MedicaidReimbursementMedium impact
Clarification of HealthChoice MCO Reimbursement for Specialty and Physician-Administered Drugs Provided by FQHCs and RHCs
Maryland Medicaid·MD·Managed Care Organizations
We identified it
Jun 20, 2026
Summary
Maryland Medicaid has clarified reimbursement rules for specialty and physician-administered drugs provided by Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) under HealthChoice MCO plans. This affects how these facilities bill for medications administered in their practices.
Action Required
FQHCs and RHCs must review the full transmittal document at the provided URL to understand specific billing procedures for specialty and physician-administered drugs under HealthChoice MCO plans. Update billing workflows according to the clarified reimbursement guidelines.