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MedicaidReimbursementHigh impact

Amendments to Nursing Facility Services Regulations

Maryland Medicaid·MD · Geriatrics·Nursing Home
Effective date
Jul 1, 2002
We identified it
Jun 20, 2026
Days to comply

Summary

Maryland Medicaid is implementing new nursing facility reimbursement regulations that reduce interim nursing payments by 95% for underutilizing providers, increase occupancy standards from 0.5% to 1.5% above state average, and make legal/accounting costs for unsuccessful appeals non-allowable. The changes also allow cost settlements before Medicare reports are received and modify nursing wage indexing methodology.

Action Required

Action needed
Immediately: Nursing facilities must review interim payment calculations as payments will be reduced by 95% of projected recovery amounts for historically underutilized nursing services. Update cost reporting to exclude legal, accounting, and professional expenses related to unsuccessful appeals. Billing teams should adjust occupancy calculations using the new 1.5% standard above state average for FY 2003. Facilities may request interim rate changes in nursing service cost center with 2% threshold documentation, limited to two requests per rate year.