Maryland Medicaid Expansion

Maryland is fully participating in the Medicaid Expansion under provisions of the Affordable Care Act (ACA). For additional background on the State’s policy decisions regarding the Medicaid Expansion option, see: Background.

Medicaid in Maryland

The MD Department of Health and Mental Hygiene administers the state’s Medicaid program, called Maryland Medical Assistance Program.
Information about Medicaid can be found at: https://mmcp.dhmh.maryland.gov/SitePages/Home.aspx.

Provider Participation

Providers must enroll in the Medicaid fee-for-service program to receive payments for covered services. Information about enrolling in the Medicaid fee-for-service program can be found at: https://mmcp.dhmh.maryland.gov/SitePages/Home.aspx. The MD Medicaid website provides information about services covered by fee-for-service payments and payment amounts: https://mmcp.dhmh.maryland.gov/SitePages/Home.aspx. In order to retain access to all Medicaid patients in the state, providers must also connect to the managed care plans individually.

Medicaid Managed Care

Some Medical Assistance Program beneficiaries are enrolled in managed care plans. Basic information about the programs, called HealthChoice, can be found at: https://mmcp.dhmh.maryland.gov/healthchoice/SitePages/Home.aspx.
Some managed care plans cover individual Maryland counties and independent cities. The Medicaid website has jurisdictional information: https://mmcp.dhmh.maryland.gov/SitePages/Home.aspx.

Medical Assistance Program Beneficiaries Participating in Managed Care

Managed care plans participating in HealthChoice offer detailed information about covered benefits for individuals enrolling in their plans. This information is available on the managed care websites shown below.

Report Problems

The state Medicaid office is primarily responsible for examining and addressing issues with the Medicaid Managed Care plans offered in the state, and for working with the companies that offer them. If you are experiencing problems as a medical provider with the Managed Care plans or companies operating in the state, or if your patients are experiencing problems with the Managed Care plans or companies in the state, including trouble with access to medications, access to preferred providers, navigating the appeals process, excessive costs, or possible discriminatory policies, or any other problems related to the Affordable Care Act, please report these problems to the state Medicaid Office:

http://www.dhr.state.md.us/blog/

800-492-5231
Additionally, if you are experiencing these or other problems, please report these problems to AAHIVM, so that we may track issues affecting our members, and seek additional policies remedies.

Managed Care Plans Participating in HealthChoice

Amerigroup Community Care
Plan Website: http://www.myamerigroup.com/English/Medicaid/md/Pages/MD-2012.aspx
Provider Enrollment: https://providers.amerigroup.com/Pages/Partner.aspx

Jai Medical Systems
Plan Website: http://www.jaimedicalsystems.com/
Provider Enrollment: http://www.jaimedicalsystems.com/

Kaiser Permanente
Plan Website: http://www.kp.org/medicaid/md
Provider Enrollment: N/A

Maryland Physicians Care (Meritus Health)
Plan Website: http://www.marylandphysicianscare.com/default.aspx
Provider Enrollment: http://www.marylandphysicianscare.com/contracting-information.aspx

MedStar Family Choice
Plan Website: http://www.medstarfamilychoice.com/msfc-body.cfm?id=627
Provider Enrollment: http://www.medstarfamilychoice.com/hc_body.cfm?id=165

Priority Partners
Plan Website: http://www.ppmco.org/
Provider Enrollment: http://www.hopkinsmedicine.org/johns_hopkins_healthcare/

Riverside Health of Maryland
Plan Website: http://www.myriversidehealth.com/
Provider Enrollment: http://www.myriversidehealth.com/AboutUs/ProviderContracting.aspx

United Healthcare
Plan Website: http://www.uhccommunityplan.com/plan/state/MD/index
Provider Enrollment: http://www.uhccommunityplan.com/physicians-network