MedicaidAdministrativeMedium impact
Amendments to HealthChoice Regulations
Maryland Medicaid·MD · Emergency Medicine·Managed Care Organizations
Effective date
Apr 9, 2007
We identified it
Jun 20, 2026
Summary
Maryland's HealthChoice Medicaid managed care program updated eligibility rules, payment structures, and service requirements. Key changes include excluding two new disability programs from managed care, requiring monthly enrollment reconciliation, and adding emergency services to self-referral options.
Action Required
By April 9, 2007: Billing teams serving Maryland Medicaid patients must update systems to reflect that Employed Person with Disabilities and Adult Primary Care program members are NOT eligible for HealthChoice managed care. Verify patient eligibility status before billing. Participate in new monthly enrollment reconciliation process with MCOs. Emergency services can now be billed as self-referred without referral requirements.