Mid-Atlantic Health Law TOPICS

1. In June 2024, the Maryland Health Services Cost Review Commission (HSCRC) approved an annual update of 4.53% per capita to the rates for Maryland hospitals for the 2025 rate year. The update includes changes for inflation, high-cost drugs, care coordination, complexity and innovation, quality, and uncompensated care.

2. Carelon Behavioral Health (formally, Beacon Health Options) will become the Maryland Medicaid Behavioral Health System Administrative Services Organization starting January 1, 2025. Carelon is already working with Optum Maryland, the current Administrative Services Organization, to transition administrative functions to provide a smooth turnover. Beacon Health Options was the Administrative Services Organization prior to Optum Maryland, which took over the services in January 2020, and faced a number of claims processing issues in its first year.

3. The Maryland Department of Health is temporarily halting the enrollment of certain kinds of behavioral health providers in the Maryland Medicaid Program. Beginning on July 1, 2024, and lasting for a period of six months, psychiatric rehabilitation programs, psychiatric rehabilitation programs—Health Home, Level 2.5 Partial Hospital Programs and Level 2.1 Intensive Outpatient Treatment Programs will not be able to enroll in the Maryland Medicaid program. The Department stated that this is being done in an effort to evaluate and to assess these types of providers following an increase in these provider types and growing concerns around potential fraud, waste and abuse.

4. The Maryland Board of Physicians is considering holding a workgroup in November 2024 to review and update the list of advanced duties that can be performed by physician assistants. 

Darci M. Smith
410-576-4153 • dsmith@gfrlaw.com