MedicaidAdministrativeMedium impact
Adoption of Amendments to HealthChoice Regulations
Maryland Medicaid·MD·Managed Care Organizations
Effective date
Nov 10, 2003
We identified it
Jun 20, 2026
Summary
Maryland's HealthChoice Medicaid managed care program adopted several regulatory amendments that allow MCOs to charge up to $2 copayments for brand name drugs, require MCOs to pass fee increases to providers, establish nursing facility bed reservation requirements, and provide more flexibility for Department sanctions without requiring corrective action plans.
Action Required
Billing teams serving Maryland Medicaid HealthChoice patients should verify with MCOs about new $2 brand name drug copayments and confirm that any Department-specified fee increases are being passed through. Update patient financial responsibility processes to account for potential new copayments.