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MedicaidAdministrativeHigh impact

Medicare Enrollment Requirement for High Risk-Provider Types

Maryland Medicaid·MD · Endocrinology·HealthChoice Diabetes Prevention Program
Effective date
Not stated
We identified it
Sep 11, 2026
Days to comply
—

Summary

Maryland Medicaid now requires all Diabetes Prevention Program providers and Nursing Facilities (high-risk provider types) to maintain active Medicare enrollment. Providers must submit proof of active Medicare enrollment during their next Medicaid revalidation, Change of Ownership application, or initial enrollment application. Failure to provide this documentation will result in application denial.

Action Required

Action needed
Before next scheduled Medicaid revalidation or Change of Ownership application: (1) Verify that your organization has active Medicare enrollment; (2) Obtain and document your active Medicare enrollment information (Medicare provider number and enrollment status); (3) Billing team must prepare to submit this documentation with the next Medicaid revalidation or Change of Ownership application to Maryland Medicaid; (4) For newly enrolling providers, include active Medicare enrollment information with initial Medicaid enrollment application. Contact mdh.healthchoicedprovider@maryland.gov for Diabetes Prevention Program providers or jarrod.terry@maryland.gov for Nursing Facilities with questions. Consequence: Applications will be denied if active Medicare enrollment documentation is not provided at revalidation or enrollment.

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