MedicaidPrior AuthMedium impact
PT 48-26: Removal of Prior Authorization Requirement for Special Pediatric Hospitals
Maryland Medicaid·MD · Pediatrics, Critical Care·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 18, 2026
Summary
Maryland Medicaid is eliminating prior authorization requirements for transfers to in-state Special Pediatric Hospitals effective January 1, 2026. Instead, providers must submit concurrent level of care reviews to Telligen within 5 calendar days of admission start date, with continued stay reviews every 14 days thereafter.
Action Required
By January 1, 2026: For Maryland Medicaid patients transferring to in-state Special Pediatric Hospitals, stop requesting prior authorization. Instead, submit concurrent level of care reviews to Telligen via Qualitrac within 5 calendar days of admission start date, selecting 'concurrent' timing. Submit continued stay reviews within 3 days of current authorization expiration. Register for Telligen training session on January 13, 2026 at 2:00pm. Continue obtaining prior authorization for out-of-state Special Pediatric Hospitals using existing processes.