# COMAR 10.09.94.03: COMAR 10.09.94.03. Conditions for Participation

> Maryland · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_94_03

## Section

- **Citation:** COMAR 10.09.94.03
- **Heading:** COMAR 10.09.94.03. Conditions for Participation
- **Jurisdiction:** Maryland
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Code of Maryland Regulations / Title 10 MARYLAND DEPARTMENT OF HEALTH / Subtitle 09 MEDICAL CARE PROGRAMS / Chapter 94 Special Pediatric Hospitals / COMAR 10.09.94.03

## Text

A. A provider shall meet all conditions for participation as set forth in COMAR 10.09.36 .
B. To participate in the Program as a special pediatric hospital services provider, the provider shall:
(1) Meet the requirements of Title XIX of the Social Security Act for participation as a hospital, as issued by the U.S. Department of Health and Human Services;
(2) Directly provide, or make available through contractual arrangements or transfer agreements, medically necessary covered services;
(3) Accept payment by the Program as payment in full for the covered services;
(4) Make available to the Department or its designee the participant’s medical record for review and certification of medical necessity for admission and continuation of stay; and
(5) Maintain documentation of each contact with the participant as part of the complete medical record, which, at a minimum, includes:
(a) Date of service;
(b) The participant’s chief medical complaint or reason for admission or outpatient visit;
(c) A description of the services provided, including:
(i) Progress notes;
(ii) Imaging studies;
(iii) Laboratory results;
(iv) Medication administration records; and
(v) Discharge summary; and
(d) A signature, electronic or handwritten, along with the printed or typed name of the individual providing care, with the appropriate title.
C. If an out-of-State or District of Columbia hospital, the hospital shall:
(1) Have in effect a utilization review plan applicable to all participants who receive Medical Assistance under Title XIX of the Social Security Act which meets the requirements of §1861(k) of the Social Security Act unless a waiver has been granted by the Secretary of Health and Human Services; and
(2) Allow HealthChoice managed care organizations to pay no more and no less than the reimbursement rates established in Regulation .07 of this chapter unless the parties mutually agree to an alternative arrangement in a contract either on or after July 1, 2011.

## Nearby sections

- [COMAR 10.09.94.01 COMAR 10.09.94.01. Definitions](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_94_01.md)
- [COMAR 10.09.94.02 COMAR 10.09.94.02. License Requirements](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_94_02.md)
- [COMAR 10.09.94.03 COMAR 10.09.94.03. Conditions for Participation](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_94_03.md)
- [COMAR 10.09.94.04 COMAR 10.09.94.04. Covered Services](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_94_04.md)
- [COMAR 10.09.94.05 COMAR 10.09.94.05. Limitations](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_94_05.md)
- [COMAR 10.09.94.06 COMAR 10.09.94.06. Utilization Review](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_94_06.md)
- [COMAR 10.09.94.07 COMAR 10.09.94.07. Payment Procedures](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_94_07.md)
- [COMAR 10.09.94.08 COMAR 10.09.94.08. District of Columbia Hospital Reimbursement](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_94_08.md)
- [COMAR 10.09.94.09 COMAR 10.09.94.09. Billing and Reimbursement Principles](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_94_09.md)
- [COMAR 10.09.94.10 COMAR 10.09.94.10. Recovery and Reimbursement](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_94_10.md)
- [COMAR 10.09.94.11 COMAR 10.09.94.11. Cause for Suspension or Removal and Imposition of Sanctions](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_94_11.md)
- [COMAR 10.09.94.12 COMAR 10.09.94.12. Appeal Procedures](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_94_12.md)
- [COMAR 10.09.94.13 COMAR 10.09.94.13. Interpretive Regulation](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_94_13.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_94_03. Check the current official text before relying on it. Not legal advice.