Medicaid Monitor
Policy Intelligence
Medicaid Monitor
Policy Intelligence
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Maryland Matters

11 stories

State Policy·MD·3d ago

Maryland to Drop 4,500 Immigrants From Medicaid Under H.R. 1

New federal immigration-status restrictions under the One Big Beautiful Bill Act take effect Thursday, disqualifying an estimated 4,500 Maryland Medicaid enrollees, including refugees, asylum seekers, humanitarian parolees and trafficking victims. Green-card holders, Cuban and Haitian immigrants, and Compact of Free Association migrants remain eligible, but other noncitizens lose coverage immediately, threatening continuity of care for conditions like cancer and diabetes. Advocacy group We Are CASA warns affected residents have few alternatives, since community clinics offer limited sliding-scale services and marketplace subsidies for these populations will also end in January 2027. The same effective date triggers a shift in SNAP administrative cost-sharing that could cost Maryland up to $57 million, compounding fiscal pressure on state safety-net programs.

State Policy·MD·11d ago

Maryland Health IG Reports $42M in Improper Payments from Audits Now Public

Maryland's Office of Inspector General for Health conducted 1,369 investigations and 53 audits over fiscal years 2023-2025 identifying $42 million in improper or unrecovered payments from healthcare providers and local health departments. The agency has now posted 20 audit reports publicly for the first time after operating largely without public disclosure since becoming independent in 2022. The reports detail $4.3 million owed by 13 healthcare providers for inadequate documentation and duplicate payments, plus $1.7 million owed by local health departments for documentation errors and missing equipment. The Maryland Department of Health, not the IG, handles recoveries and has historically forgiven portions of identified overpayments.

Industry·MD·13d ago

Maryland Insurers Request Long-Term Care Premium Increases Up to 300%

Four Maryland insurance companies have requested state approval for steep premium increases on long-term care insurance policies that would double or triple costs for thousands of seniors over five years. The rate hike requests were filed last week and await approval from state officials. If approved, the increases would affect existing policyholders' annual premiums beginning in the near term. The proposals reflect the broader financial pressures facing the long-term care insurance market, where carriers have struggled with underpriced policies and higher-than-expected claims.

State Policy·MD·20d ago

Maryland Officials Seek Funding to Offset Rising Healthcare Costs, Federal Medicaid Changes

Maryland state officials and advocates are working to secure funding to mitigate the impact of rising healthcare costs and federal Medicaid program changes on residents' ability to afford coverage. The effort responds to concerns that Marylanders may lose access to affordable health insurance as costs increase and federal policy shifts. Specific details on the federal changes, funding mechanisms, or timeline were not provided in the available excerpt. The initiative reflects state-level responses to federal program modifications that may increase cost-sharing or reduce subsidies for Medicaid and marketplace enrollees.

State Policy·MD·24d ago

State Audit Questions Medicaid Payments for Incarcerated Individuals

State auditors and health officials disputed the propriety of millions of dollars in Medicaid payments made on behalf of incarcerated individuals during a legislative hearing Wednesday. The disagreement centers on whether these payments comply with federal Medicaid eligibility rules, which generally prohibit coverage for inmates except for specific inpatient services. Lawmakers expressed frustration over the conflicting interpretations between the state's audit and health agencies. The dispute raises compliance and oversight questions for state Medicaid programs navigating federal restrictions on inmate coverage while implementing new suspension and pre-release enrollment policies.

State Policy·33d ago

Developmental Disability Providers Report Financial Crisis From State Agency Payment Delays

Developmental disability service providers report they are nearing financial insolvency due to payment delays and administrative dysfunction at state Medicaid agencies, following more than two years of erroneous disenrollments during unwinding. Providers cite slow agency responses, unresolved eligibility issues, and accumulating unpaid claims for HCBS and developmental disability services. The timeline spans the entire unwinding period from 2024 through present day. This threatens the stability of the DD service delivery system and access to long-term services and supports for one of Medicaid's most vulnerable populations.

Industry·MD·34d ago

ACLU Report Documents 143 Deaths in Maryland Police Encounters, Half Involving Medical or Behavioral Health Crises

An ACLU of Maryland report documents 143 deaths in police encounters from 2015 to 2023, finding nearly half involved individuals showing signs of medical or behavioral health crises. Black Marylanders were killed at three times the rate of white residents, and among unarmed victims, close to 80% were Black. The report calls for redirecting crisis response away from armed officers toward trained crisis teams and notes no on-duty officer was convicted of any crime related to these deaths during the study period. The findings highlight systemic failures across policing, medical examiner practices, and legal accountability.

State Policy·MD·34d ago

Maryland Cuts Home Services for Medicaid Beneficiaries with Complex Medical Needs

Maryland's Department of Health has reduced funding for disability services that enable Medicaid beneficiaries with complex medical needs to remain in their homes and communities rather than institutional settings. The cuts eliminate respite care for family caregivers, staffing for safety needs, and community inclusion programming, affecting beneficiaries who rely on self-directed services because they require nursing-level care. The state is also requiring family caregivers to provide more unpaid care to maintain eligibility for paid nursing services. The changes disproportionately impact individuals ineligible for traditional provider service models due to medical complexity.

State Policy·MD·34d ago

Maryland Launches Court-Ordered Outpatient Mental Health Treatment in Baltimore, Select Counties

Maryland's Department of Health on Thursday began implementing its new Assisted Outpatient Treatment program, allowing mental health professionals, family members, or friends to petition circuit courts to mandate treatment adherence for individuals with severe mental illness. The program launches initially in Baltimore City, Anne Arundel County, and Eastern Shore counties, with statewide rollout scheduled for July 2027. Circuit courts can now order patients with conditions like bipolar disorder or schizophrenia to comply with prescribed treatment plans. Disability rights advocates have raised concerns about patient autonomy, while local officials are still working out implementation logistics with state health officials.

State Policy·MD·34d ago

Maryland Insurers Warn AHEAD Model Transition Could Shift Hospital Costs to Commercial Payers

Maryland is transitioning from its Total Cost of Care model to the AHEAD (Achieving Healthcare Efficiency through Accountable Design) model, which will remove the state's authority to set Medicare hospital rates starting in 2028. CareFirst BlueCross BlueShield officials warned at a Maryland Association of Counties conference that the federal government is expected to contribute less under AHEAD than under the previous all-payer rate-setting system, likely shifting costs to commercial insurance. The Health Service Cost Review Commission will continue setting rates for non-Medicare payers, but insurers anticipate rate increases for counties, businesses, and individuals as the transition unfolds.

State Policy·MD·34d ago

Maryland Rate-Setting Commission Chair and Executive Director Depart During AHEAD Model Transition

Health Services Cost Review Commission Chair Joshua Sharfstein and Executive Director Jon Kromm left the commission in July 2026 as Maryland transitions from the Total Cost of Care model to the AHEAD model. Both officials joined HSCRC in 2023 and negotiated with federal officials under two administrations on Maryland's hospital rate-setting authority. William Henderson will serve as interim executive director; no new chair has been named. The leadership change occurs as the state implements a multiyear transition to AHEAD after the previous all-payer model expired December 31, 2025, with ongoing uncertainty about Maryland's authority to set Medicare rates following Trump administration renegotiation of the original 2024 agreement.

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