MedicaidAdministrativeMedium impact
Proposed Amendments to HealthChoice Regulations
Maryland Medicaid·MD·Managed Care Organizations
Effective date
Jan 1, 2004
We identified it
Jun 20, 2026
Summary
Maryland proposes comprehensive amendments to HealthChoice (Medicaid managed care) regulations affecting coverage criteria, provider network requirements, and billing procedures. Key changes include requiring medical necessity (not appropriateness) for services to enrollees 21 and younger, new specialty provider network requirements, and clarified MCO responsibilities for durable medical equipment within 90 days post-disenrollment.
Action Required
This is a historical policy document from 2003-2004 and should not impact current billing operations. However, if your practice serves Maryland Medicaid managed care patients, review current HealthChoice regulations to ensure compliance with specialty provider network requirements and verify that medical necessity documentation standards are being met for patients 21 and younger.