MedicaidPrior AuthHigh impact
MPRIME Transition, New Electronic Medication Prior Authorization Submission Process and Upcoming Medicaid Renewal Changes
CareFirst BlueCross BlueShield·MD·Prior Authorization
Effective date
Sep 1, 2026
We identified it
Sep 1, 2026
Summary
CareFirst CHPMD is implementing three major updates: (1) Maryland Medicaid transitioning from ePREP to MPRIME portal effective October 13, 2026, requiring providers to re-register and update enrollment information; (2) New electronic medication prior authorization submission process via CareFirst Provider Portal (CareFirst Direct) effective September 1, 2026, replacing manual submission; and (3) New federal work and renewal requirements for Maryland Medicaid members effective January 1, 2027, requiring members to verify eligibility to maintain coverage.
Action Required
By September 1, 2026: Billing and clinical staff must transition all medication prior authorization submissions to the CareFirst Provider Portal (CareFirst Direct). Complete the 'How to Enter Medication Prior Authorizations' training course before the effective date. Attend one of the live webinars offered (August 25, 27, September 2, 3, or 10, 2026) to learn the new electronic submission process. Before October 13, 2026: Administrative, billing, and credentialing staff must register for and complete MDH's MPRIME System Training (register at https://www.cognitoforms.com/MDH3/RegistrationMPRIMESystemTraining). Providers must not submit any new enrollment updates or applications to ePREP after August 1, 2026, as applications are no longer accepted. Plan for enrollment updates to be held until MPRIME launches. Beginning January 1, 2027: Billing and front-desk staff must inform Maryland Medicaid members of new federal work and renewal requirements to maintain coverage. Direct members to MarylandHealthConnection.gov/Checkin and provide resources from the Maryland Department of Health provider toolkit. Failure to transition to electronic medication prior authorizations by September 1, 2026, may result in processing delays. Providers unable to update enrollment information by MPRIME go-live may experience delays in revalidation and account updates.