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COMAR 10.09.20.04 — Conditions for Provider Participation: General Requirements (Community Personal Assistance Services)

MarylandregulationMaryland Department of Health, Medical Care Programs (Medicaid)· effective 2016-03-14

What this rule requires your agency to do

  • 1A provider shall not suspend, terminate, increase, or reduce services without Department authorization and only after consultation with the participant/representative, and shall submit a transition plan when suspending or terminating services.(COMAR 10.09.20.04 — Conditions for Provider Participation: General Requirements (Community Personal Assistance Services))
  • 2A provider shall report incidents and complaints within 24 hours of knowledge, submit a written report within 7 calendar days on a Department form, and immediately notify the local department of social services if it believes the participant has been subjected to abuse, neglect, self-neglect, or exploitation (per COMAR 07.02.16).(COMAR 10.09.20.04 — Conditions for Provider Participation: General Requirements (Community Personal Assistance Services))
  • 3A provider shall verify the qualifications of all individuals who render services on the provider's behalf and provide a copy of the current license or credentials on request.(COMAR 10.09.20.04 — Conditions for Provider Participation: General Requirements (Community Personal Assistance Services))
  • 4A provider shall maintain and have available written documentation of services, including dates and hours provided, for six years from the date of service.(COMAR 10.09.20.04 — Conditions for Provider Participation: General Requirements (Community Personal Assistance Services))
  • 5A provider shall meet all conditions for participation as a Medicaid provider under COMAR 10.09.36, except as otherwise specified in this chapter.(COMAR 10.09.20.04 — Conditions for Provider Participation: General Requirements (Community Personal Assistance Services))
  • 6A provider shall cooperate with required inspections, reviews, and audits by authorized governmental agents.(COMAR 10.09.20.04 — Conditions for Provider Participation: General Requirements (Community Personal Assistance Services))
  • 7A provider shall bill only for services preauthorized in the plan of service, provided consistent with the plan of service, and within the scope of Medicaid participation.(COMAR 10.09.20.04 — Conditions for Provider Participation: General Requirements (Community Personal Assistance Services))
  • 8A provider shall verify Medicaid eligibility at the beginning of each month services will be rendered, may not have unpaid overpayments due to the Department, and shall be free from conflicts of interest; a provider or principal is disqualified for enumerated adverse history within the past 24 months.(COMAR 10.09.20.04 — Conditions for Provider Participation: General Requirements (Community Personal Assistance Services))

Applies to: personal care

Sets the general Medicaid participation conditions for CPAS providers, including credential verification, 24-hour incident/complaint reporting and APS referral, recordkeeping for six years, monthly eligibility verification, and disqualifying history.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.