MedicaidCoverageMedium impact
Emergency & Proposed Amendments 10.09.03
Maryland Medicaid·MD · Pharmacy, Psychiatry·Pharmacy
Effective date
Jul 9, 1998
We identified it
Jun 20, 2026
Summary
Maryland Medicaid eliminated copayments for carved-out specialty mental health and AIDS treatment drugs for managed care recipients, revised pharmacy reimbursement calculations, increased nursing home dispensing fees, and allowed faxed prescriptions. This policy standardizes copay requirements between managed care and fee-for-service prescriptions.
Action Required
Review Maryland Medicaid billing procedures to ensure carved-out specialty mental health and AIDS treatment prescriptions for managed care recipients are billed without copayments. Update pharmacy billing systems to reflect new estimated acquisition cost calculations and increased nursing home dispensing fees. Verify faxed prescription acceptance procedures are in place.