MedicaidAdministrativeMedium impact
Updated Guidance on MCO Renewal Application Assistance and Outreach to Disenrolled Members
Maryland Medicaid·MD·Managed Care Organizations
Effective date
Aug 1, 2026
We identified it
Sep 11, 2026
Summary
Maryland MCOs now have expanded authority to assist Medicaid enrollees with renewal applications (effective August 1, 2026) and conduct outreach to members disenrolled for procedural reasons within 120 days. MCOs must ensure staff complete mandatory Maryland Health Benefits Exchange training, track assistance providers quarterly, and avoid any marketing or steering activities. This policy supersedes PT 76-25.
Action Required
REQUIREMENTS:
1. By September 30, 2026 (end of Q3): Billing and administrative staff should be aware that MCOs may now assist with Medicaid renewals. This does not directly impact billing operations but affects member retention and enrollment processes.
2. Ensure provider staff understand this applies to MCOs ONLY, not providers. Providers should direct member questions about renewal assistance to the Maryland Health Connection Application Counselor Program, not handle renewal assistance themselves.
3. For practices that are MCO-affiliated clinics: If your clinic assists with renewals on behalf of an MCO, confirm that all staff have completed mandatory Maryland Health Benefits Exchange training. MCOs must track and report this to mdh.hcqa@maryland.gov quarterly.
4. Do not use MCO outreach materials in your provider billing or administrative communications. MCOs are prohibited from sharing outreach materials with providers.
5. If your practice receives inquiries from members about renewal assistance, refer them directly to their MCO or Maryland Health Connection, not to billing staff.