Maryland Medical Assistance Provider Agreement - Maryland

Maryland Medical Assistance Provider Agreement is a legal document that was released by the Maryland Department of Health - a government authority operating within Maryland.

FAQ

Q: What is the Maryland Medical Assistance Provider Agreement?A: The Maryland Medical Assistance Provider Agreement is a contract between the state of Maryland and healthcare providers who participate in the Medical Assistance program, also known as Medicaid.

Q: What is the purpose of the agreement?A: The purpose of the agreement is to establish the terms and conditions under which healthcare providers can provide services to eligible Maryland residents who are enrolled in the Medical Assistance program.

Q: Who needs to sign the Maryland Medical Assistance Provider Agreement?A: Healthcare providers, including doctors, hospitals, clinics, and other healthcare facilities, that want to participate in the Maryland Medicaid program need to sign the agreement.

Q: What are the requirements for providers to participate in the Medical Assistance program?A: Providers must meet certain qualifications set by the state, such as having a valid license to practice in Maryland, maintaining professional liability insurance, and complying with billing and documentation requirements.

Q: What services are covered under the Maryland Medical Assistance program?A: The Maryland Medical Assistance program covers a wide range of medical services, including doctor visits, hospital care, prescription drugs, laboratory tests, mental health services, and more.

Q: How are providers reimbursed for services rendered under the Medical Assistance program?A: Providers are reimbursed based on a fee schedule established by the state. The reimbursement rates vary depending on the type of service provided and the provider's specialty.

Q: Is prior authorization required for certain services under the Medical Assistance program?A: Yes, prior authorization is required for some services, such as certain medical procedures or expensive prescription drugs. Providers need to obtain approval from the state before performing these services.

Q: What are the responsibilities of providers under the Maryland Medical Assistance Provider Agreement?A: Providers are required to deliver quality healthcare services to Medical Assistance enrollees, maintain accurate records, submit claims in a timely manner, and comply with state and federal regulations.

Q: How can providers terminate their participation in the Medical Assistance program?A: Providers can terminate their participation by giving written notice to the Maryland Department of Health. However, they may still have ongoing obligations for services provided prior to termination.