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Maryland Medicaid: Balance billing is not permitted
Act
immediately
Effective date
May 18, 2026
Identified
Jun 2, 2026
Summary
Maryland Medicaid providers are prohibited from balance billing members for any reason, including when charges exceed fee schedules, claims are denied, or during claim reviews. Providers must verify eligibility before services and can only collect permitted cost-sharing amounts.
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What to do
immediately · 6 steps
01Billing team must stop all balance billing for Maryland Medicaid members.
02Update billing system rules to prevent balance billing when charges exceed fee schedules or claims are denied.
03Front desk staff must verify member eligibility before each service and inform patients of coverage status.
04Only collect Maryland Medicaid-permitted cost-sharing amounts.
05Bill other insurance carriers first before Maryland Medicaid.
06Violation may result in payment recoupment, sanctions, or program termination.
Original notice
Maryland Medicaid: Balance billing is not permitted
uhcprovider.com · Always check the source before changing claims.