COMAR 10.14.05.08. Allowable Uses of the Funds

A. A grantee that is funded to conduct cancer research by the Fund may use the grant funds:

(1) For basic, clinical, translational, applied, or community-based participatory research;

(2) To support:

(a) The individuals engaged in the research; and

(b) The individual's support staff; and

(3) To purchase office supplies.

B. A grantee that is funded to conduct cancer primary prevention or secondary prevention by the Fund may use the grant funds for:

(1) Education;

(2) Outreach;

(3) Policy changes;

(4) Provider interventions;

(5) Clinical services;

(6) Case management;

(7) Quality assurance;

(8) Data collection; or

(9) Partnership development.

C. If a grantee is funded to conduct cancer secondary prevention services, the Fund shall provide to the grantee reimbursement for a clinical service at a rate not higher than the rate that:

(1) Medicare pays for the clinical service in the region; or

(2) The HSCRC has approved for the clinical service, if the clinical service is provided by a HSCRC-regulated facility.

D. If a grantee is funded to conduct cancer secondary prevention or treatment, the grantee shall only provide clinical services to individuals who:

(1) Are Maryland residents; and

(2) Have an annual family income that is not more than 250 percent of the federal poverty guidelines.

E. If a grantee is funded to conduct cancer treatment, a grantee may use the grant funds:

(1) For grants awarded before January 1, 2014 to provide MHIP reimbursement, to pay up to a maximum of $15,000 for direct costs per individual per year for the premium, deductible, coinsurance, and copay of the MHIP costs and for services not covered under MHIP; or

(2) To pay up to a specified amount, as determined by the Department, for direct costs per individual per year for the:

(a) Deductible and patient contribution amount for the reimbursed medical procedure or service for insured individuals; and

0 for direct costs per individual per year for the premium, deductible, coinsurance, and copay of the MHIP costs and for services not covered under MHIP; or

(2) To pay up to a specified amount, as determined by the Department, for direct costs per individual per year for the:

(a) Deductible and patient contribution amount for the reimbursed medical procedure or service for insured individuals; and

(b) Medical procedure or service not covered under their health insurance policy for individuals who meet the eligibility criteria of §D of this regulation ; or

(3) To pay up to a maximum of $20,000 for direct costs per individual per year for the cancer treatment costs under the individual’s treatment plan:

(a) Who meet the eligibility criteria in §D of this regulation ; and

(b) At a rate not to exceed the rate that Medical Assistance pays for clinical services or the rate that the HSCRC has approved for the clinical services, if treatment is provided by a HSCRC-regulated facility.

F. If a grantee is funded to pay for cancer treatment:

(1) Under §E(1) of this regulation , the grantee shall only pay or direct the Department to pay MHIP the following for services directly related to the treatment of cancer for the individual diagnosed with cancer:

(a) Premiums;

(b) Deductibles;

(c) Coinsurance; and

(d) Copays;

(2) Under §E(2) of this regulation , the grantee shall only pay or direct the Department to pay the deductible and patient contribution amount for the reimbursed medical procedure or service that the individual is required to pay for the services directly related to the diagnosis and treatment of cancer; and

ual diagnosed with cancer:

(a) Premiums;

(b) Deductibles;

(c) Coinsurance; and

(d) Copays;

(2) Under §E(2) of this regulation , the grantee shall only pay or direct the Department to pay the deductible and patient contribution amount for the reimbursed medical procedure or service that the individual is required to pay for the services directly related to the diagnosis and treatment of cancer; and

(3) May not pay any amount for the individual’s spouse, children, or other family members’ health insurance costs.

G. For the purpose of §F(1) and (2) of this regulation, the Department shall pay the health insurance costs out of the funds that are set aside for the grantee.

H. In addition to the direct costs allowed under §E of this regulation , the Fund shall also pay a maximum of 7 percent of the indirect costs to local health department grantees or non-local health department grantees.

Cross References 10.14.05.14D 10.14.05.14E