All Insurance Policy Changes (Page 299)

Continuing from page 298. Showing older policy changes tracked across all payers. Use the filters in the related-hubs section below to narrow by provider, state, or specialty.

Low impact
Waiver for Adults with Brain Injury Service Rates Effective July 1, 2017
Maryland Medicaid·Effective Jul 1, 2017
New service rates for adults with brain injury waiver services became effective July 1, 2017. This policy establishes reimbursement rates for specialized brain injury services under Maryland's Medicaid waiver program.
Medium impact
Preauthorization Guidelines and Coverage Criteria for Spinraza (Nusinersen)
Maryland Medicaid·Identified Jun 20, 2026
I cannot analyze this policy change because the policy content sections (1 of 4 through 4 of 4) are empty. The policy appears to be about Spinraza (Nusinersen) preauthorization guidelines based on the title, but without the actual policy text, I cannot determine what specific changes are being made or their impact on billing operations.
Medium impact
Two Percent Rate Increase for Community-Based Behavioral Health Providers
Maryland Medicaid·Identified Jun 20, 2026
Maryland Medicaid is implementing a 2% rate increase for community-based behavioral health providers. This affects reimbursement rates for behavioral health services provided in community settings.
Low impact
July 1, 2017 through September 30, 2017 Rates for Nursing Facility Services
Maryland Medicaid·Effective Jul 1, 2017
Maryland Medicaid updated nursing facility service reimbursement rates for the period July 1, 2017 through September 30, 2017. This is an outdated policy from over 7 years ago that should not impact current billing operations.
Low impact
Medicaid Program Updates for Spring 2017
Maryland Medicaid·Identified Jun 20, 2026
Unable to analyze policy change - the policy content appears to be missing or corrupted, showing only placeholder text (-- 1 of 4 -- through -- 4 of 4 --) instead of actual policy information.
Medium impact
Enrolling Individual/Rendering Maryland Medicaid Providers
Maryland Medicaid·Identified Jun 20, 2026
Maryland Medicaid has issued new guidance for individual/rendering provider enrollment requirements. This policy appears to update the enrollment process and requirements for providers who need to be enrolled as individual rendering providers in Maryland Medicaid.
Medium impact
Fiscal Year 2018 Medicaid Rates for Administrative Days
Maryland Medicaid·Identified Jun 20, 2026
Maryland Medicaid updated administrative day rates for Fiscal Year 2018. This affects reimbursement rates for administrative days in healthcare facilities participating in Maryland's Medicaid program.
Medium impact
Basis of Cost Determination Field Required for Drugs Purchased Under the 340B Discount Program
Maryland Medicaid·Identified Jun 20, 2026
Maryland Medicaid now requires providers to complete a 'Basis of Cost Determination' field when billing for drugs purchased under the 340B discount program. This field must specify how the drug cost was calculated and is mandatory for all 340B drug claims.
Low impact
Pricing for services on encounter data to comply with the Medicaid and CHIP Managed Care Final Rule, effective January 1, 2018
Maryland Medicaid·Effective Jan 1, 2018
Maryland Medicaid managed care plans must now include pricing information for services on encounter data submissions to comply with federal regulations. This affects how encounter data is reported but does not directly impact billing workflows or reimbursement rates for providers.
Medium impact
Hospice Payment Rates for Federal Fiscal Year 2018
Maryland Medicaid·Effective Oct 1, 2017
Maryland Medicaid updated hospice payment rates for FY 2018, effective October 1, 2017, with rates varying by geographic region and service type. The policy provides both full market basket rates and reduced market basket rates for different types of hospice care including routine home care, continuous care, respite care, and general inpatient care.
Medium impact
Implementation of the interRAI-Pediatric Home Care Assessment, interRAI Coding Clarification, and Prioritization of LHD Assessments
Maryland Medicaid·Identified Jun 20, 2026
Maryland Medicaid has implemented the interRAI-Pediatric Home Care Assessment tool, clarified coding guidelines for interRAI assessments, and established prioritization protocols for Local Health Department (LHD) assessments. This affects pediatric home care services billing and assessment documentation requirements.
Low impact
2017 Nursing Home Pay-for-Performance Scores
Maryland Medicaid·Identified Jun 20, 2026
This is a provider transmittal regarding 2017 Nursing Home Pay-for-Performance Scores from Maryland's Medicaid program. The policy content appears incomplete or corrupted, showing only structural elements without substantive content about actual policy changes or requirements.
Low impact
Drug Testing Payment Changes
Maryland Medicaid·Identified Jun 20, 2026
I cannot analyze this policy change because the policy content appears to be incomplete or missing from the provided information. Only headers and metadata are visible, but no actual policy text or changes are included.
Medium impact
Clarifications Regarding COMAR 10.09.06
Maryland Medicaid·Identified Jun 20, 2026
I cannot analyze this policy change because the actual policy content was not provided. The document shows only placeholder text ('-- 1 of 3 --', '-- 2 of 3 --', '-- 3 of 3 --') without the actual policy details from the Maryland Medicaid provider transmittal.
Low impact
Charging Participants for Unauthorized Covered Drugs
Maryland Medicaid·Identified Jun 20, 2026
I cannot analyze this policy change because the actual policy content was not provided. Only metadata (title, source URL, age) was included, but the substantive policy text showing what changed about charging participants for unauthorized covered drugs is missing.
Low impact
Clarification on Reimbursing Freestanding Birth Centers
Maryland Medicaid·Identified Jun 20, 2026
This policy clarifies reimbursement procedures for freestanding birth centers in Maryland's Medicaid managed care program. The policy provides guidance on billing requirements and coverage parameters for birth center services.
Medium impact
Retention of Medical Records
Maryland Medicaid·Identified Jun 20, 2026
This policy update addresses requirements for retention of medical records by healthcare providers. Based on the Maryland government source URL, this appears to be guidance on how long providers must maintain patient medical records and documentation.
Medium impact
Prior Authorization Changes Under the Maryland Contraceptive Equity Act Effective January 1, 2018
Maryland Medicaid·Effective Jan 1, 2018
Maryland eliminated prior authorization requirements for contraceptive drugs and devices under the Maryland Contraceptive Equity Act effective January 1, 2018. Healthcare providers can now prescribe and bill for contraceptives without obtaining prior authorization from Maryland Medicaid Managed Care Organizations.
Medium impact
HealthChoice Very Low Birth Weight Delivery Payment Policy and Billing Process Effective January 1, 2018
Maryland Medicaid·Effective Jan 1, 2018
Maryland HealthChoice updated their Very Low Birth Weight (VLBW) delivery payment policy effective January 1, 2018, establishing specific billing procedures, diagnosis codes (P07-P07.15, Z3A-Z3A.49), procedure codes (MC001, MR001, MS001), and documentation requirements for VLBW deliveries under 1500 grams. MCOs must submit monthly encrypted forms including VLBW Newborn Tracking Sheet, CMS 1500, and 4518a forms to MDH via email with specific naming conventions.
Medium impact
Reimnursement for Remote Patient Monitoring Services Provided Through Physicians, Nurse Practitioners, and Physician Assistants Effective January 1, 2018
Maryland Medicaid·Effective Jan 1, 2018
Maryland Medicaid now reimburses Remote Patient Monitoring (RPM) services using HCPCS code S9110 at $125 per 30-day period for qualified participants with COPD, congestive heart failure, or diabetes who meet specific hospitalization criteria. Preauthorization is required for all RPM episodes.
Medium impact
Reimbursement for Remote Patient Monitoring Services Through Home Health Agencies Effective January 1, 2018
Maryland Medicaid·Effective Jan 1, 2018
Home health agencies can now provide Remote Patient Monitoring (RPM) services for Medicaid participants using revenue code 0581 at $125 per 30-day episode. Preauthorization is required for up to 60-day episodes, with a limit of two episodes per 12-month rolling period.
Medium impact
Minimum Data Set Validation—Effective January 2018
Maryland Medicaid·Effective Jan 1, 2018
Maryland Medicaid implemented MDS (Minimum Data Set) validation audits for skilled nursing facilities effective January 2018. Facilities with negative error rates above 20% face penalty audits and financial penalties including rate reductions and audit costs.
Medium impact
MCO Request to Disenroll Members Who Move Out of State
Maryland Medicaid·Identified Jun 20, 2026
Maryland Medicaid MCOs must now complete a specific form to request disenrollment of members who move out of state or have return mail issues. The form requires credible documentation that recipients no longer reside in Maryland and must be submitted at least 5 business days before intended disenrollment.
High impact
Additions to the Healthy Kids Preventive Health Schedule Effective January 1, 2018
Maryland Medicaid·Effective Jan 1, 2018
Maryland updated its Healthy Kids Preventive Health Schedule effective January 1, 2018, establishing comprehensive minimum standards for preventive care visits and screenings for Maryland Medicaid recipients from birth to 21 years of age. The policy includes specific requirements for developmental screenings, mental health assessments, laboratory tests, and immunizations at designated age intervals.
Low impact
Medicaid Program Updates for Winter 2018
Maryland Medicaid·Identified Jun 20, 2026
The policy document appears to be incomplete or corrupted, showing only placeholder text (-- 1 of 6 -- through -- 6 of 6 --) without actual policy content. No specific changes, requirements, or billing updates can be determined from this document.

Browse by payer Browse by state Browse by specialty Browse by billing code Browse & filter all changes

Get alerts for changes like this

Save a search and receive a daily digest whenever a new policy change matches your filters.

Create a free alert

Archive by year

2023 2024 2025 2026

Waiver for Adults with Brain Injury Service Rates Effective July 1, 2017

Preauthorization Guidelines and Coverage Criteria for Spinraza (Nusinersen)

Two Percent Rate Increase for Community-Based Behavioral Health Providers

July 1, 2017 through September 30, 2017 Rates for Nursing Facility Services

Medicaid Program Updates for Spring 2017

Enrolling Individual/Rendering Maryland Medicaid Providers

Fiscal Year 2018 Medicaid Rates for Administrative Days

Basis of Cost Determination Field Required for Drugs Purchased Under the 340B Discount Program

Pricing for services on encounter data to comply with the Medicaid and CHIP Managed Care Final Rule, effective January 1, 2018

Hospice Payment Rates for Federal Fiscal Year 2018

Implementation of the interRAI-Pediatric Home Care Assessment, interRAI Coding Clarification, and Prioritization of LHD Assessments

2017 Nursing Home Pay-for-Performance Scores

Drug Testing Payment Changes

Clarifications Regarding COMAR 10.09.06

Charging Participants for Unauthorized Covered Drugs

Clarification on Reimbursing Freestanding Birth Centers

Retention of Medical Records

Prior Authorization Changes Under the Maryland Contraceptive Equity Act Effective January 1, 2018

HealthChoice Very Low Birth Weight Delivery Payment Policy and Billing Process Effective January 1, 2018

Reimnursement for Remote Patient Monitoring Services Provided Through Physicians, Nurse Practitioners, and Physician Assistants Effective January 1, 2018

Reimbursement for Remote Patient Monitoring Services Through Home Health Agencies Effective January 1, 2018

Minimum Data Set Validation—Effective January 2018

MCO Request to Disenroll Members Who Move Out of State

Additions to the Healthy Kids Preventive Health Schedule Effective January 1, 2018

Medicaid Program Updates for Winter 2018