Traditional MedicareReimbursementMedium impact
Part B Coinsurance Payments
Maryland Medicaid·MD·General Provider
We identified it
Jun 20, 2026
Summary
Maryland Medicaid Managed Care Organizations (MCOs) must now make Part B coinsurance payments for dual-eligible members when Medicare is the primary payer. This change affects billing and coordination of benefits for patients with both Medicare and Maryland Medicaid coverage.
Action Required
Immediately: Billing team must update coordination of benefits procedures for dual-eligible patients in Maryland. Ensure secondary claims to Maryland Medicaid MCOs include Medicare Part B coinsurance amounts. Update billing system settings to properly bill MCOs for Part B coinsurance when Medicare pays primary. Train staff on new dual-eligible billing requirements.