MedicaidAdministrativeMedium impact
Financial Reporting
Maryland Medicaid·MD·Managed Care Organizations
Effective date
Jan 1, 1998
We identified it
Jun 20, 2026
Summary
Maryland Medicaid managed care organizations must implement an 85% medical loss ratio requirement starting in 1998, with the first potential payment adjustments occurring in fiscal year 2000. MCOs must use NAIC reporting standards for cost allocation between medical and administrative expenses.
Action Required
Maryland Medicaid MCO billing teams must: 1) Ensure compliance with 85% medical loss ratio calculations for CY 1998 and thereafter, 2) Use NAIC Annual Statement instructions for Health Maintenance Organizations when completing MIA Annual Reports to properly allocate medical versus administrative costs, 3) Direct financial questions in writing to Abraham John at Maryland Insurance Administration and Kenneth Smoot at Medical Care Finance and Compliance Administration.