MedicaidAdministrativeMedium impact
Maryland Medicaid: See which primary care provider policies have changed
UnitedHealthcare·MD · Family Medicine, Internal Medicine, General Practice +1 more·State news
Effective date
Jul 18, 2025
We identified it
Jan 12, 2026
Summary
UnitedHealthcare Community Plan (Maryland Medicaid) clarified that participating providers can see any Medicaid member regardless of PCP assignment, but PCPs remain responsible for generating referrals to network specialists and coordinating care before members seek specialist services.
Action Required
Immediately: Front desk staff should verify member eligibility through Maryland Department of Health's EVS Portal or UnitedHealthcare Provider Portal for all Maryland Medicaid patients, regardless of PCP assignment. PCPs must ensure proper referral generation and care coordination for all specialist visits to maintain compliance with referral requirements.