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2005 LAWS OF MARYLAND
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Ch. 443
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organizations meeting or exceeding
targets for high performing managed care
organizations.
Further provided that $1,500,000 of this
appropriation may not be expended for
any program or purpose except that funds
may be expended for State funded
Medicaid coverage for pregnant women
who are legal immigrants but with the
exception of emergency care do not
currently qualify for federally funded
Medicaid benefits.
Prior to performing annual reviews for
medical day care recipients, the
Department of Health and Mental
Hygiene shall develop protocols for a
continuing eligibility review process
that includes assessment of: (1) the
recipient's medical condition: (2) the
potential for medical destabilization
following discharge: and (3) whether
the recipient's medical or mental well
being would be compromised by a
discharge. In developing the annual
review criteria, the department shall
include a mechanism for considering
a physician evaluation concerning
the need for medical day care to
maintain a recipient's medical
stability. The department will work
with medical day care provider
representatives to implement an
annual review process that minimizes
the provider administrative burdens.
Further provided that no funds may be
expended to re-determine the medical
eligibility of individuals served through
medical day care until the Department of
Health and Mental Hygiene establishes a
process for transitioning to a more
appropriate setting individuals who
require monitoring. supervision. or
medication management that is best
provided in an alternative setting. The
process shall ensure that patients continue
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