Maryland
LLC
Website link to register:
https://egov.maryland.gov/BusinessExpress
Naming conventions
Cannot use words that require additional regulatory approval without obtaining it. Must include “Limited Liability Company,” “LLC,” or “L.L.C.” PLLCs must include “Professional LLC.”
Licensing Requirements
Medical licenses are issued and verified by the Maryland Board of Physicians. Proof of malpractice insurance required. Compliance with Maryland Health Care Commission guidelines is mandatory.
Required documentation for medical practices
Articles of Organization, Compliance with Maryland Health Commission, Professional Licenses, Malpractice Insurance
Filing Fee: $100
Annual/Biennial Fee: $300
Additional Notes: Annual report due April 15.
Medicaid
Program Name: Maryland Medical Assistance Program
Official Website: mmcp.health.maryland.gov
Legislation: Maryland does not have specific DPC legislation; practices operate under general healthcare and insurance laws.
Private Contracting
Permitted; DPC practices must ensure compliance with state insurance regulations to avoid being classified as insurers.
Restrictions
No explicit restrictions for DPC providers; compliance with federal and state regulations is required.
Medicaid Program
Maryland Medicaid provides health coverage to eligible low-income residents, including children.
Notification Requirements
Notification required if not accepting Medicaid patients.
Provider Enrollment Requirements
Providers must enroll with Maryland Medicaid to serve beneficiaries directly or offer reimbursable services.
Enrollment Options
No "Ordering and Referring Only" status available.
Ordering, Referrals, and Testing
Non-enrolled providers may face challenges with Medicaid recognition for orders and referrals.
Designated PCP Restrictions
DPC physicians cannot act as Medicaid-designated PCPs.
Billing and Reimbursement
DPC practices typically do not bill Medicaid for services covered under private agreements.
Managed Care Plan Exemptions
Not specified.
Billing Clarity
Cannot bill Medicaid patients for covered services unless explicitly agreed upon.
CMS Guidance
CMS guidelines support innovative Medicaid integration models.
Opportunities for Collaboration
Opportunities may exist to collaborate with Medicaid Managed Care Organizations (MCOs) or state programs.
State-Specific Notes
Maryland Medicaid Managed Care Organizations provide opportunities for collaboration.
Dispensing Medication
Board of Pharmacy Official Link: https://health.maryland.gov/pharmacy/
State Licensing
Physicians must register with the Maryland Board of Physicians and the Board of Pharmacy for controlled substances.
Scope of Practice
Dispensing medications is allowed within the scope of practice; controlled substances require stricter licensing.
Inventory Management
Maintain inventory logs with compliance to state laws; secure storage is mandatory for controlled substances.
Record-Keeping
Records must meet Maryland and federal standards, including HIPAA compliance.
Dispensing Standards
Labels must include patient name, prescribing physician, dosage, and directions for use.
Controlled Substances
DEA registration and reporting to Maryland’s PDMP are mandatory for controlled substances.
Billing and Reimbursement
Follow Maryland-specific billing requirements and federal anti-kickback laws.
Federal Compliance
Physicians must comply with FDA, DEA, and Maryland state dispensing laws.
State Pharmacy Laws
Registration with the Maryland Board of Pharmacy is required for controlled substances.
Patient Consent
Obtain informed consent before dispensing medications.
Insurance and Liability
Physicians must ensure malpractice insurance includes dispensing coverage.
Training Requirements
Maryland mandates continuing education specific to controlled substances.
Audits and Inspections
Regular inspections are conducted by the Maryland Board of Pharmacy, with penalties for violations.