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MedicaidAdministrativeMedium impact

Rare and Expensive Case Management (REM) Program

CareFirst BlueCross BlueShield·MD·Provider News
Effective date
Feb 1, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

CareFirst launched a new Rare and Expensive Case Management (REM) Program for Maryland Medicaid members with rare, catastrophic, or high-cost conditions. Providers can refer eligible members using specific MDH forms, and approved members will transition from CareFirst managed care to Medicaid fee-for-service providers.

Action Required

Action needed
Immediately: Identify Maryland Medicaid members with rare diseases, high-cost medications, complex DME, or frequent hospitalizations who may qualify for REM Program. Complete MDH REM Intake & Referral Form and MDMC Medical Record Request Form for eligible patients. Submit via fax to 410-333-5426 or email to remreferralfax@maryland.gov. Ensure provider signatures are included on required pages to avoid enrollment delays.