MedicaidAdministrativeHigh impact
Primary Adult Care (PAC) Program
Maryland Medicaid·MD · Pharmacy·Pharmacy
Effective date
Jul 1, 2006
We identified it
Jun 20, 2026
Summary
Maryland is transitioning MPAP recipients to a new Primary Adult Care (PAC) Program starting July 1, 2006, which combines pharmacy and primary care benefits through managed care organizations. Mental health drugs and all antiretroviral medications will remain carved-out and paid as fee-for-service with copays up to $7.50 for brand name and $2.50 for generic drugs.
Action Required
By July 1, 2006: Pharmacy staff must identify PAC recipients by their yellow and white Medical Care Program Cards and EVS messages. Submit mental health drugs and antiretroviral medications (including abacavir, zidovudine, amprenavir, atazanavir, delavirdine, efavirenz, tenofovir, enfuvirtide and combination products) as fee-for-service claims to the PAC Program rather than to MCO PBMs. Update billing procedures to handle three MCOs: Jai Medical Systems, UnitedHealthcare, and Maryland Physicians Care. Claims submitted incorrectly will be rejected with instructions to bill the appropriate PBM unless the drug is carved-out.