MedicaidPrior AuthMedium impact
Policy for Use of Medication Quauntity Limitations by Managed Care Organizations
Maryland Medicaid·MD·Managed Care Organizations
We identified it
Jun 20, 2026
Summary
Maryland managed care organizations (MCOs) must now follow specific guidelines when implementing medication quantity limitations. The policy establishes standardized procedures for quantity limits, override processes, and appeals that affect prescription drug coverage and prior authorization requirements.
Action Required
Immediately: Billing team should review current medication prior authorization workflows for Maryland Medicaid MCO patients. Update staff training on new quantity limitation override procedures and appeals processes. Contact Maryland MCO representatives to understand specific quantity limits for commonly prescribed medications in your practice.