MedicaidPrior AuthMedium impact
Maryland Medicaid: Expanded coverage for CGM systems
UnitedHealthcare·MD · Endocrinology, Family Medicine, Internal Medicine +1 more·State news
Effective date
Jan 1, 2026
We identified it
Jun 13, 2026
Summary
Maryland Medicaid expanded coverage for continuous glucose monitoring (CGM) systems effective January 1, 2026, for members with type 1/2 diabetes using insulin, gestational diabetes, or problematic hypoglycemic events. Prior authorization is required and providers must evaluate diabetes control within 6 months before ordering CGM.
Action Required
Immediately: Billing team must update prior authorization workflows for CGM systems for Maryland Medicaid members. Providers must document diabetes control evaluation within 6 months prior to ordering CGM and verify patient meets coverage criteria (type 1/2 diabetes using insulin, gestational diabetes, or hypoglycemic events) before submitting prior authorization through UnitedHealthcare Provider Portal.