MedicaidAdministrativeMedium impact
PT 82-26: Clarification of the Continued Stay Review Process
Maryland Medicaid·MD·Specialty Services
Effective date
May 5, 2026
We identified it
Jun 18, 2026
Summary
Maryland Medicaid has clarified the Continued Stay Review (CSR) process for nursing facility residents, requiring quarterly reviews in the first year then annually thereafter. Facilities must submit CSRs through Qualitrac and maintain active Level of Care determinations to avoid billing disruptions.
Action Required
Immediately: Nursing facility billing teams must ensure all Continued Stay Reviews are submitted timely through Qualitrac according to the quarterly/annual schedule. Monitor facility task queue in Qualitrac for pending CSRs. Stop billing at full room and board rate if CSR is denied and not appealed within 10 days - switch to administrative day rate per PT 79-26. Claims without corresponding approved LOC in Qualitrac may be subject to recoupment.