MedicaidAdministrativeMedium impact
PT 80-26: Spring 2026 General Provider Updates
Maryland Medicaid·MD·Provider Communication
Effective date
Oct 1, 2026
We identified it
Jun 18, 2026
Summary
Maryland Medicaid issued a general provider update covering multiple topics: MPRIME enrollment system launching October 2026, expanded CGM and biomarker testing coverage effective January 1, 2026, preferred drug list benefits, out-of-state provider licensing deferrals, SDAT requirements, and enhanced Remote Patient Monitoring benefits from 2025.
Action Required
By October 2026: All Maryland Medicaid providers must transition from ePREP to new MPRIME enrollment system. Before November 15, 2026: Out-of-state licensed providers must update license information in MPRIME or face automatic account suspension. Immediately: Verify SDAT identification number is in good standing before submitting MPRIME applications. Billing teams should review expanded CGM and biomarker testing coverage for appropriate utilization and consider prescribing from Preferred Drug List to reduce prior authorization requirements.