Care Coordination/Care Management in Maryland
Care Coordination/Care Management in Maryland
| Subtopic | Statute/Regulation | Description |
|---|
| Care Coordination/Care Management | Md. Code Ann., Health-Gen. § 19-1A-02 - Participation in program | The Health Care Commission must establish the Maryland Patient Centered Medical Home Program to promote development of patient centered medical homes... |
| Md. Code Ann., Health-Gen. § 19-1A-03 - Program requirements | The Health Care Commission must establish the Maryland Patient Centered Medical Home Program to efficiently deliver health care services and to be in... | |
| Md. Code Ann., Health-Gen. § 19-1A-05 - Evaluation of effectiveness of program | The Health Care Commission must retain a consultant or consulting firm to conduct an independent evaluation of the effectiveness of the Maryland... | |
| Md. Code Ann., Ins. § 15-1802 - Payments and information sharing by participating carriers | A health insurer that is authorized to implement a patient centered medical home program may: Pay a patient centered medical home for services... | |
| Md. Code Ann., Ins. § 15-1902 - Contracts between carriers and clinically integrated organizations | A contract between a health insurer and a clinically integrated organization may include a provision to pay: For services associated with the... | |
| Md. Code Regs. 10.11.03.16 - Conditions of hospital participation | A Children's Medical Services Program participating hospital must provide the following services: Directing the development of the care... | |
| Md. Code Regs. 10.12.01.19 - Penalties | The Department of Health and Mental Hygiene may impose administrative fines of up to $1,000 against a surgical abortion facility for each violation... |
| Information sharing across providers (including communication with other providers, across state lines, patient transfer) | Md. Code Ann., Ins. § 15-1903 - Medical information | A health insurer may share a patient's medical information with a clinically integrated organization in order to: Promote the efficient,... |
| Md. Code Regs. 10.01.16.06 - Instructions for handling medical records upon discontinuation of medical practice | When a health care provider discontinues medical practice, the health care provider must immediately secure the medical records until the medical... | |
| Md. Code Regs. 10.05.01.09 - Medical records | Freestanding ambulatory care facilities must maintain medical records for each patient. Each patient’s medical record must contain patient... | |
| Md. Code Regs. 10.05.02.11 - Health record | Health Record. A freestanding birthing center must maintain health records of each patient. The health record of each patient must... | |
| Md. Code Regs. 10.28.14.03 - General conduct | General conduct. An optometrist must: Notify the patient promptly and seek the transfer, referral, or continuation of care if the... |
| Treatment planning when using interdisciplinary team (including assessments, plan of care, discharge/transfer planning | Md. Code Regs. 10.05.04.09 - Patient care plan | Patient Care Plan. A kidney dialysis center must provide a patient with an interdisciplinary health care team to develop an... |
| Md. Code Regs. 10.07.01.27 - Discharge planning requirements | Discharge planning requirements. In order to facilitate a patient’s discharge or transfer, hospitals must: Develop plans for... | |
| Md. Code Regs. 10.07.02.10 - Physician services | Physician Services. In order to support resident discharges and transfers, nursing facilities’ attending physicians must:... | |
| Md. Code Regs. 10.07.02.37 - Care planning | Care Planning. A nursing facility must have an interdisciplinary team to develop a care plan for each resident. | |
| Md. Code Regs. 10.07.09.08 - Resident’s rights and services | Resident's rights and services. A nursing facility resident has the following rights: Choose an attending physician; Choose a... | |
| Md. Code Regs. 10.07.21.10 - The interdisciplinary plan of care | The interdisciplinary plan of care. Hospices must provide each patient with an interdisciplinary team that develops a written plan of... | |
| Md. Code Regs. 10.07.21.25 - Home-based hospice care | Home-based hospice care provided in a licensed health care facility A hospice care program delivered in a licensed health care facility must... | |
| Md. Code Regs. 10.09.44.12 - Marketing and information | A PACE provider must provide a patient with an enrollment agreement within 14 days of the patient’s coverage with the PACE Program. The... |
| Discharge instructions/Required follow-up. | Md. Code Regs. 10.07.01.27 - Discharge planning requirements | Discharge planning requirements. In order to facilitate a patient’s discharge or transfer, hospitals must: Develop plans for... |
| Md. Code Regs. 10.07.21.12 - Transfer or discharge | Transfer or discharge. Before the patient's discharge, hospices must: Provide patients with a written discharge summary; and... | |
| Md. Code Regs. 10.07.22.15 - Relocation and discharges | Relocatoin and discharges. When a patient is discharged or transferred to another facility, a hospice house must provide to the... |
| Licensure laws requiring or recommending care coordination or care management activities (Cross reference with private insurance/Medicaid/Medicare data requirements) | Md. Code Regs. 10.07.21.11 - Continuity of care | Continuity of care. A hospice care program must coordinate care to ensure continuity of care for a patient and the patient’s... |
| Md. Code. Regs. 10.45.01.01 - Purpose | The purpose of Maryland's Health Care Commission is to: Reduce health disparities in Maryland; Increase access to health care services;... |
| New coordinated systems of care (ACOs, Patient Centered Medical Homes/Health homes) (Cross reference with Quality Measurement) | Md. Code Regs. 10.09.65.02 - Conditions for participation | Conditions for Participation. A Medicaid managed care organization may not discriminate against an enrollee on any basis including age,... |
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