MedicaidCoverageMedium impact
Clarification of Eligibility and Coverage for Dialysis Services for Undocumented or Unqualified Aliens (X02/X03)
Maryland Medicaid·MD · Nephrology, Critical Care·Provider Transmittal
Effective date
Mar 24, 2023
We identified it
Jun 20, 2026
Summary
Maryland Medicaid clarifies that dialysis services (both emergency and ongoing treatment) are covered under limited emergency medical benefits for undocumented or unqualified non-citizens. Coverage requires active enrollment in emergency medical services, Maryland Medicaid provider prescription, and utilization control agent approval for periods up to 12 months, renewable annually.
Action Required
Immediately: Billing and registration staff must verify patient eligibility for emergency medical services coverage before processing dialysis claims for undocumented or unqualified non-citizens. Implement workflow to confirm: (1) active emergency medical services enrollment status in Maryland Medicaid system, (2) Maryland Medicaid provider prescription on file, and (3) utilization control agent approval with valid certification period (up to 12 months). Update intake forms and billing software screening rules to flag these patients for eligibility verification. Do not process dialysis claims without documented approval from the fee-for-service program's utilization control agent. Train front desk, registration, and billing staff on these requirements. Contact Earl Tucker (earl.tucker@maryland.gov) with questions. Failure to obtain and verify approval will result in claim denials.