnitude

D. On regulated industries or trade groups:

 

 

Maryland Medicaid providers

(+)

$3,811,947

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. This amount assumes:

(1) ABA utilization will continue at current levels.

(2) Effective July 1, 2022, ABA providers received a 7.25 percent rate increase. For the period July 1, 2022 through June 30, 2023, the total impact is $3,811,947.

(3) This amount is subject to a 58.8 percent federal match (41.2 percent general funds $1,570,522 and 58.8 percent federal funds $2,241,425).

D. See A. above.

Economic Impact on Small Businesses

The proposed action has a meaningful economic impact on small businesses. An analysis of this economic impact follows:

The proposed action effectuates a 7.25 percent rate increase effective July 1, 2022. To the extent that ABA providers qualify as small businesses, they will benefit from increased reimbursement during FY 2023.

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 (TTY 800-735-2258), or email to mdh.regs@maryland.gov. Comments will be accepted through July 31, 2023. A public hearing has not been scheduled.

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

(1) (text unchanged)

(2) “ABA program” means an association, partnership, corporation, or unincorporated group that includes:

(a) (text unchanged)

(b) A BCaBA [or an], RBT, or a BT.

(3)—(4) (text unchanged)

(5) “Behavior technician (BT)” means a paraprofessional in the process of obtaining BACB certification who delivers ABA services that are provided to participants with ASD under the supervision of a licensed:

(a) Psychologist;

(b) BCBA-D; or

(c) BCBA.

[(5)] (6)[(12)] (13) (text unchanged)

[(13)] (14) “Direction of a technician” means the in-person monitoring of a BCaBA [or an], RBT, or BT, performed by a licensed psychologist or an LBA.

[(14)] (15)[(32)] (33) (text unchanged)

[(33)] (34) “Registered behavior technician (RBT)” means a paraprofessional certified by the BACB who delivers ABA services that are provided to participants with ASD under the supervision of:

(a)—(b) (text unchanged)

[(34)] (35) “Remote access technology” means the use of HIPAA compliant technological methods to provide auditory and visual connection between a licensed psychologist or an LBA, who is not directly present, and a BCaBA [or an], RBT, or BT when services are being provided at the participant’s home.

[(35)] (36) “Remote direction of a technician” means the monitoring of a BCaBA [or an], RBT, or BT, who is physically with the participant, performed via synchronous two-way audio-visual remote access technology by a licensed psychologist or an LBA.

[(36)] (37) (text unchanged)

.02 Provider Qualifications and Conditions for Participation.

A.—I. (text unchanged)

J. A BT provider who renders ABA services shall:

(1) Be 18 years old or older;

(2) Obtain BACB registration within 90 days of enrollment with Maryland Medicaid;

(3) Have a high school degree or national equivalent;

(4) Work under the direction of:

(a) A licensed psychologist; or

(b) An LBA; and

(5) Have the supervisory relationship documented in writing.

.04 Covered Services.

A. (text unchanged)

B. The Program covers the following ABA services:

(1) (text unchanged)

(2) A behavior identification supporting assessment which is a follow-up assessment that is administered:

(a) In person, by an RBT, BT, or BCaBA, with a participant present; and

(b) (text unchanged)

(3) An exposure behavior identification supporting assessment which is a follow-up assessment that:

(a) (text unchanged)

(b) Is administered in person by a licensed psychologist or an LBA with the assistance of two or more BCaBAs [or], RBTs, or BTs;

(c)—(d) (text unchanged)

(4) An adaptive behavior treatment with protocol modification which is an in-person service that:

(a) (text unchanged)

(b) Is administered in-person by a licensed psychologist or an LBA with the assistance of two or more BCaBAs [or], RBTs, or BTs;

(c)—(d) (text unchanged)

(5) Group adaptive behavior treatment by protocol which is an in-person service provided to a group of two or more participants by:

(a)—(b) (text unchanged)

(c) A BCaBA [or an], RBT, or BT under the direction of a licensed psychologist or an LBA utilizing a behavioral intervention protocol designed in advance by the psychologist or an LBA who may or may not provide in-person direction of a technician during the treatment;

(6)—(9) (text unchanged)

(10) Adaptive behavior treatment direction of a technician which is the clinical direction and oversight of a BCaBA [or an], RBT, or a BT by a licensed psychologist or an LBA that:

(a) Requires the licensed psychologist or the LBA to directly or remotely observe the BCaBA [or the], RBT, or BT administering ABA services to the participant, group of participants, parent, or caregiver; and

(b) Is performed on an ongoing basis, equal to at least 10 percent of the amount of hours that the BCaBA [or the], RBT, or BT is providing direct ABA services to the participant, or group of participants;

(11) Adaptive behavior treatment by protocol which is an in-person service provided to a participant by:

(a) (text unchanged)

(b) A BCaBA [or an], RBT, or BT under the direction of a licensed psychologist or an LBA utilizing a behavioral intervention designed in advance by the licensed psychologist or an LBA, who may or may not provide in-person or remote direction during the treatment; and

(12) (text unchanged)

C. ABA services shall only be provided by a licensed psychologist, LBA, BCaBA, [or] RBT, or BT.

D.—F. (text unchanged)

.06 Payment Procedures.

A.—B. (text unchanged)

C. Reimbursement for ABA services may not be made directly to a BCaBA [or], RBT, or BT rendering ABA services.

D.—E. (text unchanged)

[F. For dates of service between July 1, 2020 and December 31, 2020, reimbursement for ABA services covered under this chapter is as follows:

(1) Behavior identification assessment at a rate of $28.60 per 15 minutes;

(2) Behavior identification assessment follow-up at a rate of $14.30 per 15 minutes;

(3) Exposure behavior identification supporting assessment at a rate of $39 per 15 minutes;

(4) Adaptive exposure behavior treatment with protocol modification at a rate of $39 per 15 minutes;

(5) Group adaptive behavior treatment by protocol at a rate of:

(a) $7.80 per 15 minutes, per participant, when provided by a licensed psychologist or an LBA;

(b) $6.24 per 15 minutes, per participant, when provided by a BCaBA; and

(c) $5.20 per 15 minutes, per participant, when provided by an RBT;

(6) Adaptive behavior treatment with protocol modification at a rate of $28.60 per 15 minutes;

(7) Multiple-family group adaptive behavior treatment guidance at a rate of $9.62 per 15 minutes per family;

(8) Family adaptive behavior treatment guidance with the participant present at a rate of:

(a) $28.60 per 15 minutes when provided by a licensed psychologist or an LBA; and

(b) $15.60 per 15 minutes when provided by a BCaBA;

(9) Family adaptive behavior treatment guidance without the participant present at a rate of:

(a) $15.60 per 15 minutes when provided by a licensed psychologist or an LBA; and

(b) $9.10 per 15 minutes when provided by a BCaBA;

(10) Behavior identification reassessment at a rate of $28.60 per 15 minutes;

(11) Group adaptive treatment with protocol modification at a rate of $7.80 per 15 minutes per participant;

(12) Adaptive behavior treatment direction at a rate of $28.60 per 15 minutes;

(13) Adaptive behavior treatment by protocol at a rate of:

(a) $18.20 per 15 minutes when provided by a licensed psychologist or an LBA;

(b) $15.60 per 15 minutes when provided by a BCaBA; and

(c) $14.30 per 15 minutes when provided by an RBT; and

(14) Adaptive behavior treatment planning:

(a) At a rate of $28.60 per 15 minutes; and

(b) For a maximum of 4 hours per month.

G. For dates of service between January 1, 2021 and October 31, 2021, reimbursement for ABA services covered under this chapter is as follows:

(1) Behavior identification assessment at a rate of $29.60 per 15 minutes;

(2) Behavior identification assessment follow-up at a rate of $14.80 per 15 minutes;

(3) Exposure behavior identification supporting assessment at a rate of $40.37 per 15 minutes;

(4) Adaptive exposure behavior treatment with protocol modification at a rate of $40.37 per 15 minutes;

(5) Group adaptive behavior treatment by protocol at a rate of:

(a) $8.07 per 15 minutes, per participant, when provided by a licensed psychologist or an LBA;

(b) $6.46 per 15 minutes, per participant, when provided by a BCaBA; and

(c) $5.38 per 15 minutes, per participant, when provided by an RBT;

(6) Adaptive behavior treatment with protocol modification at a rate of $29.60 per 15 minutes;

(7) Multiple-family group adaptive behavior treatment guidance at a rate of $9.96 per 15 minutes per family;

(8) Family adaptive behavior treatment guidance with the participant present at a rate of:

(a) $29.60 per 15 minutes when provided by a licensed psychologist or an LBA; and

(b) $16.15 per 15 minutes when provided by a BCaBA;

(9) Family adaptive behavior treatment guidance without the participant present at a rate of:

(a) $16.15 per 15 minutes when provided by a licensed psychologist or an LBA; and

(b) $9.42 per 15 minutes when provided by a BCaBA;

(10) Behavior identification reassessment at a rate of $29.60 per 15 minutes;

(11) Group adaptive treatment with protocol modification at a rate of $8.07 per 15 minutes per participant;

(12) Adaptive behavior treatment direction at a rate of $29.60 per 15 minutes;

(13) Adaptive behavior treatment by protocol at a rate of:

(a) $18.84 per 15 minutes when provided by a licensed psychologist or an LBA;

(b) $16.15 per 15 minutes when provided by a BCaBA; and

(c) $14.80 per 15 minutes when provided by an RBT; and

(14) Adaptive behavior treatment planning:

(a) At a rate of $29.60 per 15 minutes; and

(b) For a maximum of 4 hours per month.]

[H.] F. [Effective] For dates of service from November 1, 2021 through June 30, 2022, reimbursement for ABA services covered under this chapter is as follows:

(1)—(14) (text unchanged)

G. Effective July 1, 2022, reimbursement for ABA services covered under this chapter is as follows:

(1) Behavior identification assessment at a rate of $33.46 per 15 minutes;

(2) Behavior identification assessment follow-up at a rate of $16.73 per 15 minutes;

(3) Exposure behavior identification supporting assessment at a rate of $45.63 per 15 minutes;

(4) Adaptive exposure behavior treatment with protocol modification at a rate of $45.63 per 15 minutes;

(5) Group adaptive behavior treatment by protocol at a rate of:

(a) $9.13 per 15 minutes, per participant, when provided by a licensed psychologist or an LBA;

(b) $7.30 per 15 minutes, per participant, when provided by a BCaBA; and

(c) $6.08 per 15 minutes, per participant, when provided by an RBT or BT;

(6) Adaptive behavior treatment with protocol modification at a rate of $33.46 per 15 minutes;

(7) Multiple-family group adaptive behavior treatment guidance at a rate of $11.26 per 15 minutes per family;

(8) Family adaptive behavior treatment guidance with the participant present at a rate of:

(a) $33.46 per 15 minutes when provided by a licensed psychologist or an LBA; and

(b) $18.25 per 15 minutes when provided by a BCaBA;

(9) Family adaptive behavior treatment guidance without the participant present at a rate of:

(a) $18.25 per 15 minutes when provided by a licensed psychologist or an LBA; and

(b) $10.65 per 15 minutes when provided by a BCaBA;

(10) Behavior identification reassessment at a rate of $33.46 per 15 minutes;

(11) Group adaptive treatment with protocol modification at a rate of $9.13 per 15 minutes per participant;

(12) Adaptive behavior treatment direction at a rate of $33.46 per 15 minutes;

(13) Adaptive behavior treatment by protocol at a rate of:

(a) $21.30 per 15 minutes when provided by a licensed psychologist or an LBA;

(b) $18.25 per 15 minutes when provided by a BCaBA; and

(c) $16.73 per 15 minutes when provided by an RBT or BT; and

(14) Adaptive behavior treatment planning:

(a) At a rate of $33.46 per 15 minutes; and

(b) For a maximum of 4 hours per month.

LAURA HERRERA SCOTT
Secretary of Health

 

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.36 General Medical Assistance Provider Participation Criteria

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

Notice of Proposed Action

[23-079-P]

The Secretary of Health proposes to amend Regulations .01—.03, .07, and .09—.11 under COMAR 10.09.36 General Medical Assistance Provider Participation Criteria.

Statement of Purpose

The purpose of this action is to alter existing regulations to align them with current Program policies, including:

(1) Amending provider license requirements to allow for certification or other legal authorization when appropriate;

(2) Requiring providers to fully comply with terms and conditions stated in their provider agreements;

(3) Establishing a provider enrollment effective date;

(4) Prohibiting providers from assuming a participant’s fair hearing rights unless permitted by the participant or law;

(5) Authorizing the Department to conduct audits as authorized by State and federal law;

(6) Prohibiting providers from appealing termination by the Program when the termination is the result of certain actions; and

(7) Changing the outdated term “recipient” to “participant”.

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 (TTY 800-735-2258), or email to mdh.regs@maryland.gov. Comments will be accepted through July 31, 2023. A public hearing has not been scheduled.

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(18) (text unchanged)

(19) “Provider” means:

(a) An individual, association, partnership, corporation, unincorporated group, or any other person authorized, licensed, or certified to provide services for Program [recipients] participants and who, through appropriate agreement with the Department, has been identified as a Program provider by the issuance of an individual account number;

(b)—(c) (text unchanged)

(20) (text unchanged)

.02 License Requirements.

[Providers of] Medical Assistance Program [services] providers shall, to the extent required by law, be licensed [and], certified, or otherwise legally authorized to practice or deliver services in the state in which the service is provided.

.03 Conditions for Participation.

A. To participate in the Program, the provider shall:

(1)—(5) (text unchanged)

(6) Have a current provider agreement with the Program in effect and fully comply with the terms and conditions stated in the provider agreement;

(7)—(11) (text unchanged)

(12) Verify the [recipient's] participant’s eligibility by:

(a) Viewing the [recipient's] participant’s Medical Assistance card and another identification card; and

(b) Calling the Program's Eligibility Verification Interactive Voice Response System (EVS/IVR) or accessing the web-based [recipient] participant eligibility system;

(13) Place no restriction on a [recipient's] participant’s right to select health care providers of the [recipient's] participant’s choice, except that a participant in a managed care program shall be required to obtain certain specified Program services from or through the participant's care manager, in accordance with the restrictions imposed by the managed care program;

(14) 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;

(15) (text unchanged)

(16) Maintain the confidentiality of all [recipient] participant information by not releasing the information without authorization by the [recipient] participant or as authorized by law;

(17) (text unchanged)

(18) Obtain a referral from a [recipient's] participant’s care manager in a manner prescribed by the Department before rendering services, when:

(a) The [recipient] participant is enrolled in a managed care program; and

(b) (text unchanged)

(19) Supply a signed service order or prescription that includes the individual rendering number of the ordering or prescribing practitioner, as well as the full name and Medical Assistance number of the [recipient] participant, when ordering services to be supplied by other providers, such as hospital admission, diagnostic testing, supplies, or pharmacy services[:];

(20) Ensure that Clinical Laboratory Improvement Amendments (CLIA) certification exists for all clinical laboratory services performed; [and]

(21) Provide a [recipient's] participant’s medical records at no charge when the records are requested by another physician or licensed provider on behalf of the [recipient] participant[.]; and

(22) Comply with the requirements of COMAR 10.01.04.12 regarding the designation of an authorized representative;

(23) Place no restriction on a participant’s fair hearing appeal rights as a condition of rendering services; and

(24) Comply with provider audits authorized by State and federal law to ensure compliance with Program requirements.

B. Enrollment Effective Date.

(1) Unless a provider is enrolled under the provisions of §B(2) of this regulation, the effective date of a provider’s enrollment is the date the Program completes all screenings required by State and federal law, which may include a site visit, following the Program’s receipt of the provider’s submission of a complete application with all required supporting documents.

(2) If an out-of-State emergency transportation services or emergency services provider meets provider enrollment requirements, the enrollment effective date is the date the provider renders the emergency services.

[B.] C. (text unchanged)

[C.] D. If the Program denies payment or requests repayment on the basis that an otherwise covered service was not medically necessary or preauthorized, the provider may not seek payment for that service from the [recipient] participant.

[D.] E. If the Program denies payment due to late billing, payment from the [recipient] participant may not be sought.

[E.] F. The Program may pay for a covered service rendered by a provider to a [recipient] participant under any of the following circumstances:

(1) The provider charges for [nonrecipients] nonparticipants who receive the same service by:

(a)—(d) (text unchanged)

(2) The State, using its own funds, pays for services rendered to a targeted group of [nonrecipients] nonparticipants, and the provider charges nontargeted users of the services;

(3)—(5) (text unchanged)

[F.] G. (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, covered services, 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 Program shall pay the difference between what was paid by the insurance carrier and the Program's maximum fees. Total payment cannot exceed the Program's maximum fee. 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)

C. The Department may conduct provider audits as authorized by State and federal law to ensure compliance with Program requirements.

[C.] D.[D.] E. (text unchanged)

.09 Filing Appeal.

A. Source of Appeals.

(1)—(2) (text unchanged)

(3) A provider may not file an appeal from a Program action to terminate the provider when that action is the result of either:

(a) Termination of the provider or an owner by the federal government or another state Medicaid agency pursuant to 42 CFR §445.416; or

(b) Suspension or termination of the provider’s license or certificate by their respective licensing or certification authority.

B.—F. (text unchanged)

.10 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.

.11 Provider Rights.

Providers participating in the Program shall have the right to:

A.—C. (text unchanged)

D. Be reimbursed for covered services provided to Program [recipients] participants; and

E. (text unchanged)

LAURA HERRERA SCOTT
Secretary of Health

 

Notice of Proposed Action

[23-098-P]

The Secretary of Health proposes to adopt:

(1) New Regulations .01—.06 under a new chapter, COMAR 10.09.63 Community Violence Prevention Services; and

(2) New Regulation .26-7 under COMAR 10.67.06 Maryland Medicaid Managed Care Program: Benefits.

Statement of Purpose

The purpose of this action is to establish regulations governing the provision of community violence prevention services in accordance with Ch. 505 (S.B. 350), Acts of 2022, Maryland Medical Assistance Program – Community Violence Services.

Estimate of Economic Impact

I. Summary of Economic Impact. The proposed action establishes Medicaid coverage for community violence prevention services, effective July 1, 2023. The Program anticipates an economic impact of $4,552,416 in Fiscal Year (FY) 2024.

II. Types of Economic Impact.

Impacted Entity

Revenue (R+/R-)

Expenditure

(E+/E-)

Magnitude

A. On Issuing agency:

 

 

Maryland Department of
Health

(E+)

$4,552,416

B. On other state agencies:

NONE

 

C. On local governments:

NONE

 

 

 

 

 

Benefit (+)

Cost (-)

Magnitude

D. On regulated industries or trade groups:

 

 

Community violence
 prevention professionals

(+)

$4,551,183

E. On other industries or trade groups:

 

 

Provider enrollment vendor

(+)

$1,233

F. Direct and indirect effects on public:

NONE

 

III. Assumptions. (Identified by Impact Letter and Number from Section II.)

A. This amount assumes:

(1) For dates of service beginning July 1, 2023, the Program will begin reimbursing for community violence prevention services.

(2) The estimated number of participants who will be eligible for the benefit is 5,557. The uptake rate for this benefit is projected at 25 percent, or 1,389 participants.

(3) The Program will cover up to 100 service units per person on a rolling 12-month basis. Costs for these services are approximately $273 per member per month (PMPM).

(4) The total impact of this new benefit for FY24 is $4,552,416.

(5) This amount is subject to a 60 percent blended federal match ($1,820,966 general funds and $2,731,449 federal funds).

(6) Vendor costs are estimated at 15 x $6.85= $102.75 monthly = $1,2333 Total cost annually ($925 federal funds, $308 general funds).

D. and E. See A. above.

Economic Impact on Small Businesses

The proposed action has a meaningful economic impact on small businesses. An analysis of this economic impact follows:

The proposed action establishes community violence prevention service coverage, effective July 1, 2023. To the extent that community violence service providers who qualify as small businesses render services to individuals exposed to acts of community violence, they will benefit from the expanded coverage of services.

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 (TTY 800-735-2258), or email to mdh.regs@maryland.gov. Comments will be accepted through July 31, 2023. A public hearing has not been scheduled.

 

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.63 Community Violence Prevention Services

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

.01 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) “Certified violence prevention professional” means a prevention professional who meets the requirements of Regulation .02 of this chapter.

(2) “Community violence” means intentional acts of interpersonal violence committed in public areas by individuals who are not family members or intimate partners of the victim.

(3) “Community violence prevention services” means evidence-based, trauma-informed, supportive, and nonpsychotherapeutic services provided by a certified violence prevention professional, within or outside a clinical setting, for the purpose of promoting improved health outcomes and positive behavioral change, preventing injury recidivism, and reducing the likelihood that an individual who is the victim of community violence will commit or promote violence.

(4) “Department” means the Maryland Department of Health, the single State agency designated to administer the Maryland Medical Assistance Program under Title XIX of the Social Security Act, 42 U.S.C. §§1396 et seq.

(5) “Interpersonal violence” means the intentional use of physical force or power against another individual by an individual or a small group of individuals.

(6) “Provider” means the entity who through appropriate agreement with the Department has been identified as a Program provider by the issuance of an individual account number.

.02 Certification Requirements.

A. An individual rendering services under this chapter shall complete an accredited training and certification program for certified violence prevention professionals, approved by the Department.

B. An accredited training and certification program for certified violence prevention professionals shall:

(1) Consist of at least 35 hours of initial training, addressing the following topics:

(a) The profound effects of trauma and violence and the basics of trauma-informed care;

(b) Community violence prevention strategies, including conflict mediation and retaliation prevention related to community violence;

(c) Case management and advocacy practices; and

(d) Patient privacy and the federal Health Insurance Portability and Accountability Act of 1996; and

(2) Require at least 6 hours of continuing education every 2 years.

.03 Conditions for Participation.

A. General requirements for participation in the Program are that a provider shall:

(1) Meet all conditions for participation as set forth in COMAR 10.09.36.03; and

(2) If rendering services via telehealth, comply with COMAR 10.09.49 and any sub regulatory guidance issued by the Department.

B. Specific requirements for participation in the Program as a community violence prevention service provider are that a provider shall:

(1) Maintain documentation that an individual rendering community violence prevention services under this chapter meets the certification requirements as provided in Regulation .02 of this chapter and maintain documentation of certification;

(2) Maintain an affiliation with at least one trauma Primary Adult Resource Center (PARC), level I, or level II licensed short-term general hospital or children’s hospital in Maryland through which the provider entity is authorized to provide community violence prevention services to beneficiaries in the hospital; and

(3) Ensure that the certified violence prevention professional is providing community violence prevention services in compliance with any applicable standard of care, rule, regulation, and State or federal law.

 .04 Covered Services.

A. Effective July 1, 2023, the Department shall reimburse for community violence prevention services as described in §B of this regulation when these services:

(1) Are medically necessary; and

(2) Rendered to a participant who:

(a) Has been exposed to community violence or has a personal history of injury resulting from community violence;

(b) Is at an elevated risk of violent injury or retaliation resulting from another act of community violence, as determined by a certified or licensed health care provider or social services provider; and

(c) Has been referred by a certified or licensed health care provider to a certified violence prevention professional to receive community violence prevention services.

B. Community violence prevention services shall include one or more of the following interventions:

(1) Mentorship;

(2) Conflict mediation;

(3) Crisis intervention;

(4) Referrals to certified or licensed health care professionals or social services providers;

(5) Patient education; and

(6) Screening services.

C. The Program shall cover a maximum of 100 30-minute units of services in a rolling 12-month period.

.05 Limitations.

Under this chapter, the Program does not cover services:

A. Following an episode of intimate partner violence or domestic violence;

B. Delivered by a provider that is not affiliated with a trauma PARC, level I, or level II licensed short-term general hospital or children’s hospital in Maryland; and

C. Provided in excess of 100 30-minute units of services in a rolling 12-month period.

.06 Payment Procedures.

A. General policies governing payment procedures that are applicable to all providers are set forth in COMAR 10.09.36.04.

B. The provider shall charge the Program the provider’s customary charge to the general public for similar services. If the service is free to individuals not covered by Medicaid:

(1) The provider:

(a) May charge the Program; and

(b) Shall be reimbursed in accordance with §G of this regulation; and

(2) The provider’s reimbursement is not limited to the provider’s customary charge.

C. The Program will reimburse a provider for covered services:

(1) The lesser of the provider’s customary charge to the general public unless the service is free to individuals not covered by Medicaid; or

(2) In accordance with §G of this regulation.

D. The provider may not bill the Program or the participant for:

(1) Completion of forms and reports;

(2) Broken or missed appointments;

(3) Professional services rendered by mail; or

(4) Providing a copy of a program participant’s medical record when requested by another provider on behalf of the participant.

E. Payments for services rendered to a Program participant shall be made directly to a qualified provider or program.

F. Billing time limitations for claims submitted pursuant to this chapter are set forth in COMAR 10.09.36.06.

G. Reimbursement.

(1) Payments shall be made in 30-minute units of service.

(2) Effective July 1, 2023, rates for the services outlined in this chapter shall be reimbursed at $32.76 per unit. 

 

Subtitle 67 MARYLAND HEALTHCHOICE PROGRAM

10.67.06 Maryland Medicaid Managed Care Program: Benefits

Authority: Health-General Article, Title 15, Subtitle 1, Annotated Code of Maryland

.26-7 Social Determinants of Health.

Subject to COMAR 10.09.63, an MCO shall provide coverage for community violence prevention.

LAURA HERRERA SCOTT
Secretary of Health

 

Subtitle 14 CANCER CONTROL

10.14.08 Professional and Volunteer Firefighter Innovative Cancer Screening Technologies Program

Authority: Health-General Article, §§13-4001—13-4007, Annotated Code of Maryland

Notice of Proposed Action

[23-094-P]

The Secretary of Health proposes to adopt new Regulations .01—.08 under a new chapter, COMAR 10.14.08 Professional and Volunteer Firefighter Innovative Cancer Screening Technologies Program.

Statement of Purpose

The purpose of this action is to adopt regulations for the Professional and Volunteer Firefighter Innovative Cancer Screening Technologies Program, which was established by Ch. 219 (S.B. 727), Acts of 2019, to provide grants to fire departments to procure innovative cancer screening tests to reduce cancer mortality among professional and volunteer firefighters.

Estimate of Economic Impact

I. Summary of Economic Impact. Ch. 219 (S.B. 727), Acts of 2019, Health—Professional and Volunteer Firefighter Innovative Cancer Screening Program, requires the Governor to include in the budget at least $100,000 for the Professional and Volunteer Firefighter Innovative Cancer Screening Program in fiscal year (FY) 2021 and each year thereafter. In FY 2021, the Department intends to consider awarding the entire amount of $100,000 to at least one qualified applicant.

II. Types of Economic Impact.

Impacted Entity

Revenue (R+/R-)

Expenditure

(E+/E-)

Magnitude

A. On issuing agency:

 

 

Maryland Department of Health

(E+)

$100,000

B. On other State agencies:

NONE

 

C. On local governments:

NONE

 

 

Benefit (+)

Cost (-)

Magnitude

D. On regulated industries or trade groups:

 

 

Professional and volunteer firefighters

(+)

$100,000

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. Ch. 219 (S.B. 727), Acts of 2019, Health—Professional and Volunteer Firefighter Innovative Cancer Screening Program, requires the Governor to include in the budget at least $100,000 for the Program in fiscal year (FY) 2021 and each year thereafter. The Department expects $100,000 to be appropriated annually for the Program.

D. The Department intends to consider awarding the entire amount of $100,000 to at least one qualified applicant.

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 (TTY 800-735-2258), or email to mdh.regs@maryland.gov. Comments will be accepted through July 31, 2023. A public hearing has not been scheduled.

.01 Purpose and Scope.

This chapter sets forth the:

A. Responsibilities of the Maryland Department of Health for the Professional and Volunteer Firefighter Innovative Cancer Screening Technologies Program established by Health-General Article, §§13-4001—13-4007, Annotated Code of Maryland;

B. Responsibilities of a grantee that receives funds under the Professional and Volunteer Firefighter Innovative Cancer Screening Technologies Program;

C. Application process for a grant under the Professional and Volunteer Firefighter Innovative Cancer Screening Technologies Program; and

D. Reporting requirements for the Professional and Volunteer Firefighter Innovative Cancer Screening Technologies Program.

.02 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) “Applicant” means an entity that applies to receive a grant under the Professional and Volunteer Firefighter Innovative Cancer Screening Technologies Program.

(2) Cancer Screening Test.

(a) “Cancer screening test” means a test that is designed to find cancer in an individual who does not present cancer signs or symptoms.

(b) “Cancer screening test” includes, but is not limited to:

(i) A laboratory test;

(ii) An imaging procedure;

(iii) A medical procedure; and

(iv) A genetic test.

(3) “Cost effectiveness” means a comparison between cost and expected health outcomes of a cancer test or intervention.

(4) “Department” means the Maryland Department of Health.

(5) “Grant” means funds distributed to a grantee under the Professional and Volunteer Firefighter Innovative Cancer Screening Technologies Program.

(6) “Grantee” means a local fire department, volunteer fire department, or volunteer fire company approved to receive funds under the Professional and Volunteer Firefighter Innovative Cancer Screening Technologies Program.

(7) “Health care provider” means a doctor of medicine or osteopathy, dentist, nurse practitioner, or physician assistant who is authorized to practice medicine, surgery, or dentistry by the state in which the individual practices.

(8) “Local fire department” means a fire department operating in a Maryland county or Baltimore City.

(9) “Program” means the Professional and Volunteer Firefighter Innovative Cancer Screening Technologies Program.

(10) “Qualifications” means the education, experience, skills, and licensing of an individual associated with a Program grant application.

(11) “Volunteer fire company” means a volunteer fire company operating in a Maryland county or Baltimore City.

(12) “Volunteer fire department” means a volunteer fire department operating in a Maryland county or Baltimore City.

.03 Responsibilities of the Department.

The Department shall:

A. Administer the Program;

B. Provide one or more grants to local fire departments, volunteer fire companies, or volunteer fire departments to procure innovative cancer screening tests according to Health-General Article, §13-4003(a), Annotated Code of Maryland;

C. Develop and distribute an application for Program grants each fiscal year if funding is available;

D. Maintain a record of information submitted by a grantee to the Department; and

E. Monitor the activities of a grantee to ensure compliance with the requirements of the Program.

.04 Entities Eligible for Grants.

The following entities are eligible to apply for and receive a grant from the Department under the Program:

A. A local fire department;

B. A volunteer fire company;

C. A volunteer fire department; and

D. If authorized by a local fire department, volunteer fire company, or volunteer fire department, a county.

.05 Use of Grant Funds.

A. A grantee may use awarded funds to:

(1) Procure and administer innovative cancer screening tests that are not otherwise conducted during routine physical examinations or covered by insurance to professional firefighters employed by a local fire department and volunteer firefighters who serve in a volunteer fire company or department; and

(2) Pay for activities directly associated with the grant that are approved by the Department.

B. A grantee may not use awarded funds to pay for an activity that is not included in the approved grant application.

.06 Application for Professional and Volunteer Firefighter Innovative Cancer Screening Technologies Program Grants.

A. An applicant:

(1) Shall submit a completed application to the Department by the due date listed in the request for applications;

(2) Shall include in the application all required information listed in the request for applications, including:

(a) The names and qualifications of the health care providers that will advise the applicant on the selection and administration of cancer screening tests;

(b) The number of firefighters to be screened;

(c) The selection criteria the applicant used to identify firefighters at the highest cancer risk based on the latest scientific and medical research; and     

(d) A description of each test to be procured by the applicant, including:

(i) The claimed accuracy and reliability of the test;

(ii) The scientific and clinical evidence supporting the claimed accuracy and reliability of the test;

(iii) Whether the test employs innovative or novel technologies, such as DNA sequencing, genomics, proteomics, metabolomics, machine learning, artificial intelligence, big data analytics, or other state-of-the-art technology;

(iv) Whether the test has the ability to simultaneously screen for two or more cancer types for which firefighters have a higher incidence or death rate;

(v) The cost of the test; and

(vi) Whether the test is developed, manufactured, or commercialized by a business entity located in the State; and

(3) May voluntarily withdraw an application at any time.

B. The county in which a volunteer fire company or department is located shall assist a volunteer fire company or a volunteer fire department in submitting an application.

.07 Application Review, Selection of Grantees, and Grant Period.

A. The Department shall:

(1) Determine the amount of money available for grants under the Program in each fiscal year;

(2) Develop a weighting formula to rate each application received by the Program;

(3) Make available the weighting formula on the Program website and include the weighting formula in the request for applications;

(4) Request additional information or changes to the application if necessary; and

(5) Reject an application that does not meet the application requirements.

B. The Department shall review and prioritize applications based on the quality of the application received and the degree to which the tests listed on the application meet the following criteria:

(1) The scientific and clinical evidence supporting the claimed accuracy and reliability of test;

(2) Whether the test employs innovative or novel technologies;

(3) The ability of the test to simultaneously screen for two or more cancer types;

(4) The cost effectiveness of the test; and

(5) Whether the test is developed, manufactured, or commercialized by a business entity located in the State.

C. The Department may review an application in consultation with one or more experts in cancer screening.

D. If the Department receives applications for grant funds totaling more than the amount of funds appropriated for the Program, the Department shall award the funds on a pro rata basis.

E. Funds shall be awarded under the Program for a maximum of 1 year.

.08 Payments, Terms and Conditions of Grant Awards, and Terminations.

A. Payments.

(1) The Department may approve an advance payment based on financial need.

(2) If a financial or progress report required by §B or C of this regulation is overdue, the Department may withhold payment of funds to a grantee until the financial or progress report is submitted.

B. Financial Reports and Records.

(1) A grantee shall:

(a) Establish a separate account to track expenditures under the grant;

(b) Maintain accurate records, including documentation of each transaction associated with the grant;

(c) Submit invoices for payment of grant funds to the Department within the deadline specified by the Department;

(d) Submit a final report listing grant expenditures signed by the financial officer or designee of the grantee within the deadline specified by the Department;

(e) Submit a final invoice for any unbilled expenditures within the deadline specified by the Department; and

(f) Submit a refund of any unexpended funds within the deadline specified by the Department.

(2) The Department may audit the accounts referenced in §B(1) of this regulation at any time.

(3) A grantee shall retain all records pertaining to a grant for 3 years from the date the final report is submitted under §B(1) of this regulation.

(4) In the case of an audit or litigation, the Department may extend the time period under §B(1) or (3) of this regulation until the completion of the audit or litigation.

C. Progress Reports. A grantee shall submit to the Program:

(1) Interim reports describing the progress of the grant; and

(2) A comprehensive final report that provides a summary of all activities conducted under the grant no later than the deadline specified by the Department, including the:

(a) Number of individuals screened;

(b) Tests used;

(c) Cost of the tests; and

(d) Cancers detected by the tests.

D. Publications.

(1) A grantee who publishes results from activities supported by a grant approved under this chapter shall include in the publication the following acknowledgement: “Supported in part with funds from the Professional and Volunteer Firefighter Innovative Cancer Screening Technologies Program of the Maryland Department of Health.”

(2) A grantee shall provide the Department with one electronic copy of any published article associated with an activity conducted under a grant.

E. Ownership of Cancer Screening Tests. A grantee:

(1) Shall ensure that a cancer screening test purchased under a Program grant is used for the sole purpose of the grant;

(2) Shall keep an inventory of cancer screening tests purchased; and

(3) May not transfer a cancer screening test to another entity without written permission from the Department.

F. Termination.

(1) The Department may terminate a grant:

(a) If a grantee fails to comply with:

(i) The requirements of this chapter; or

(ii) State, federal, and municipal laws applicable to the grant;

(b) If a grantee fails to carry out the purposes for which the grant was awarded;

(c) In compliance with a court order; or

(d) At the request of the grantee.

(2) The Department may not be held responsible for any expenses incurred by a grantee after cancellation of a grant.

(3) The grantee shall return all unexpended funds to the Department within 30 days of termination of a grant.

G. Liability.

(1) A grantee shall be solely responsible for its actions related to the:

(a) Program application process; and

(b) Activities conducted under a grant.

(2) The Department may not be held liable for any claims, losses, liabilities, expenses, or damages arising from activities related to the:

(a) Program application process; or

(b) Activities conducted under a grant.

LAURA HERRERA SCOTT
Secretary of Health

 

Subtitle 19 DANGEROUS DEVICES AND SUBSTANCES

Notice of Proposed Action

[23-117-P]

The Secretary of Health proposes to:

(1) Amend Regulation .02 under COMAR 10.19.07 Prohibition of Child Care Products Containing TCEP or TDCPP; and

(2) Adopt new Regulations .01—.06 under a new chapter, COMAR 10.19.08 Prohibition of Consumer Products Containing Flame-Retardant Chemicals.

Statement of Purpose

The purpose of this action is to:

(1) Update the definition of a “child care product” to exclude nursing pillows, crib mattresses, strollers, and products regulated under a new chapter, COMAR 10.19.08, or Health-General Article, §24–306.1, Annotated Code of Maryland; and

(2) Add a new chapter, COMAR 10.19.08 Prohibition of Consumer Products Containing Flame-Retardant Chemicals.

Changes were initiated in accordance with Ch.555 (S.B. 447), Acts of 2020, Public Health — Products Containing a Flame-Retardant Chemical.

Estimate of Economic Impact

I. Summary of Economic Impact. Certain businesses may be impacted on the ban of products containing flame-retardant chemicals.

II. Types of Economic Impact.

Impacted Entity

Revenue (R+/R-)

Expenditure

(E+/E-)

Magnitude

A. On issuing agency:

NONE

 

B. On other State agencies:

NONE

 

C. On local governments:

NONE

 

 

 

 

 

Benefit (+)

Cost (-)

Magnitude

D. On regulated industries or trade groups:

NONE

 

E. On other industries or trade groups:

 

 

Maryland businesses

(-)

Indeterminable

 

F. Direct and indirect effects on public:

 

 

NONE

 

III. Assumptions. (Identified by Impact Letter and Number from Section II.)

E. The impact may be meaningful for some businesses that include the use of flame-retardant chemicals in the products they import or sell. The Department is unable to estimate how many businesses this may include. Existing measures in other states similarly limit the sale of products containing flame-retardant chemicals, and the Department estimates that some businesses may have already reformulated products to exclude flame-retardant chemicals. The Department estimates that the effects of these prohibitions, which went into effect in January 2021, are primarily short-term as businesses phase out existing stock and reformulate products. The proposed regulations do not require businesses to test, certify, or otherwise self-report to the Department their compliance with these regulations, which will be enforced on a complaint basis.

Economic Impact on Small Businesses

The proposed action has a meaningful economic impact on small businesses. An analysis of this economic impact follows:

Based on the fiscal and policy note completed for Ch.555 (S.B. 447), Acts of 2020, the impact of these changes on small businesses “may be meaningful as the bill provides only limited time to phase out existing stock (of products that are no longer compliant with the updated limits of flame-retardant chemicals).”

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 (TTY 800-735-2258), or email to mdh.regs@maryland.gov. Comments will be accepted through July 31, 2023. A public hearing has not been scheduled.

 

10.19.07 Prohibition of Child Care Products Containing TCEP or TDCPP

Authority: Health-General Article, §§24-306 and 24-306.1, Annotated Code of Maryland

.02 Definitions.

A. (text unchanged)

B. Terms Defined.

(1) Child Care Product.

(a) “Child care product” means a consumer product intended for use by a child [under the age of] younger than 3 years old, including a:

[(a)] (i) (text unchanged)

[(b)] (ii) Toy; and

[(c)] (iii) Car seat[;

(d) Nursing pillow;

(e) Crib mattress; and

(f) Stroller].

(b) “Child care product” does not include a product regulated under Health-General Article, §24–306.1, Annotated Code of Maryland, or COMAR 10.19.08.

(2)—(4) (text unchanged)

 

10.19.08 Prohibition of Consumer Products Containing Flame-Retardant Chemicals

Authority: Health-General Article, §24-306.1, Annotated Code of Maryland

.01 Scope.

A. This chapter establishes regulations that prohibit the import, sale, or offering for sale of juvenile products, mattresses, upholstered furniture, or reupholstered furniture containing more than 0.1 percent of flame-retardant chemical by mass.

B. This chapter does not apply to the sale or distribution of a juvenile product, a mattress, upholstered furniture, or reupholstered furniture that is resold, offered for resale, or distributed by a consumer for consumer use.

.02 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) “Adult mattress” means any mattress other than a toddler mattress, a crib mattress, or any other infant sleep product.

(2) “Flame-retardant chemical” means a chemical that:

(a) Is used to resist or inhibit the spread of fire or act as a synergist to chemicals that resist or inhibit the spread of fire, including any chemical for which the term “flame retardant” appears on a safety data sheet developed in accordance with 29 CFR §1910.1200(g); and

(b) Is a nanoscale chemical or has one or more of the following properties:

(i) Contains one or more halogen elements, including fluorine, chlorine, bromine, or iodine;

(ii) Contains one or more carbon elements and one or more phosphorus elements; and

(iii) Contains one or more carbon elements and one or more nitrogen elements.

(3) Juvenile Product.

(a) “Juvenile product” means a consumer product intended for use by a child younger than 12 years old.

(b) “Juvenile product” includes:

(i) A bassinet;

(ii) A booster seat;

(iii) A changing pad;

(iv) A children’s nap mat;

(v) A floor playmat;

(vi) A high chair;

(vii) A high chair pad;

(viii) An infant bouncer;

(ix) An infant carrier;

(x) An infant seat;

(xi) An infant swing;

(xii) An infant walker;

(xiii) A nursing pad;

(xiv) A nursing pillow;

(xv) A playpen side pad;

(xvi) A play yard;

(xvii) A portable hook-on chair; and

(xviii) A stroller.

(c) “Juvenile product” does not include a:

(i) Product that is not primarily intended for use in the home, including a product that is, or is a component part of, a motor vehicle, a watercraft, an aircraft, or any other vehicle;

(ii) Product regulated under 49 CFR Part 571;

(iii) Consumer electronic product; or

(iv) Child care product regulated under Health-General Article, §24-306, Annotated Code of Maryland, or COMAR 10.19.07.

(4) “Mattress” has the meaning stated in 16 CFR § 1632.1.

(5) “Reupholstered furniture” means furniture for which the original fabric, padding, decking, barrier material, foam, or other resilient filling has been replaced and that has not been sold since the time of replacement.

(6) “Upholstered furniture” means furniture that includes filling materials, barrier materials, decking materials, or cover fabrics.

.03 Prohibition of Flame-Retardant Chemicals in Consumer Products.

A. This regulation does not apply to:

(1) An electronic component, or the casing for an electronic component, of a juvenile product, a mattress, upholstered furniture, or reupholstered furniture;

(2) A component of upholstered or reupholstered furniture other than cover fabric, barrier material, resilient filling material, and decking material;

(3) Thread or fiber when used for stitching mattress components together; or

(4) Except for foam, a component of an adult mattress.

B. A person may not import, sell, or offer for sale any juvenile product, mattress, upholstered furniture, or reupholstered furniture that contains more than 0.1 percent of flame-retardant chemicals by mass.

.04 Complaints and Investigations.

A. The Secretary or the Secretary’s designee may investigate conditions relative to the enforcement of this chapter.

B. The person in charge of an establishment shall permit the Secretary or the Secretary’s designee to enter an establishment during its business hours for the purpose of determining compliance with this chapter.

C. The person in charge of an establishment shall provide to the Secretary or the Secretary’s designee product safety data sheets, technical specifications, and any information available related to the composition of the juvenile product.

.05 Violations.

A. If a person willfully violates this chapter, the Secretary may assess a civil penalty:

(1) For a first violation after receiving a letter of reprimand, not exceeding $2,500;

(2) For a second violation, not exceeding $5,000;

(3) For a third violation, not exceeding $7,500; and

(4) For any subsequent violation, not exceeding $10,000 for each violation.

B. In determining the amount of a penalty under §A of this regulation, the Secretary shall consider:

(1) The nature and severity of the violation;

(2) The good faith of the person;

(3) The history of violations by the person;

(4) The extent to which the person cooperated with any investigation by the Department; and

(5) Whether the person has previously been issued a letter of reprimand.

C. For a violation of this chapter, the Secretary shall issue a letter of reprimand.

.06 Request for Hearing.

A. In order to preserve a right to a hearing on a violation and penalty of this chapter, a person shall submit a written request to the Department for a hearing, if a hearing is desired, within 10 days of receipt of the notice of violation and penalty.

B. In accordance with the Administrative Procedure Act, State Government Article, Title 10, Subtitle 2, Annotated Code of Maryland, the Secretary shall provide for a hearing on the violation by referring the matter to the Office of Administrative Hearings.

C. The Office of Administrative Hearings shall:

(1) Schedule and conduct the hearing on the violation; and

(2) Render a decision and notify the parties of the decision within 30 days after the hearing.

LAURA HERRERA SCOTT
Secretary of Health

 

Subtitle 27 BOARD OF NURSING

10.27.01 Examination and Licensure

Authority: Health Occupations Article, §§8-205, 8-206, 8-302, 8-304, and
8-308, Annotated Code of Maryland

Notice of Proposed Action

[23-112-P]

The Secretary of Health proposes to amend Regulation .05 under COMAR 10.27.01 Examination and Licensure.

Statement of Purpose

The purpose of this action is to revise the English language proficiency examinations accepted by the Maryland Board of Nursing and to outline overall and minimum passing section scores.

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 (TTY 800-735-2258), or email to mdh.regs@maryland.gov. Comments will be accepted through July 31, 2023. A public hearing has not been scheduled.

.05 Qualifications of Applicants for Examination.

A.—B. (text unchanged)

C. Applicants who are unable to prove written and oral competency in the English language in accordance with Health Occupation Article, §8-302(e)(2) or (4), Annotated Code of Maryland, shall submit evidence of proficiency in listening, reading, speaking, and writing the English language by obtaining a minimum passing score on one of the following Board-approved English language competency examinations:

(1) Test of English as a Foreign Language Internet Based Test (TOEFL iBT) with minimum passing scores of:

(a) Listening — [22] 21;

(b) Reading — [22] 19;

(c) Speaking — 26; [and]

(d) Writing — [24; or] 19; and

(e) Overall score of at least 84;

(2) International English Language Testing System (IELTS) with minimum passing scores of:

(a)—(b) (text unchanged)

(c) Speaking — [7] 6;

(d) (text unchanged)

(e) Overall score of at least 6.5[.];

(3) Michigan English Test (MET) with minimum passing scores of:

(a) Listening — 53;

(b) Reading — 53;

(c) Speaking — 53; and

(d) Writing — 53;

(4) Pearson Test of English (PTE) Academic with minimum passing scores of:

(a) Listening — 50;

(b) Reading — 50;

(c) Speaking — 50;

(d) Writing — 50; and

(e) Overall score of at least 55; or

(5) Occupational English Test (OET) with minimum passing scores of:

(a) Listening — 6;

(b) Reading — 6;

(c) Speaking — 6;

(d) Writing — 6; and

(e) Overall score of at least 6.5.

D. (text unchanged)

LAURA HERRERA SCOTT
Secretary of Health

 

Subtitle 34 BOARD OF PHARMACY

10.34.34 Pharmacy Technicians

Authority: Health Occupations Article, §§12-101, 12-205, and 12-6B-01—12-6B-14, Annotated Code of Maryland

Notice of Proposed Action

[23-110-P]

The Secretary of Health proposes to amend Regulations .02 and .03, adopt new Regulation .04, and recodify existing Regulations .04—.11 to be Regulations .05—.12 under COMAR 10.34.34 Pharmacy Technicians. This action was considered by the Board of Pharmacy during public meetings held in September 2017, July 2018,
March 2019, February 2020, April 2020, May 2020, June 2020,
and August 2020. The Board of Pharmacy informed the public that
the proposed regulations would be discussed during an open
session by publication on the Board’s website at https://health.maryland.gov/pharmacy/Pages/index.aspx pursuant to General Provisions Article, §3–302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this proposal is to permit a validated pharmacy technician to perform final product verification of prescription and medication orders, as well as of medications selected for stocking into medication distribution systems, under specified circumstances.

Final product verification by a validated pharmacy technician is permitted under the proposed regulation if: (1) the verification is being performed on a prescription device, drug product, or medication order; (2) bar code scanning or similar technology is utilized during the filling process and product verification step to validate the accuracy of device, drug product, or medication selection; and (3) the product being verified is packaged in unit-dose or unit-of-use packaging.  The term “final product verification” as used in the proposed regulation does not include determining the appropriateness of the prescription device, drug product, or medication, dosage form, directions for use, labeling, packaging, or any other determination that requires the application of clinical expertise.

The proposed regulation allows a validated pharmacy technician to perform final product verification of a prescription device, drug product, or medication order selected for stocking into a medication distribution system if (1) the distribution system utilizes bar code scanning or other similar technology to validate the prescription device, drug, or medication selection, and (2) the pharmacy responsible for the medication distribution system maintains and reviews a quality assurance policy annually which includes routine audits of the system to ensure accuracy of the stocked prescription devices, drugs, or medications.

To become a validated pharmacy technician eligible to perform final product verification, the proposed draft regulation requires that a registered pharmacy technician obtain additional training.  In particular, the proposed regulation requires that a registered pharmacy technician have a minimum of 1 year of experience working as a pharmacy technician, and then obtain and maintain an active product verification certificate issued by a Board-approved national pharmacy technician certification program.  Once a registered pharmacy technician has met these requirements, the registered pharmacy technician may be classified as a validated pharmacy technician, and a pharmacist may delegate final product verification under the circumstances outlined above.

The proposed regulation further imposes record-keeping requirements on a pharmacy permit holder that utilizes validated pharmacy technicians to perform final product verification and requires the pharmacy permit holder to further maintain policies and standard operating procedures for validated pharmacy technicians.  Upon request, a pharmacy permit holder must produce a current list of all validated pharmacy technicians that are utilized, and a job description for each validated pharmacy technician. 

Finally, the proposed regulation makes clear that a pharmacist maintains professional and supervisory responsibility for every prescription device, drug product, or medication dispensed, and for each prescription device, drug product, or medication stocked into a medication distribution system, notwithstanding any delegation of pharmacy acts to a validated pharmacy technician.

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 (TTY 800-735-2258), or email to mdh.regs@maryland.gov. Comments will be accepted through July 31, 2023. A public hearing has not been scheduled.

.02 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(5) (text unchanged)

(6) Final Product Verification. 

(a) “Final product verification” means:

(i) Confirming the accuracy of the device or drug product, and dosage form of a filled prescription or medication order; or

(ii)  Confirming the accuracy of the device or drug product, and dosage form of a prescription or medication selected for stocking into a medication distribution system.

(b) “Final product verification” does not include determining the appropriateness of the prescription device or drug product, dosage form, directions for use, labeling, packaging, or any other determination that requires the application of a pharmacist’s clinical expertise.

(7) “Medication distribution system” means an automated medication system, emergency box, interim box, medication carousel or cart, or other storage and dispensing system.

[(6)] (8)[(11)] (13) (text unchanged)

(14) “Unit dose” means a package labeled with bar code scanning or other similar technology containing a single dose of a device, drug, or medication ordered or prescribed for a patient.

(15) “Unit-of-use” means a package or container, such as a unit dose (injectable, liquid, or solid), otic, ophthalmic product, otic product, topical product, or a prescription vial filled from a stock bottle or in the original manufacturer’s packaging, designed to be dispensed to a patient that is labeled with bar code scanning or other similar technology.

(16) “Validated pharmacy technician” means a registered pharmacy technician who has obtained a product verification certificate issued by a Board-approved national training program and satisfied other regulatory requirements.

.03 Delegated Pharmacy Acts.

A. A pharmacy technician may not:

(1)—(7) (text unchanged)

(8) Provide the final verification for accuracy, [validity] appropriateness, completeness, or [appropriateness] validity of a filled prescription or medication order, except as provided for in Regulation .04 under this chapter;

(9)—(17) (text unchanged)

B.—C. (text unchanged)

.04 Validated Pharmacy Technician.

A. Validated Pharmacy Technician — Minimum Requirements.

(1) Experience. Prior to working as a validated pharmacy technician, an individual shall have a minimum of 1 year of experience as a registered pharmacy technician in the State.

(2) Training. In addition to the requirements for pharmacy technician registration, to act as a validated pharmacy technician, an individual shall possess an active product verification certificate issued by a Board-approved national pharmacy technician certification program.

B. Validated Pharmacy Technician — Final Product Verification. A pharmacist may delegate responsibility to perform the final verification of a prescription device, drug product, or medication order to a validated pharmacy technician under the following circumstances:

(1) Prescription or Medication Order.

(a) A pharmacist shall verify the data entry of the prescription device, drug product, or medication order in the pharmacy management system or, if applicable, the electronic health record for:

(i) Accuracy;

(ii) Appropriateness of the device, drug product, or medication;

(iii) Appropriateness of the dosage form;

(iv) Directions for use;

(v) Labeling;

(vi) Packaging; and

(vii) Any other determination that requires the application of clinical expertise.

(b) Bar code scanning or similar technology is utilized during the filling process and at the verification step to validate device, drug product, or medication selection accuracy.

(c) The product being verified is packaged in unit-dose or unit-of-use packaging.

(2) Stocking or Replenishing a Medication Distribution System. Notwithstanding any other regulation, a validated pharmacy technician may perform the final product verification of a prescription device, drug product, or medication selected for stocking into a medication distribution system provided that:

(a) The medication distribution system utilizes bar code scanning or other similar technology to validate the device, drug product, or medication selection; and

(b) The pharmacy responsible for the medication distribution system maintains and reviews annually a quality assurance policy which includes routine audits of the system to ensure the accuracy of stocked prescriptions.

(3) A validated pharmacy technician may not perform the final product verification of a prescription device, drug product, or medication that the technician personally prepared.

C. Validated Pharmacy Technician — Pharmacy Permit Holder’s Responsibilities. A pharmacy utilizing a validated pharmacy technician shall maintain records for a minimum of 2 years, and have those records readily available to the Board upon request, including:

(1) A current list of all validated pharmacy technicians;

(2) A job description for each validated pharmacy technician; and

(3) Policies and standard operating procedures for validated pharmacy technicians.

D. Validated Pharmacy Technician – Pharmacist’s Responsibilities.

(1) A pharmacist may not delegate the final product verification of a compounded medication under any circumstance.

(2) Notwithstanding any delegation of a pharmacy act to a validated pharmacy technician, a pharmacist shall maintain professional responsibility for every medication or prescription dispensed, and for each medication or prescription stocked into a medication distribution system under the supervision of the pharmacist.

LAURA HERRERA SCOTT
Secretary of Health

 

Title 14
INDEPENDENT AGENCIES

Subtitle 22 COMMISSION ON CRIMINAL SENTENCING POLICY

14.22.01 General Regulations

Authority: Criminal Procedure Article, §6-211, Annotated Code of Maryland

Notice of Proposed Action

[23-102-P]

The Maryland State Commission on Criminal Sentencing Policy proposes to amend Regulations .12 and .14 under COMAR 14.22.01 General Regulations.

Statement of Purpose

The purpose of this action is to modify Regulation .12 under COMAR 14.22.01 General Regulations to clarify that animals may not be considered victims for the purposes of applying the multiple victims stacking rule. The rule involves adding or “stacking” the upper guidelines limit for each offense with a unique victim in a criminal event to determine the upper limit of the overall guidelines range. Additionally, the purpose of this action is to modify Regulation .14 under COMAR 14.22.01 General Regulations to indicate that when there is a criminal event with multiple offenses, and the sentence for one of the offenses is statutorily required to run consecutive to the sentence for another offense in the same criminal event, the upper limit of the guidelines range for the offense whose sentence is required to run consecutive to another offense shall be added to the upper limit of the guidelines range for the eligible other offense to obtain the upper limit of the overall guidelines range.

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, 4511 Knox Rd., Suite 309, College Park, MD 20740, or call 301-403-2707, or email to dsoule@umd.edu. Comments will be accepted through July 31, 2023. A public hearing has not been scheduled.

.12 Multiple Offense Scoring.

A. Single Criminal Event, Not More Than One Seriousness Category I or II Offense.

(1) (text unchanged)

(2) The individual completing the worksheet shall determine the overall guideline range by:

(a)—(b) (text unchanged)

(c) If there are separate offenses involving different victims, adding or “stacking” the highest of the upper guidelines limit for each offense with a unique victim. Only one convicted offense per distinct victim may be used to calculate the overall guidelines range. Animals may not be considered victims for the purposes of applying the multiple victims stacking rule.

B.—D. (text unchanged)

.14 Mandatory Sentences.

A. Statutory Maximums. If the guidelines sentence range exceeds the statutory maximum for a given offense, the statutory maximum is the upper limit of the guidelines range.

B. Mandatory Minimums. If the guidelines range is below the nonsuspendable mandatory minimum, that minimum is the lower limit of the guidelines range.

C. First Degree Murder. The adjusted guidelines range for first degree murder is always a term of "life to life" and should replace the calculated guidelines range.

D. Mandatory Consecutive Sentences. When there is a criminal event with multiple offenses, and the sentence for one of the offenses is statutorily required to run consecutive to the sentence for another offense in the same criminal event, the person completing the sentencing guidelines worksheet shall add the upper limit of the guidelines range for the offense whose sentence is required to run consecutive to another offense to the upper limit of the guidelines range for the eligible other offense to obtain the upper limit of the overall guidelines range. Whenever the sentence for an offense is statutorily required to run consecutive to the sentence for more than one other offense in the criminal event, the person filling out the worksheet shall add the upper limit of the guidelines range for that offense to the upper limit of the guidelines range for the eligible offense with the highest upper guidelines limit.

DAVID SOULE
Executive Director

 


Subtitle 35 MARYLAND HEALTH BENEFIT EXCHANGE

14.35.07 Eligibility Standards for Enrollment in a Qualified Health Plan, Eligibility Standards for APTC and CSR, and Eligibility Standards for Enrollment in a Catastrophic Qualified Health Plan in the Individual Exchange

Authority: Insurance Article, §31-106(c)(1)(iv), Annotated Code of Maryland

Notice of Proposed Action

[23-090-P]

The Maryland Health Benefit Exchange proposes to adopt new Regulation .22 under COMAR 14.35.07 Eligibility Standards for Enrollment in a Qualified Health Plan, Eligibility Standards for APTC and CSR, and Eligibility Standards for Enrollment in a Catastrophic Qualified Health Plan in the Individual Exchange. This action was considered at the regular session of the MHBE Board of Trustees on May 15, 2023.

Statement of Purpose

The purpose of this action is to adopt a new regulation regarding the parameters of the Medicaid to Private Plan Enrollment Program.

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 Becca Lane, Senior Health Policy Analyst, Maryland Health Benefit Exchange, 750 E. Pratt St., 6th Floor, Baltimore, MD 21202, or call 410-547-7371, or email to becca.lane@maryland.gov. Comments will be accepted through July 31, 2023. A public hearing has not been scheduled.

.22 Medicaid to Private Plan Enrollment Program.

A. To the extent permissible by federal law, the Exchange shall enroll an individual into a QHP if the individual was enrolled in Medicaid or MCHP through the Exchange and loses Medicaid or MCHP eligibility after:

(1) A redetermination based on a change in circumstances reported after April 15, 2023, pursuant to which the individual is determined eligible for a QHP but does not enroll in a QHP following receipt of the QHP eligibility determination; or

(2) A renewal conducted between April 15, 2023, and April 30, 2024, provided the Exchange verifies that the individual’s most recent attested income exceeds the Medicaid-eligible amount as described in Health-General Article, §15-103(a)(2), Annotated Code of Maryland, and the individual meets eligibility requirements under this chapter to enroll in a QHP.

B. The Exchange shall select a plan for an individual described in §A(1) of this regulation on a date no earlier than the seventh day after the date of the QHP eligibility determination.

C. To the extent permissible by federal law, the Exchange shall select a plan for an individual described in §A(2) of this regulation on a date no earlier than the day immediately following the day that the individual’s Medicaid coverage terminates.

D. The QHP into which the Exchange enrolls an individual shall be determined by the Exchange using the following guidance:

(1) For an individual who has tax household members who are already enrolled in a QHP, the Exchange may enroll the individual into the household QHP if the Exchange determines that the enrollment would be in the best interest of the consumer.

(2) For an individual who is eligible for a CSR plan for up to 150 percent FPL or a CSR plan for 151—200 percent FPL and does not have tax household members already enrolled in a QHP, the Exchange shall enroll the individual in:

(a) The lowest-cost Silver plan in the individual's region, if the individual’s former managed care organization does not have an affiliate offering QHPs in that region; or

(b) The lowest-cost Silver plan offered by an affiliate of the individual’s former managed care organization, if an affiliate offers a QHP in the individual’s region.

(3) For an individual who is not eligible for a CSR plan for up to 150 percent FPL or a CSR plan for 151—200 percent FPL and does not have tax household members already enrolled in a QHP, the Exchange shall enroll the individual in a plan based on the following guidance:

(a) If an affiliate of the individual’s former managed care organization offers QHPs in the individual’s region, the Exchange shall enroll the individual in the lower-cost option of either:

(i) The lowest-cost Gold plan offered by the managed care organization affiliate; or

(ii) The lowest-cost Silver plan offered by the managed care organization affiliate.

(b) If an affiliate of the individual’s former managed care organization does not offer QHPs in the individual’s region, the Exchange shall enroll the individual in the lower-cost option of either:

(i) The lowest-cost Gold plan in the region; or

(ii) The lowest-cost Silver plan in the region.

E. For plans selected for an individual under §A(1) of this regulation, enrollment shall be effective on:

(1) The first day of the month following the date of QHP selection pursuant to §B of this regulation, if the selected plan has a premium greater than zero dollars; or

(2) The first day of the month following the individual’s confirmation of enrollment, if the selected plan has a premium of zero dollars.

F. To the extent permissible by federal law, for plans selected for an individual under §A(2) of this regulation, enrollment shall be effective on:

(1) The first day of the month following the date of QHP selection pursuant to §C of this regulation, if the selected plan has a premium greater than zero dollars; or

(2) The first day of the month following the individual’s confirmation of enrollment, if the selected plan has a premium of zero dollars.

G. References to “cost” under this regulation mean premium cost to the consumer after APTCs and State-based subsidies are applied.

MICHELE EBERLE
Executive Director

 


Subtitle 35 MARYLAND HEALTH BENEFIT EXCHANGE

14.35.20 Hearings by the Board of Trustees

Authority: Insurance Article, §§31-106(c)(1)(iv), 31-112, and 31-113; State Government Article, Title 10, Subtitle 2; Annotated Code of Maryland

Notice of Proposed Action

[23-101-P]

The Maryland Health Benefit Exchange proposes to adopt new Regulations .01—.12 under a new chapter, COMAR 14.35.20 Hearings by the Board of Trustees. This action was considered at the regular meeting of the Board of Trustees on May 15, 2023.

Statement of Purpose

The purpose of this action is to adopt new regulations under a new chapter to address those hearings which will be retained by the Board and not delegated to another authority, following revision of COMAR 14.35.10. The Exchange believes that the regulations require another chapter in order to be congruent with the relevant provisions of the Administrative Procedures Act (APA).

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 Becca Lane, Senior Health Policy Analyst, Maryland Health Benefit Exchange, 750 E Pratt St., 6th Floor, Baltimore, MD 21202, or call 410-547-7371, or email to becca.lane@maryland.gov. Comments will be accepted through July 31, 2023. A public hearing has not been scheduled.

.01 Scope.

A. In General. This chapter applies to hearings conducted by the Board of Trustees of the Maryland Health Benefit Exchange.

B. Determinations Entitled to Hearings. This chapter applies only to the appeal of an Exchange determination regarding:

(1) The amount of State-based subsidy paid by the Exchange to carriers pursuant to COMAR 14.35.19;

(2) Contested cases under COMAR 14.35.10 in which the Board has revoked delegation authority;

(3) Rehearings held pursuant to COMAR 14.35.10.11E; and

(4) Any other matter in which the Board has the authority to conduct hearings, and the Board has determined that a hearing is necessary.

.02 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) “Board” means the Maryland Health Benefit Exchange Board of Trustees.

(2) “Board Secretary” means the Secretary for the Board of Trustees.

(3) Contested Case.

(a) “Contested case” has the meaning stated in State Government Article, §10-202(d), Annotated Code of Maryland.

(b) “Contested case” includes a proceeding:

(i) Arising out of a determination made by the Exchange;

(ii) Regarding an authorization, certification, or permit issued by the Exchange; or

(iii) Arising out of any act of or failure to act by the Exchange, involving an authorization or a certification issued by the Exchange, that aggrieves a person.

(c) “Contested case” does not include any other quasi-legislative hearing.

(4) Determination.

(a) “Determination” means a decision by the Exchange that requires the Board to provide the opportunity for a hearing to a person aggrieved by the decision.

(b) “Determination” includes:

(i) A decision as to whether a person against whom an administrative complaint has been received violated a law, regulation, or order; and

(ii) An order issued pursuant to the Board's authority.

(5) “Exchange” means the Maryland Health Benefit Exchange.

(6) “Executive Director” means the Executive Director of the Maryland Health Benefit Exchange, appointed pursuant to Insurance Article, §31-105, Annotated Code of Maryland.

(7) “Maryland Health Benefit Exchange” has the meaning set forth under Insurance Article, §31-101(e), Annotated Code of Maryland.

(8) “Office” means the Office of Administrative Hearings.

(9) “Person” has the meaning set forth under COMAR 28.02.01.02B(12).

(10) “Presiding officer” means the Board member selected by the board to conduct, manage, and oversee the hearing and the administrative matters of an appeal on behalf of the Board of Trustees of the Maryland Health Benefit Exchange.

.03 Request for Hearing—In General.

A. Scope. This regulation applies to all requests for a hearing permitted under Regulation .01B of this chapter.

B. Except as provided in §D of this regulation, a person aggrieved may request a hearing by submitting a written statement to the Board Chair, signed by the requesting person and containing the following information:

(1) The action or nonaction of the Exchange causing the person requesting the hearing to be aggrieved;

(2) The facts related to the incident or incidents about which the person requests the Board to act or not to act; and

(3) The ultimate relief requested.

C. Hearing Requests—Timing.

(1) Except as provided in §D of this regulation, a request for a hearing shall be received by the Board within 30 calendar days of the date of the letter notifying the party of the Exchange’s action, intention to act, or failure to act.

(2) In calculating the 30-day period, the date of the letter notifying the party of the Exchange's action, intention to act, or failure to act is not included.

(3) The end of a day is considered to be 11:59 p.m. Eastern Time.

(4) The last day of the 30-day period is included unless it is a Saturday, Sunday, legal holiday, or day that the Maryland Health Benefit Exchange is closed for a part of the day.

(5) If the last day of the 30-day period is a Saturday, Sunday, legal holiday, or a day that the Maryland Health Benefit Exchange is closed for a part of the day, the 30-day period runs until the end of the next day which is not a Saturday, Sunday, legal holiday, or day that the Maryland Health Benefit Exchange is closed for a part of the day.

(6) Intermediate Saturdays, Sundays, legal holidays, and days that the Maryland Health Benefit Exchange is closed for a part of the day shall be counted toward the 30-day period.

D. Request for Hearing—Appeals of Procurement Bid Protests.

(1) A person aggrieved may request a hearing under this subparagraph by submitting a written statement to the Board Chair postmarked within 10 calendar days after issuance of the decision resolving the protest, and containing the following information:

(a) Each ground on which the protestor claims that the protest was resolved in error; and

(b) A copy of the initial protest and the decision of the Executive Director or designated procurement officer resolving the protest

(2) Ten copies of all required materials shall be submitted.

E. Except as provided in §F of this regulation, upon receipt of a proper request, the Board shall grant a hearing unless, in viewing the facts set forth by the person making the request, in the light most favorable to that person, the Board determines that:

(1) The Board has no authority to take action;

(2) The request does not contain the information required by this chapter;

(3) The request is untimely; or

(4) The request is moot.

F. For appeals of procurement bid protests, instead of granting a hearing, the Board may:

(1) Resolve the appeal without granting a hearing;

(2) Elect to refer the matter for a hearing and recommended decision to a single member of the Board; or

(3) Elect to refer the matter for a hearing and recommended decision to a panel consisting of two or more members of the Board.

.04 Service of Notices, Decisions, Orders, and Other Documents.

A. The Board Secretary shall provide notice of a hearing pursuant to State Government Article, §10-209, Annotated Code of Maryland.

B. The notice shall state:

(1) The date, time, place, and nature of the hearing;

(2) The right to call witnesses and submit documents or other evidence under State Government Article, §10-213(f), Annotated Code of Maryland;

(3) Any applicable right to request subpoenas for witnesses and evidence and specify the costs, if any, associated with such a request;

(4) That a copy of the hearing procedure is available on request and specify the costs associated with such a request;

(5) Any right or restriction pertaining to representation;

(6) That failure to appear for the scheduled hearing may result in an adverse action against the party; and

(7) That, unless otherwise prohibited by law, the parties may agree to the evidence and waive their right to appear at the hearing.

C. Notices, decisions, orders, and other documents issued by the Board may be served on a person by:

(1) Personal delivery to the person;

(2) Mailing a copy of the document, first class, postage prepaid, to the person's address of record on file with the Exchange;

(3) Mailing a copy of the document, first class, postage prepaid, to the person's last known address if different from the person's address of record on file with the Exchange;

(4) Mailing a copy of the document by certified mail to the person's address of record on file with the Exchange or last known address; or

(5) Delivering or mailing a copy of the document, first class, postage prepaid, to the person's attorney, if the person is represented by counsel.

D. Notice of a hearing is sufficient if the initial notice of a hearing is sent by regular mail to a party at the party's business and resident addresses, as applicable, on file with the Exchange.

E. A hearing may be rescheduled if there is satisfactory showing that the notice was sent not less than 30 calendar days before the hearing, or upon agreement of all parties.

F. The Board shall maintain a record stating:

(1) To whom the initial notice was sent;

(2) The address to which the initial notice was sent;

(3) The date the initial notice was sent;

(4) The manner of service; and

(5) The name of the person who sent the initial notice.

.05 Discovery.

A. By written request served on other parties and filed with the presiding officer not later than 30 calendar days before the scheduled hearing, a party may require any other party to produce, within 15 calendar days, for inspection or copying, any file, memorandum, correspondence, document, object, or tangible item:

(1) Relevant to the subject matter of the case; and

(2) Not privileged.

B. Unless provided by agreement of the parties, no other discovery procedure is allowed.

C. Copies.

(1) Copies of requested documents and records shall be made at the expense of the party making the request.

(2) The charge for copies of requested documents and records may be waived by the custodian of the documents in accordance with State Government Article, §10-621(e), Annotated Code of Maryland, or other applicable law.

D. Objection to Production.

(1) A party may object to the production of a file, memorandum, correspondence, document, object, or tangible item by filing a motion to quash discovery or for other relief.

(2) The presiding officer, for cause shown, may issue any order that justice requires to protect the party from annoyance, embarrassment, oppression, or undue burden or expense.

E. A party who has responded to a request for production and who obtains or discovers, before the hearing, additional files, memoranda, correspondence, documents, objects, or tangible things that are relevant to the request for production shall supplement the response to the request promptly.

F. If a party fails to comply with a request for production, the presiding officer, either on the presiding officer's own motion or by motion of the party requesting the production, may issue an order:

(1) Refusing to allow the party to support or oppose designated claims or defenses;

(2) Prohibiting the party from introducing designated matters into evidence;

(3) Striking any allegations or charges made by the party failing to produce;

(4) Staying further proceedings until the discovery is provided; or

(5) Dismissing the action or any part of it.

.06 Subpoenas.

A. On request of a party, the presiding officer may issue subpoenas requiring the attendance and testimony of witnesses and the production, at the hearing, of any tangible items in the possession or under the control of a witness.

B. Subpoena Requests.

(1) A request for a subpoena shall:

(a) Be made, in writing, to the Board Chair; and

(b) Specify the:

(i) Name and full address of the person to be subpoenaed; and

(ii) Name, full address, and telephone number of the party requesting the subpoena.

(2) A subpoena that requests the production of tangible items, books, papers, or other documents shall describe those items with particularity.

(3) A subpoena request need not be served on all parties.

C. Service of Subpoenas.

(1) Except as provided in §C(2) of this regulation, subpoenas shall be served by hand delivery by an individual 18 years old or older who is not a party to the proceeding. For subpoenas requested 15 calendar days or less before the scheduled hearing, the requester shall provide service.

(2) In a case where the individual to be served resides outside Maryland, the subpoena may be served by certified mail.

D. Return of service shall be made by:

(1) Affidavit, if hand delivered; or

(2) Return receipt, if mailed.

E. A person may object to a subpoena by filing a motion to quash or for other relief.

F. If a request for a subpoena was filed less than 15 calendar days before the hearing date, the presiding officer may refuse to postpone the hearing based on the party's inability to serve the subpoena.

.07 Conduct of Hearing—In General.

A. A hearing conducted under this chapter shall be audio recorded and presided over by a quorum of the Board.

B. The presiding officer will determine whether a hearing will be open to the public, unless otherwise required by law.

C. Parties to Proceeding.

(1) The necessary parties to a contested case proceeding or other matter for which a hearing is being held are:

(a) The Exchange; and

(b) A person who requests a hearing due to being aggrieved by:

(i) A determination made by the Exchange; or

(ii) Any other act of or failure to act by the Exchange, involving an authorization or a certification issued by the Exchange.

(2) Not later than 15 calendar days before the earlier of the prehearing conference or the hearing date, a person who is not a necessary party under §C(1) of this regulation may seek to become a party by intervention by filing a motion to intervene, which shall state:

(a) The basis for considering intervention to be timely; and

(b) How the financial interests of the person will be directly and immediately affected by an order of the Board resulting from the hearing.

D. The presiding officer shall conduct the hearing and may allow the case to proceed in a manner necessary to ensure the fair resolution of the issues, including, but not limited to, placing reasonable limitations on the number of witnesses a party may call and the exclusion of evidence which is repetitive, irrelevant, immaterial, or otherwise not probative. The Maryland Rules of Civil Procedure may be used as a guide for resolving procedural issues regarding the conduct of the hearing.

E. The presiding officer shall rule on all procedural matters, including motions, objections, and offers of proof.

F. The Board may designate an attorney to represent the Exchange. Once the hearing is closed by the presiding officer, the individual presenting the case on behalf of the Exchange may not have a further role in the decision process of the Exchange.

G. Motion for Summary Decision.

(1) A party may move for summary decision at any time on any appropriate issue in the case.

(2) The Board may grant a final summary decision if the Board finds that:

(a) There is no genuine issue of material fact; and

(b) A party is entitled to prevail as a matter of law.

H. Motion to Dismiss. Upon motion, the Board may issue a final decision dismissing an initial pleading which fails to state a claim for which relief may be granted.

I. Motion for Judgment.

(1) A party may move for judgment on any or all of the issues in any action at the close of the evidence offered by an opposing party. The moving party shall state all reasons why the motion should be granted. No objection to the motion for judgment shall be necessary. A party does not waive the right to make the motion by introducing evidence during the presentation of any opposing party's case.

(2) When a party moves for judgment at the close of the evidence offered by an opposing party, the Board may:

(a) Proceed to determine the facts and to render judgment against an opposing party; or

(b) Decline to render judgment until the close of all evidence.

(3) A party who moves for judgment at the close of the evidence offered by an opposing party may offer evidence if the motion is not granted, without having reserved the right to do so and to the same extent as if the motion had not been made. In so doing, the party withdraws the motion.

.08 Postponements.

A. At the discretion of the presiding officer, a hearing may be postponed if a written request for postponement is filed with the presiding officer not later than 15 calendar days before the date of the hearing.

B. A hearing may not be postponed, except for good cause, when the request for postponement is filed within 15 calendar days of the date of the hearing.

.09 Default Orders.

A. The presiding officer may issue a default order against a party other than the Exchange that, after receiving proper notice, fails to appear at a hearing if:

(1) Notice is issued by the Board, and the party failing to appear is the person against whom the notice was issued; or

(2) In any other contested case hearing, the party failing to appear is the person that requested the hearing.

B. In a hearing arising out of a notice or determination issued by the Exchange, the default order shall:

(1) State the facts supporting the finding of proper notice to the person against whom the notice or determination was issued;

(2) Adopt the facts and violations of law as alleged by the Exchange in its notice or determination as if by admission of the person against whom the charging document, order, or notice was issued; and

(3) Adopt the sanction requested by the Exchange.

C. The Board Secretary shall serve the default order directly on the parties by certified mail.

D. Within 15 calendar days after service of a default order, the party in default may submit to the Board a written motion:

(1) Requesting that the default order be vacated or modified; and

(2) Stating the grounds for the request.

E. If the presiding officer finds that there is:

(1) Good cause to excuse the default, the presiding officer may:

(a) Vacate or modify the default order; and

(b) Schedule the case for further appropriate proceedings; or

(2) No good cause to excuse the default, the presiding officer shall:

(a) Deny the motion; and

(b) Affirm the default order as the final order.

.10 Decisions.

A. The presiding officer shall:

(1) Sign the final order following a hearing; and

(2) File a copy of the final order with the Exchange and serve a copy on all parties to the hearing.

B. The final order is effective when issued, unless a different date is specified in the decision.

C. The decision of the Board is the final administrative decision of the case.

.11 Mistake or Error in the Final Order.

The Board may correct an order if, upon review, the final order was issued as a result of fraud, mistake, or inadvertence or contains a clerical error.

.12 Judicial Review.

A party adversely affected by a final decision of the Board may obtain judicial review of the decision as provided by law.

MICHELE EBERLE
Executive Director

 

Title 21
STATE PROCUREMENT REGULATIONS

Notice of Proposed Action

[23-089-P]

The Board of Public Works proposes to amend:

(1) Regulation .14 under COMAR 21.05.02 Procurement by Competitive Sealed Bidding;

(2) Regulation .03 under COMAR 21.05.03 Procurement by Competitive Sealed Proposals; and

(3) Regulation .10 under COMAR 21.11.03 Minority Business Enterprise Policies.

This action was considered at the Board of Public Works meeting held on May 3, 2023.

Statement of Purpose

The purpose of this action is for the Board of Public Works to propose amendments to COMAR Title 21, State Procurement Regulations, to revise the minority business enterprise (MBE) policies.

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 Gabriel Gnall, Procurement Advisor, Board of Public Works, 80 Calvert Street, Room 117, Annapolis, MD 21401, or call 410-260-7335, or email to gabriel.gnall@maryland.gov. Comments will be accepted through July 31, 2023. A public hearing has not been scheduled.

 


Subtitle 05 PROCUREMENT METHODS AND PROJECT DELIVERY METHODS

21.05.02 Procurement by Competitive Sealed Bidding

Authority: State Finance and Procurement Article, §§12-101, 13-103, 13-210, and 14-301—14-308, Annotated Code of Maryland; Chs. 586 and 587, Acts of 2017

.14 Tie Bids.

A. (text unchanged)

B. Award. The award shall be made to the in-State business if identical favorable bids are received from an in-State and out-of-State bidder. In order for a procurement agency to achieve its overall minority participation goal a contract may be awarded as follows pursuant to COMAR 21.11.03.10A(1):

(1) (text unchanged)

(2) If identical favorable bids are received from tying in-State or out-of-State certified minority business enterprises, the award may be made to the certified minority business enterprise having the greatest amount of certified minority business enterprise participation in the particular contract as determined after obtaining the information required under COMAR 21.11.03.10B[(2)—(6)].

(3) If identical favorable bids are received from tying in-State or out-of-State non-minority business enterprises, the award may be made to the non-minority business enterprise having the greatest amount of minority participation in the contract, including staff, or certified minority business enterprise subcontract participation in the contract as determined after obtaining the information required under COMAR 21.11.03.10B[(2)—(6)].

(4) (text unchanged)

C. (text unchanged)

 

21.05.03 Procurement by Competitive Sealed Proposals

Authority: State Finance and Procurement Article, §§12-101, 13-104, and 13-105, Annotated Code of Maryland

.03 Evaluation of Proposals, Negotiations and Award.

A.—E. (text unchanged)

F. Award. Upon completion of all discussions and negotiations, the procurement officer shall make a determination recommending award of the contract to the responsible offeror whose proposal is determined to be the most advantageous to the State, considering price and the evaluation factors set forth in the request for proposals. In order for a procurement agency to achieve its overall minority participation goal and if the solicitation documents expressly permit it to be done, a procurement agency may, pursuant to COMAR 21.11.03.10A(1), recommend and award a contract to a certified minority business enterprise or to a person whose offer otherwise reflects the greatest amount of certified MBE or minority participation in the event of two or more offers in which the offerors' technical and price proposals are determined by the procurement officer to be equally most advantageous to the State. The MBE documentation required by COMAR 21.11.03.10B[(2)—(6)] shall be used in making this determination. If the procurement agency is not a department, the procurement officer shall promptly notify all offerors of the recommended contract award, otherwise the notification is optional. After obtaining the approval of this recommendation by the agency head or designee, all other approvals required by this title, and certification by the appropriate fiscal authority as to the availability of funds, the procurement agency shall award the contract.

G. (text unchanged)

 

Subtitle 11 SOCIOECONOMIC POLICIES

21.11.03 Minority Business Enterprise Policies

Authority: State Finance and Procurement Article, §§12-101 and 14-301—14-308, Annotated Code of Maryland

.10 Contract Award.

A. (text unchanged)

B. Additional Documentation.

(1) The documentation in §B(2)—(4) of this regulation is considered as part of the contract, and shall be furnished by the apparent successful bidder or offeror to the procurement officer within 10 working days from notification of apparent award[, or from the date of the award, whichever is earlier]. If the documentation is not furnished within the specified time, the bidder or offeror may be rejected as nonresponsible.  No contract award may be made until the documentation is provided to and reviewed by the procuring agency.

(2) An MBE subcontractor project participation statement shall be furnished, signed by the bidder or offeror and each MBE listed in the MBE participation schedule, which includes:

(a) A statement of intent to enter into a [contract] subcontract agreement between the [prime contractor] apparent successful bidder or offeror and each proposed MBE subcontractor at the time the State contract is awarded to the apparent successful bidder or offeror;

(b) [If a contract is executed between the procurement agency and the prime contractor or, if the prime contract has been awarded and the procurement officer makes a request, copies of the subcontract agreement or agreements] A copy of each subcontract agreement between the apparent successful bidder or offeror and each proposed MBE subcontractor, that the apparent successful bidder or offeror and each proposed MBE subcontractor intend to enter into contingent upon the State’s contract award to the apparent successful bidder or offeror, containing all necessary terms, including pricing, required for the MBE to perform its proposed work and for the apparent successful bidder or offeror to pay the MBE for its work during the contract term; and

(c) (text unchanged)

(3) [Within 10 days after notice from the prime contractor of the State’s intent to award a contract, each] Each MBE [serving] proposed as a subcontractor on the recommended contract award shall complete a document stating the percentage and type of work assigned to the proposed MBE subcontractor under the recommended contract award and submit copies of the completed form to both the procurement officer and the [prime contractor] apparent successful bidder or offeror.

(4) An affidavit shall be completed and signed by the [prime contractor] apparent successful bidder or offeror stating that, in the solicitation of subcontract quotations or offers, MBE subcontractors were provided not less than the same information and amount of time to respond as were non-MBE subcontractors. [If this affidavit is part of the utilization affidavit, it shall be submitted with the bid or proposal.] With this affidavit, the apparent successful bidder or offeror shall provide to the procuring agency a list of MBEs with whom the apparent successful bidder or offeror negotiated, including price quotes from minority and nonminority firms.

(5) (text unchanged)

(6) The procuring agency shall review the documentation submitted under §B(2)—(5) of this regulation and confirm in writing that the submitted documents meet the requirements of this regulation, including verifying that all MBE subcontract agreements contain necessary terms, prior to any State contract award with MBE subcontractor participation.

[(6)] (7)—[(7)] (8) (text unchanged)

C. Contracts Involving MBE Subcontracts.

(1) A contract involving MBE subcontracts is subject to the procurement agency's concluding that the apparent successful bidder or offeror meets the applicable certified MBE participation provisions contained in the solicitation, law, and regulations. 

(2) Upon review of the documentation submitted under §B of this regulation, the procurement agency shall make a finding whether the apparent successful bidder or offeror has complied in good faith with the outreach efforts required under Regulation .09C(2)(a)—(e) of this chapter. If the procurement agency finds that the apparent successful bidder or offeror has not complied in good faith, the agency may require the apparent successful bidder or offeror to renegotiate any MBE subcontract agreement with a proposed MBE to attempt to meet compliance, without altering the MBE’s proposed participation included in the MBE utilization affidavit or MBE participation schedule.  Any renegotiated MBE subcontract agreement shall be reviewed and approved by the procurement agency for compliance prior to any State contract award to the apparent successful bidder or offeror.  If the procurement agency finds that the [contractor] apparent successful bidder or offeror has complied in good faith, the agency may not require the [contractor] the apparent successful bidder or offeror to renegotiate any subcontract in order to achieve a different result.

[(3) Nothing in this regulation is intended to preclude the award of a contract conditionally upon receipt of the documentation specified in §B of this regulation.]

D.—F. (text unchanged)

JOHN T. GONTRUM
Executive Secretary

 

Title 30
MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS)

Subtitle 09 COMMERCIAL AMBULANCE SERVICES

Notice of Proposed Action

[23-100-P]

The Maryland Emergency Medical Services Board proposes to amend:

(1) Regulation .04 under COMAR 30.09.12 Neonatal Ambulance Service and Infant Transport; and

(2) Regulation .04 under COMAR 30.09.14 Specialty Care Transport Services.

This action was considered by the EMS Board at its regular meeting held on March 14, 2023.

Statement of Purpose

The purpose of these amendments is to update the standards to expand the personnel able to staff neonatal and specialty care transport units.

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 Scott Legore, Director, SOCALR, MIEMSS, 653 West Pratt Street, Baltimore, MD 21201, or call 410-706-8511, or email to slegore@miemss.org. Comments will be accepted through August 4, 2023. A public hearing has not been scheduled.

 

30.09.12. Neonatal Ambulance Service and Infant Transport

Authority: Education Article, §13-515, Annotated Code of Maryland

.04 Staffing.

A. A licensed commercial ambulance, when providing neonatal service, shall be staffed by:

(1) (text unchanged)

(2) At least two individuals, in addition to the driver:

(a) (text unchanged)

(b) The second individual shall be a Maryland licensed health care provider, including a physician, registered nurse, respiratory therapist, nurse practitioner, physician assistant, [or] paramedic, or CRT, who is medically qualified to care for the patient and has additional training needed to care for neonatal patients during interfacility transport including:

(i)—(iii) (text unchanged)

B. (text unchanged)

C. All personnel attending to neonatal patients shall:

(1)—(2) (text unchanged)

(3) If a physician[,]:

(a) [maintain] Maintain board certification in neonatology[.];

(b) Maintain board certification in pediatric critical care; or

(c) Be a licensed physician serving in the second or third year of a neonatology or pediatric critical care fellowship.

 

30.09.14. Specialty Care Transport Services

Authority: Education Article, §13-515, Annotated Code of Maryland

.04 Additional Staffing Requirements for Specialty Care Commercial Ambulance Services.

A. (text unchanged)

B. If the care required is outside the scope of practice of a paramedic credentialed to provide specialty care transport under the Maryland Medical Protocols for EMS Providers:

(1) (text unchanged)

(2) At least two additional individuals who meet the following requirements:

(a) One shall be at least:

(i) At the level of a paramedic who has successfully completed a paramedic specialty care transport course approved by the EMS Board or equivalent as determined by MIEMSS, or holds current Critical Care Paramedic or Flight Paramedic certification through the International Board of Specialty Certification, and is credentialed by the specialty care transport service under COMAR 30.03.03.06; or

(ii) (text unchanged)

(b) One shall be a registered nurse, physician assistant, or physician with advanced training and certification in the care of specialty care patients and current knowledge of the EMS system as defined in Regulation .02G(3) of this chapter.

C. If the care required is within the scope of practice of a paramedic with specialty care transport training:

(1) (text unchanged)

(2) At least one individual who is:

(a) A paramedic who has successfully completed a paramedic specialty care transport course approved by the EMS Board, or holds current Critical Care Paramedic or Flight Paramedic certification through the International Board of Specialty Certification, and is credentialed by the specialty services under COMAR 30.03.03.06; or

(b) (text unchanged)

(3) (text unchanged)

D. (text unchanged)

THEODORE DELBRIDGE, MD
Executive Director

 

Title 33
STATE BOARD OF ELECTIONS

Notice of Proposed Action

[23-086-P]

The State Board of Elections proposes to:

(1) Adopt new Regulations .01 and .05, recodify existing Regulations .01 and .02 to be Regulations .02 and .03, amend and recodify existing Regulation .03 to be Regulation .04, and repeal existing Regulation .04 under COMAR 33.02.03 Judges' Manuals and Training;

(2) Amend Regulation .01 under COMAR 33.12.02 Initiation of Recounts;

(3) Amend Regulation .06 under COMAR 33.17.04 Early Voting Center Equipment and Materials;

(4) Amend Regulation .03 under COMAR 33.17.05 Election Judges;

(5) Amend Regulation .01 under COMAR 33.17.07 Non-Voting Hours Procedures;

(6) Amend Regulation .01 under COMAR 33.19.01 Definitions; General Provisions; and

(7) Amend Regulation .01 under COMAR 33.19.02 Public Notice.

This action was considered by the State Board of Elections at its May 5, 2023, meeting, notice of which was given in accordance with General Provisions Article, §3-302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to:

(1) Allow local boards of elections to use electronic copies of the election judges’ manual, as well as online or virtual election judge training;

(2) Update election judge compensation for election day and early voting judges in accordance with Ch. 157 (H.B. 1200), Acts of  (2023); (3) Limit the number of recount options a candidate may select to one;

(4) Remove the option to provide an early voting supplement for election judges and remove all references to such supplement;

(5) Allow local boards of elections to use electronic copies of the election judges’ manual to train election judges for early voting;

(6) Clarify when same-day registration and address change is available during special elections; and

(7) Provide flexibility on how the State Administrator provides notice of same-day registration to pre-qualified voters.  

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 Nikki Charlson, Deputy
Administrator, State Board of Elections, P.O. Box 6486, Annapolis, MD 21401-0486, or call 410-269-2843, or email to
DL_regcomments_SBE@maryland.gov. Comments will be accepted through July 31, 2023. A public hearing has not been scheduled.

 

Subtitle 02 MEETINGS AND TRAINING

33.02.03 Judges’ Manuals and Training

Authority: Election Law Article, §§2-102(b)(4), 2-202(b), 10-205, and
10-206, Annotated Code of Maryland; Ch. 157, Acts of 2023

.01 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(2) Training Class.

(a) “Training class” means a class prepared and conducted by the election director to train election judges that is long enough to cover all of the requirements of the State Administrator’s training curriculum through an in-person, virtual, or online delivery method of instruction, as determined appropriate by the election director.

(a) “Training class” includes a hands-on practice session with any technology that will be used by the election judge in a polling place.

(1) “Training program” means the required course of instruction prepared by the election director to train election judges for each election.

[.03] .04 Use of Training Materials.

Each local board shall use the manual, instruction sheets, and curriculum, or electronic copies of them, approved by the State Administrator:

A.—B. (text unchanged)

.05 Judges' Training Program.

A. Delivery of Training Program.

(1) Each election director shall prepare a training program for election judges.

(2) The training program shall include training classes:

(a) Before the primary and general elections in a presidential election year;

(b) Before the primary election in a gubernatorial election year; and

(c) If the State Administrator considers it necessary:

(i) Before the general election in a gubernatorial election year; and

(ii) Before a special primary or general election.

(3)  The election director shall hold as many training classes and hands-on practice sessions as needed to accommodate all of the election judges.

B. Requirements for Training Program Completion.

(1) Each election judge shall complete the required training program. 

(2) An election director may require an election judge to attend additional classes.

(3) Unless appointed under emergency circumstances, an individual may not serve as an election judge unless the individual completes the required training program.

C. Requirements for Training Compensation.

(1) A local board shall pay at least $50 to an election judge who completes the training program.

(2) If the training program includes a training class that is offered through virtual instruction or online delivery and a hands-on practice session, the election judge shall complete the hands-on practice session to be entitled to compensation.

(3) An election judge who is required to complete a training program prior to both a primary and general election is entitled to compensation for each training program.

 

Subtitle 12 RECOUNTS

33.12.02 Initiation of Recounts

Authority: Election Law Article, §§2-102(b)(4), 2-202(b), and 12-106(a), Annotated Code of Maryland

.01 Petition.

A. (text unchanged)

B. Contents. The petition shall specify:

(1) (text unchanged)

(2) [Which of the] The recount [methods] method authorized by this subtitle the petitioner selects to use; and

(3) (text unchanged)

C.—E. (text unchanged)

 

Subtitle 17 EARLY VOTING

33.17.04 Early Voting Center Equipment and Materials

Authority: Election Law Article, §§2-102(b)(4) and 10-301.1(h), Annotated Code of Maryland

.06 Information for Voters at Early Voting Centers.

A. Except as provided in §B of this regulation, a local board shall post at each early voting center:

(1) (text unchanged)

(2) The number of voters who have voted as specified in the election judges' manual [or supplement];

(3)—(4) (text unchanged)

B. (text unchanged)

 

33.17.05 Election Judges

Authority: Election Law Article, §§2-102(b)(4), 9-102(i), 10-206(g),
10-301.1(h), and 12-106(a), Annotated Code of Maryland

.03 Training of Election Judges.

A. Required Materials. The State Administrator shall develop and issue for the local boards:

(1) A judges' manual [or supplement for early voting] that includes all information necessary to conduct early voting; and

(2) Instruction sheets summarizing certain early voting procedures[; and

(3) A curriculum for training election judges appointed for early voting].

B. Development of Manual. The State Administrator shall comply with the process established in COMAR 33.02.03 for developing the judges' manual [or supplement for early voting].

C. Use of Training Materials. Each local board shall use the manual [or supplement,] and instruction sheets, [and curriculum,] or electronic copies  of them, approved by the State Administrator for early voting.

[D. Judges' Training Sessions. Each election director shall:

(1) Prepare and conduct training classes for election judges in accordance with COMAR 33.02.03.04; and

(2) Conduct separate training classes for election judges serving during early voting.

E. Attendance Mandatory.

(1) Each election judge serving during early voting shall attend one training class.

(2) An election director may require an election judge to attend additional classes.

(3) If an election judge serves when the election judge was assigned, the election judge is entitled to compensation of at least $20 for each required class the election judge attends.

(4) Unless appointed under emergency circumstances, an individual may not serve as election judge unless the individual has attended the required class.]

D. Judges Training Program.

(1) For an election judge who serves during early voting, each election director shall conduct training in accordance with COMAR 33.02.03.04. and include instruction necessary to conduct early voting. 

(2) Requirements for Training Program Completion.

(a) Each election judge shall complete the required training program. 

(b) An election director may require an election judge to attend additional classes.

(c) Unless appointed under emergency circumstances, an individual may not serve as an election judge unless the individual completes the required training program.

(3) Requirements for Training Compensation.

(a) A local board shall pay at least $50 to an election judge who completes the training program, with the following stipulations:

(i) Attendance at additional classes to train on the conduct of early voting does not entitle an election judge to further compensation.

(ii) If the training program includes a training class that is offered through virtual instruction or online delivery and a hands-on practice session, the election judge shall complete the hands-on practice session to be entitled to compensation.

(b) An election judge who is required to complete a training program prior to both a primary and general election is entitled to compensation for each training program.

 

33.17.07 Non-Voting Hours Procedures

Authority: Election Law Article, §§2-102(b)(4), 2-202(b), 10-301.1, and
11-301, Annotated Code of Maryland

.01 Voting Equipment Supplies.

At the end of each night of early voting, the local board shall ensure that:

A. The election judges have closed all equipment in accordance with the procedures in the election judges' manual [or supplement];

B.—C. (text unchanged)

D. Ballot and other reconciliation procedures specified in the election judges' manual [or supplement] are performed; and

E. (text unchanged)

 


Subtitle 19 SAME DAY REGISTRATION AND ADDRESS CHANGES

33.19.01 Definitions; General Provisions

Authority: Election Law Article, §§2-102(b)(4), 2-202(b), 3-305(e), [and]
3-306(a), (d), and (e), and 9-507, Annotated Code of Maryland

.01 Applicability to Elections.

A.—B. (text unchanged)

C. For special primary and general elections[,]:

(1) [same] Same day registration is available on election day[.]; and

(2) Same day registration and address change is available during early voting if the special election is conducted by mail under Election Law Article, Title 9, Subtitle 5, Annotated Code of Maryland.

 

33.19.02 Public Notice

Authority: Election Law Article, §§2-102(b)(4), 2-202(b), 3-305(d) and (e), and 3-306(d) and (e), Annotated Code of Maryland

.01 Minimum Requirements.

A. State Board. After the close of registration for each election, but prior to election day, the State Administrator shall [send a pre-election mailing to each pre-qualified voter, which shall either:

(1) Include the correct polling place for the pre-qualified voter’s address; or

(2) Instruct the pre-qualified voter how to find the individual’s correct polling place.] take appropriate measures to notify each pre-qualified voter how to find the individual’s correct polling place. When feasible, the State Administrator shall send a pre-election mailing to each pre-qualified voter, which shall include the correct polling place for the pre-qualified voter’s address.

B. (text unchanged)

LINDA LAMONE
State Administrator of Elections

 


Special Documents


 


DEPARTMENT OF THE ENVIRONMENT

SUSQUEHANNA RIVER BASIN COMMISSION

Projects Approved for Consumptive Uses of Water

 

AGENCY:  Susquehanna River Basin Commission.

 

ACTION:  Notice.

 

SUMMARY:  This notice lists Approvals by Rule for projects by the Susquehanna River Basin Commission during the period set forth in DATES.

 

DATES:  May 1-31, 2023.

 

ADDRESSES:  Susquehanna River Basin Commission, 4423 North Front Street, Harrisburg, PA  17110-1788.

 

FOR FURTHER INFORMATION CONTACT:  Jason E. Oyler, General Counsel and Secretary to the Commission, telephone:  (717) 238-0423, ext. 1312; fax:  (717) 238-2436; e-mail:  joyler@srbc.net.  Regular mail inquiries May be sent to the above address.

 

SUPPLEMENTARY INFORMATION:  This notice lists the projects, described below, receiving approval for the consumptive use of water pursuant to the Commission’s approval by rule process set forth in 18 CFR §806.22 (f) for the time period specified above.

 

Water Source Approval — Issued Under 18 CFR 806.22( f ):

Repsol Oil & Gas USA, LLC; Pad ID: HARVEY (02 192) D; ABR-202305002; Covington Township, Tioga County, Pa.; Consumptive Use of Up to 6.0000 mgd; Approval Date: May 8, 2023.

Repsol Oil & Gas USA, LLC; Pad ID: TWIN RIDGE (02 185); ABR-201804001.R1; Covington Township, Tioga County, Pa.; Consumptive Use of Up to 6.0000 mgd; Approval Date: May 8, 2023.

Seneca Resources Company, LLC; Pad ID: DCNR 100 Pad R; ABR-201304013.R2; Lewis Township, Lycoming County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: May 8, 2023.

Seneca Resources Company, LLC; Pad ID: SGL 90D Pad; ABR-201103021.R2; Lawrence Township, Clearfield County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: May 8, 2023.

Coterra Energy Inc.; Pad ID: MooreS P1; ABR-201804002.R1; Jessup Township, Susquehanna County, Pa.; Consumptive Use of Up to 5.0000 mgd; Approval Date: May 9, 2023.

Pennsylvania General Energy Company, L.L.C.; Pad ID: COP Tract 322 Pad C; ABR-201304006.R2; Cummings Township, Lycoming County, Pa.; Consumptive Use of Up to 4.5000 mgd; Approval Date: May 9, 2023.

Pennsylvania General Energy Company, L.L.C.; Pad ID: COP Tract 596 Pad B; ABR-201304007.R2; Liberty Township, Tioga County, Pa.; Consumptive Use of Up to 4.5000 mgd; Approval Date: May 9, 2023.


Chesapeake Appalachia, L.L.C.; Pad ID: Runabuck Drilling Pad; ABR-201305008.R2; Elkland Township, Sullivan County, Pa.; Consumptive Use of Up to 10.0000 mgd; Approval Date: May 24, 2023.

Repsol Oil & Gas USA, LLC; Pad ID: HUGHES (02 204) E; ABR-201804003.R1; Liberty Township, Tioga County, Pa.; Consumptive Use of Up to 6.0000 mgd; Approval Date: May 24, 2023.

Seneca Resources Company, LLC; Pad ID: DCNR 100 Pad J; ABR-202305001; Lewis Township, Lycoming County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: May 24, 2023.

SWN Production Company, LLC; Pad ID: Martin (Pad 11); ABR-201304009.R2; Standing Stone Township, Bradford County, Pa.; Consumptive Use of Up to 4.9990 mgd; Approval Date: May 24, 2023.

SWN Production Company, LLC; Pad ID: RU-23 MITCHELL PAD; ABR-201304012.R2; New Milford Township, Susquehanna County, Pa.; Consumptive Use of Up to 4.9990 mgd; Approval Date: May 24, 2023.

SWN Production Company, LLC; Pad ID: Tice (13 Pad); ABR-201304011.R2; Orwell Township, Bradford County, Pa.; Consumptive Use of Up to 4.9990 mgd; Approval Date: May 24, 2023.

SWN Production Company, LLC; Pad ID: WY-10-FALCONERO-PAD; ABR-201804004.R1; Forkston Township, Wyoming County, Pa.; Consumptive Use of Up to 4.9990 mgd; Approval Date: May 24, 2023.

Campbell Oil & Gas, Inc.; Pad ID: Mid Penn Unit A Well Pad; ABR-201304002.R2; Bigler Township, Clearfield County, Pa.; Consumptive Use of Up to 2.0000 mgd; Approval Date: May 28, 2023.

Chesapeake Appalachia, L.L.C.; Pad ID: Hooker; ABR-201305001.R2; Auburn Township, Susquehanna County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: May 28, 2023.

Chesapeake Appalachia, L.L.C.; Pad ID: Lightcap; ABR-201303009.R2; Overton Township, Bradford County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: May 28, 2023.

Chesapeake Appalachia, L.L.C.; Pad ID: P. Cullen A Drilling Pad; ABR-201304019.R2; Overton Township, Bradford County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: May 28, 2023.

Chesapeake Appalachia, L.L.C.; Pad ID: Visneski; ABR-201305002.R2; Mehoopany Township, Wyoming County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: May 28, 2023.

Coterra Energy Inc.; Pad ID: ThomasR P1; ABR-201305005.R2; Lenox Township, Susquehanna County, Pa.; Consumptive Use of Up to 5.0000 mgd; Approval Date: May 28, 2023.

Repsol Oil & Gas USA, LLC; Pad ID: REPINE (07 022) T; ABR-201305009.R2; Apolacon Township, Susquehanna County, Pa.; Consumptive Use of Up to 6.0000 mgd; Approval Date: May 28, 2023.

Seneca Resources Company, LLC; Pad ID: Gamble Pad C Alt; ABR-201605001.R1; Gamble Township, Lycoming County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: May 28, 2023.

Seneca Resources Company, LLC; Pad ID: Root #1; ABR-201605003.R1; Jackson Township, Tioga County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: May 28, 2023.

Seneca Resources Company, LLC; Pad ID: Showalter 822; ABR-201105018.R2; Chatham Township, Tioga County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: May 28, 2023.

Coterra Energy Inc.; Pad ID: DiazM P1; ABR-201805003.R1; Springville Township, Susquehanna County, Pa.; Consumptive Use of Up to 5.0000 mgd; Approval Date: May 30, 2023.

EQT ARO LLC; Pad ID: Alden Evans Pad A; ABR-201805001.R1; Cascade Township, Lycoming County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: May 30, 2023.

Repsol Oil & Gas USA, LLC; Pad ID: KROPP (07 017)  C; ABR-201305010.R2; Apolacon Township, Susquehanna County, Pa.; Consumptive Use of Up to 6.0000 mgd; Approval Date: May 30, 2023.

Repsol Oil & Gas USA, LLC; Pad ID: SCHMITT (07 043) D; ABR-201305012.R2; Apolacon Township, Susquehanna County, Pa.; Consumptive Use of Up to 6.0000 mgd; Approval Date: May 30, 2023.

Repsol Oil & Gas USA, LLC; Pad ID: TAYLOR BUCKHORN LAND CO (07 010); ABR-201305011.R2; Apolacon Township, Susquehanna County, Pa.; Consumptive Use of Up to 6.0000 mgd; Approval Date: May 30, 2023.

SWN Production Company, LLC; Pad ID: Ferguson-Keisling (Pad B); ABR-201304010.R2; Herrick Township, Bradford County, Pa.; Consumptive Use of Up to 4.9990 mgd; Approval Date: May 30, 2023.

Coterra Energy Inc.; Pad ID: HouselR P1; ABR-201305015.R2; Lenox Township, Susquehanna County, Pa.; Consumptive Use of Up to 5.0000 mgd; Approval Date: May 31, 2023.

Coterra Energy Inc.; Pad ID: HustonJ P1; ABR-201305014.R2; Brooklyn Township, Susquehanna County, Pa.; Consumptive Use of Up to 5.0000 mgd; Approval Date: May 31, 2023.

 

AUTHORITY: Public Law 91-575, 84 Stat. 1509 et seq., 18 CFR parts 806 and 808.

 

DATED: June 7, 2023

 

JASON E. OYLER
General Counsel and Secretary to the Commission

[23-13-06]

 

SUSQUEHANNA RIVER BASIN COMMISSION

Projects Approved for Minor Modifications

 

AGENCY:  Susquehanna River Basin Commission.

 

ACTION:  Notice.

 

SUMMARY:  This notice lists the minor modifications approved for a previously approved project by the Susquehanna River Basin Commission during the period set forth in DATES.

 

DATES: May 1-31, 2023

 

ADDRESSES:  Susquehanna River Basin Commission, 4423 North Front Street, Harrisburg, PA 17110-1788.

 

FOR FURTHER INFORMATION CONTACT:  Jason E. Oyler, General Counsel and Secretary to the Commission, telephone: (717) 238-0423, ext. 1312; fax (717) 238-2436; e-mail:  joyler@srbc.net.  Regular mail inquiries may be sent to the above address.

 

SUPPLEMENTARY INFORMATION:  This notice lists previously approved projects, receiving approval of minor modifications, described below, pursuant to 18 CFR § 806.18 or to Commission Resolution Nos. 2013-11 and 2015-06 for the time period specified above. 

 

Nature’s Way Purewater Systems, Inc. – USHydrations – Dupont Bottling Plant, Docket No. 20230319, Dupont Borough, Luzerne County, Pa.; modification to rescind approval to withdraw groundwater from Covington Springs Borehole 1 and remove from approved consumptive use sources; Approval Date:  May 10, 2023. 

 

AUTHORITY: Public Law 91-575, 84 Stat. 1509 et seq., 18 CFR parts 806 and 808.

 

DATED:  June 7, 2023.

JASON E. OYLER
General Counsel and Secretary to the Commission

[23-13-07]


________________________________

 

DEPARTMENT OF STATE POLICE

HANDGUN ROSTER BOARD

Proposed Additions to Handgun Roster and Notice of Right to Object or Petition

 

     The following is a list of handguns that the Handgun Roster Board proposes to add to the official handgun roster.  These handguns will be officially placed on the Handgun Roster if no timely objection is received or if all timely objections are dismissed.

     Under the Public Safety Article, §5-405, Annotated Code of Maryland and COMAR 29.03.03.13 and .14, any person may object to the placement of any of those handguns on the Handgun Roster.  Objections must be filed within 30 days after June 30, 2023.  In addition, any person may petition for the placement of an additional handgun on the Handgun Roster.  Forms for objections or petitions may be obtained from: Rachel Rosenberg, Administrator, Handgun Roster Board, 1201 Reisterstown Road, Baltimore, Maryland 21208 (Phone: 410-653-4247).

 

Make

Model

Caliber

Additional Comments

Agaoglu Inc. Co. (T and M Gunsmithing)

AG-9

9 mm

 

TISAS (SDS IMPORTS)

1911 Carry B9

9 mm

Model addition

WILSON COMBAT

CQB TACTICAL LE

45 ACP

Caliber addition

BUL TRANSMARK, LTD. (BUL ARMORY USA, LLC)

SAS II TAC PRO 4.25”

9 mm

Model addition

NIGHTHAWK CUSTOM

TREASURER

9 mm, 10 mm, 45 ACP

Model addition

NIGHTHAWK CUSTOM

TRS COMMANDER

9 mm, 10 mm, 45 ACP

Model addition

NIGHTHAWK CUSTOM

TRS COMP

9 mm, 10 mm, 45 ACP

Model addition

NIGHTHAWK CUSTOM

WAR HAWK GOVERNMENT

9 mm, 10 mm, 45 ACP

Model addition

NIGHTHAWK CUSTOM

WAR HAWK OFFICER

9 mm, 10 mm, 45 ACP

Model addition

NIGHTHAWK CUSTOM

DELEGATE

9 mm, 10 mm, 45 ACP

Model addition

NIGHTHAWK CUSTOM

VIP AGENT 2

9 mm, 10 mm, 45 ACP

Model addition

NIGHTHAWK CUSTOM

TURNBULL VIP

9 mm, 10 mm, 45 ACP

Model addition

ALCHEMY CUSTOM WEAPONRY

Prime Target

38 Super, 45 ACP, 9 mm

Model addition

TISAS

1911 Stingray Carry B45BA

45 ACP

Model addition

TISAS

1911 Stingray Carry B9BA

9 mm

Model addition

TISAS

1911 Yukon Carry C10

10 mm

Model addition

ALDO UBERTI & CO. (TAYLOR & CO.)

CATTLEMAN

32 WCF

Caliber addition

NOVA MODUL (CENTURY ARMS)

DRACO 9S

9 mm

Model addition

Charter Arms / Whiteknuckler Brand

Working Man Special

38 Spl

Model addition

CARL WALTHER (WALTHER ARMS)

COLT GOLD CUP TROPHY

22 LR

Model addition

ZENITH FIREARMS

ZF-5P

9 mm

Model addition

SIG SAUER/SIGARMS INC.

P365-XMACRO TACOPS

9 mm

Model addition

ALPHA FOXTROT

AF1911 Government

9 mm, 10 mm, 45 ACP

 

ALPHA FOXTROT

AF1911 Compact

9 mm, 10 mm, 45 ACP

Model addition

ALPHA FOXTROT

AF1911 Commander

9 mm, 10 mm, 45 ACP

Model addition

ALPHA FOXTROT

AF-C

9 mm

 

ALPHA FOXTROT

AF-SC

9 mm

Model addition

PARA-USA, INC & PARA-USA, LLC

LDA Officer

45 ACP

Model addition

Taurus Armas (Taurus International Mfg.)

1911 Officer

9 mm

Model addition

Arsenal Firearms Italy (American Precision Firearms)

Strike One Speed

9 mm

Model addition

Arsenal Firearms Italy (American Precision Firearms)

Strike One Mark II

9 mm

Model addition

ISRAEL WEAPON INDUSTRIES (IWI US)

GALIL ACE SAR GEN II PISTOL

7.62X51MM NATO

Caliber addition

GLOCK

28 Gen 3

380 ACP

Model addition

FN HERSTAL

FIVE-SEVEN MK2P

5.7X28 mm

Model addition

Taran Tactical Innovations

JW4 Pit Viper

9 mm

 

BERSA S.A. (TALON DISTRIBUTING, LLC)

TPR45C

45 ACP

 

ATLAS GUNWORKS, INC.

Artemis RDS V2

9 mm

Model addition

SIG SAUER/SIGARMS INC.

P320 AXG LEGION

9 mm

Model addition

ROCK ISLAND ARMORY

BBR 3.10

9 mm

Caliber addition

F. TANFOGLIO (ITALIAN FIREARMS GROUP)

Defiant Limited Pro

45 ACP

Caliber addition

AXON

TASER 10

MULTI-TASER, 6.35MM TASER

 

Rossi/CBC (Braztech International, LC)

Brawler

45 Colt/410 Bore

 

SIG SAUER/SIGARMS INC.

P320 XCARRY SPECTRE

9 mm

Model addition

GRENDEL

P-10

380 ACP

Model addition

UMAREX (FN AMERICA, LLC)

502 TACTICAL

22 LR

Model addition

STURM RUGER

Super Wrangler

22 LR/22 WMR

Model addition

SIG SAUER/SIGARMS INC.

P365-380 ROSE

380 ACP

Model addition

BRUGGER & THOMET (BRUGGER & THOMET USA)

STATION SIX-45

45 ACP

Model addition

GQ ARMORY/SIG SAUER

Paladin Sig P320 Pistol

9 mm

Model addition

FN HERSTAL (FN America, LLC)

SCAR 15P Pistol

5.56x45 mm

 

WILSON COMBAT/SIG SAUER

WCP365

9 mm

Model addition

TISAS (SDS IMPORTS)

1911 Carry SS45R

45 ACP

Model addition

VOLQUARTSEN

Mini Mamba

22 LR

Model addition

GIRSAN (EAA)

MC 14T

380 ACP

Model addition

CMMG, INC.

DISSENT MK4

300 BLK

Caliber addition

E.M.F. (ALDO UBERTI)

Hartford

45 LC

Model addition

ALDO UBERTI & CO. (CIMARRON ARMS)

Tuco Special 1860 Conversion

45 LC

Model addition

SAVAGE ARMS

Savage 1911

45 ACP, 9 mm

 

MANURHIN

MR-96

357 Mag

Model addition

ALFA-PROJ (ARMSCOR PRECISION INTERNATIONAL)

AL3.0

357 Mag

 

GIRSAN (R.OX.NJ)

MC 1911

45 ACP

Model addition

SIG SAUER/SIGARMS INC.

P938 Legion

9 mm

Model addition

F. LLI PIETTA

GREAT WESTERN II "1873 CALIFORNIAN"

9 mm

Caliber addition

SPRINGFIELD ARMORY/INC.

1911 OPERATOR

9 mm

Caliber addition

WILSON COMBAT

X-TAC Elite

9 mm

 

F. TANFOGLIO (ITALIAN FIREARMS GROUP)

Defiant Limited Pro

9 mm

Caliber addition

Stealth Arms

Platypus

9 mm

 

Stealth Arms

Platypus

40 S&W, 45 ACP, 10 mm, 357 Sig

Caliber addition

Mauser (Blue Line Solutions)

M20

22 LR

 

Mauser (Blue Line Solutions)

1911

22 LR

 

ALDO UBERTI & CO. (TAYLOR & CO.)

1875 OUTLAW

9 mm

Model addition

ZENITH FIREARMS

ZF-5K

9 mm

Model addition

ZENITH FIREARMS

ZF-5T

9 mm

Model addition

SIG SAUER/SIGARMS INC.

1911 EMPEROR SCORPION

10 mm

Caliber addition

REMINGTON ARMS CO., INC.

700 (CHASSIS PISTOL)

8.6 Blackout

Caliber addition

PIONEER ARMS CORPORATION

PM63-C

9x18mm Makarov

 

ALDO UBERTI & CO. (STOEGER IND.)

1873 Cattleman Bisley

357 Mag

Model addition

SIG SAUER/SIGARMS INC.

MCX SPEAR

7.62x51 mm

 

SIG SAUER/SIGARMS INC.

P365-XMACRO COMP

9 mm

Model addition

SIG SAUER/SIGARMS INC.

P365-XMACRO COMP ROMEOZERO ELITE

9 mm

Model addition

BRIXIA (CHIAPPA USA/CHARLES DALY)

1911 FIELD

9 mm

Caliber addition

SMITH & WESSON

627-5

357 Mag

Model addition

GIRSAN (EAA)

MC P35 Select 1

9 mm