UnitedHealthcareMedium ImpactAdministrative

Maryland Medicaid: See which primary care provider policies have changed

Published January 12, 2026Effective July 18, 2025

AI 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.

Plan Types

Medicaid

States

MD

Specialties

family-medicine, internal-medicine, general-practice, pediatrics, all-specialties