MedicaidCoverageMedium impact
Proposed Amendments to HealthChoice Regulations
Maryland Medicaid·MD · Family Medicine, OB-GYN, General Practice +1 more·Managed Care Organizations
We identified it
Jun 20, 2026
Summary
Maryland Medicaid managed care organizations (MCOs) can no longer impose pharmacy copayments on family planning drugs/devices, individuals under 21, pregnant women, and institutionalized individuals in long-term care facilities. The policy removes reference to general pharmacy regulations and provides specific exemptions from copays.
Action Required
By May 17, 2004: For Maryland Medicaid managed care patients, billing team must ensure no copayments are charged for pharmacy services to individuals under 21, pregnant women, institutionalized individuals in long-term care, or for family planning drugs and devices. Update billing system rules to automatically waive copays for these patient categories. Comments on proposed regulations may be submitted to Michele Phinney at Maryland Department of Health.