MedicaidAdministrativeHigh impact
New Online Format for Hospice e-Request Submissions
Maryland Medicaid·MD · Palliative Care·Provider Transmittal
Effective date
Oct 10, 2022
We identified it
Jun 20, 2026
Summary
Maryland Medicaid has implemented a new mandatory online submission process for hospice e-requests using Cognito Forms platform. The old email-based submission method (mdh.hospice mailbox) will be discontinued after October 9, 2022.
Action Required
By October 9, 2022: Hospice billing staff must transition from email submissions to the new Cognito Forms platform for all Medicaid hospice e-requests. Access the new form at cognitoforms.com/MDH3/MedicaidHospiceRequestForm and review instructions at the Maryland health website. Complete available training sessions in September 2022. The mdh.hospice mailbox will no longer accept requests after October 9, 2022, making this transition mandatory.