MedicaidCoverageMedium impact
Emergency and Proposed Amendments to HealthChoice Regulations
Maryland Medicaid·MD · Dentistry·Managed Care Organizations
Effective date
Jul 1, 2004
We identified it
Jun 20, 2026
Summary
Maryland Medicaid managed care (HealthChoice) removed the 6-month eligibility guarantee, updated MCO reimbursement rates, and clarified orthodontic care criteria to require a minimum score of 15 points on the Handicapping Labio-Lingual Deviations Index No. 4 plus dysfunction for adults 21+ years old.
Action Required
Billing team must verify Medicaid eligibility more frequently as the 6-month guarantee no longer applies. For orthodontic claims, ensure documentation includes HLD Index No. 4 scores of at least 15 points and dysfunction evidence for patients 21+ years old before submitting claims to Maryland Medicaid MCOs.