MedicaidAdministrativeMedium impact
New Utilization Control Agent as of February 1, 2016
Maryland Medicaid·MD·Provider Transmittal
Effective date
Feb 1, 2016
We identified it
Jun 20, 2026
Summary
A new utilization control agent has been appointed effective February 1, 2016 to manage certain healthcare services requiring prior authorization or utilization review. This change affects the process for obtaining approvals for specific procedures and services.
Action Required
By February 1, 2016: Billing and prior authorization teams must update contact information and procedures for utilization management requests to reflect the new utilization control agent. Review current prior authorization workflows and update contact lists with new agent information. Claims requiring prior authorization may be delayed if submitted to incorrect entities.