MedicaidAdministrativeMedium impact
Acute Care Utilization Review Process
Maryland Medicaid·MD·Hospital
We identified it
Jun 20, 2026
Summary
Maryland Medicaid has updated their Acute Care Utilization Review Process for hospital services. This policy establishes new review procedures for inpatient and acute care services requiring prior authorization or concurrent review.
Action Required
Immediately: Billing and utilization review teams must review the complete Maryland Medicaid transmittal PT15-11 to understand new acute care review requirements. Update internal workflows to comply with new utilization review timelines and submission processes for Maryland Medicaid hospital claims. Contact Maryland Medicaid for specific implementation requirements as this summary lacks detailed procedural information.