The Maryland Department of Health is extending a temporary pause on new Medicaid enrollments for certain behavioral health providers as the state continues reviewing the provider network for potential fraud, waste and abuse.
The six-month extension begins July 1 and applies to new providers seeking Medicaid enrollment for four community-based behavioral health programs: Psychiatric Rehabilitation Programs, Psychiatric Rehabilitation Programs serving Health Home participants, Level 2.5 Partial Hospital Programs and Level 2.1 Intensive Outpatient Treatment Programs.
The pause affects providers in 10 Maryland jurisdictions: Anne Arundel, Baltimore City, Baltimore County, Carroll, Frederick, Harford, Howard, Montgomery, Prince George’s and Washington counties.
The health department said the temporary suspension is intended to address concerns about improper practices and protect the quality of behavioral health services while maintaining access for Maryland residents who rely on them.
“We remain committed to maintaining strong fiscal integrity across the program while maintaining robust behavioral health services available to Marylanders,” said Deputy Secretary for Behavioral Health Dr. Rachel Talley in a statement. “We continue to work to strengthen the quality of our providers, including rooting out negligent bad actors, without compromising the behavioral health needs of participants or providing support to the network of healthcare professionals who deliver these critical services.”
The department said the affected programs have experienced rapid growth since Maryland shifted to an accreditation-based model for provider licensing, prompting the need for additional oversight.
The extension does not prevent the licensing process from continuing for providers seeking to become licensed community behavioral health providers. Existing Medicaid provider revalidations, relocations, mergers and acquisitions will also continue, officials said.
The Maryland Department of Health did not provide details on specific providers or cases that prompted the pause.
Officials said the goal is to maintain access to behavioral health services while ensuring providers meet state standards.
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