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Maryland Medicaid: Balance billing is not permitted
Effective date
Not stated in the notice
Identified
Oct 6, 2026
Summary
This is a historical reminder (published May 18, 2026, discovered October 6, 2026) that UnitedHealthcare Community Plan Maryland Medicaid prohibits balance billing members. The policy clarifies when balance billing is not permitted, requires eligibility verification before service delivery, and outlines consequences including payment recoupment, sanctions, and program termination for violations.
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What to do
Action · 7 steps
01Already effective (historical material): Verify whether the practice has implemented these balance billing compliance measures for UnitedHealthcare Community Plan Maryland Medicaid members and confirm current applicability.
02Billing team should ensure.
03Member eligibility and covered/non-covered services are verified in advance before service delivery via the UnitedHealthcare Provider Portal.
04Only Maryland Medicaid-permitted cost-sharing is collected.
05All other liable third parties are billed first, with primary payer explanation of benefits or remittance advice submitted with claims to UnitedHealthcare Community Plan.
06Accurate health insurance information is maintained in all billing systems.
07Non-compliance may result in payment recoupment, sanctions, and/or termination from the Maryland Medicaid program.
Original notice
Maryland Medicaid: Balance billing is not permitted
uhcprovider.com · Always check the source before changing claims.