Maryland Medicaid Briefing
July 14, 2025

On July 14, 2025, the Maryland Department of Health held a stakeholder briefing to discuss the potential impacts of federal legislation H.R.1 on the state's Medicaid program. Deputy Secretary Ryan Moran emphasized that the Department is still reviewing the bill and awaiting further federal guidance. Key changes under H.R.1 could result in the loss of coverage for approximately 175,000 Marylanders and a potential reduction of up to $2.7 billion in annual federal funding. Proposed changes include the implementation of work requirements for ACA expansion adults, more frequent eligibility renewals, restrictions on immigrant eligibility, and limitations on provider taxes and state-directed payments. Other provisions affect payments to certain providers, retroactive coverage, and impose new cost-sharing requirements. These changes will require significant state investment and system updates, and written guidance from the Department is expected later this week.

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What Health Care Provisions of the One Big Beautiful Act Means for States
July 15, 2025

The National Academy for State Health Policy (NASHP) highlights the significant implications of the recently enacted H.R. 1, the One Big Beautiful Bill Act (OBBBA), particularly its sweeping health-related provisions. The law introduces major changes to Medicaid and Health Insurance Marketplace programs, prompting states to undertake rapid and strategic implementation efforts that will shape their health care systems and impact consumers across the country.

As a comprehensive spending and tax law passed through the reconciliation process, the OBBBA extends the 2017 Tax Cuts and Jobs Act while increasing federal investment in areas like border security, defense, and energy. To balance this spending, the law includes cost-saving measures—many of which affect Medicaid and the Marketplaces. NASHP will continue to monitor the implementation and support states in navigating these complex transitions.

A detailed summary of the key health care provisions follows below.

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Final CMS Medicaid Access Rule, NAHC Webinar Today at 2PM
April 25, 2024

On Tuesday, April 22, 2024, CMS released the Final Medicaid Access Rule. This rule contains a broad range of impactful policies that will significantly reshape Medicaid HCBS for home care providers. Most notable is the “payment adequacy provision,” which requires that a minimum percentage of Medicaid HCBS reimbursements be passed through to workers. The rule is effective on July 9, 2024, which is 60 days after its publication in the federal register; however a number of the provisions do not actually take effect until several years after the effective date of the rule.

Today, April 25th from 2-3PM, NAHC will be hosting a webinar to begin unpacking this rule in its final form and provide information on next steps that the provider community and associations can take. This webinar is free for NAHC members. You can register here.

NAHC and PMHC, our national partners, have made available some preliminary analysis and resources (attached)

- CMS Fact Sheet – Medicaid Access Final Rule
- CMS Timeline for Various Effective Dates Within the Final Rule

MNCHA will continue to share updates and information as available.

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Jurisdiction A Updated Guidelines for PAP and RAD Masks
February 9, 2024

To the Jur A, Region B and Jur C Councils -  GREAT NEWS! In case you haven't seen this yet - the 4 DMD's updated their Dear Clinician letters:  
MASKS: POSITIVE AIRWAY PRESSURE DEVICES AND RESPIRATORY ASSIST DEVICES

Respective links to letters:
- Jur A - Noridian letter
- Jur B - CGS letter
- Jur C - CGS letter

This is a great win accomplished through AAH Reg Council, the Medicare Councils and the CGS Innovation Survey! 

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EVV Home Health FAQs
October 26, 2023

View Maryland Department of Health - Division of Nursing Services (DONS) Home Health Billing and Reimbursement of Services EVV FAQS

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EVV Private Duty Nursing FAQs
October 26, 2023

View Maryland Department of Health - Division of Nursing Services (DONS) Private Duty Nursing EVV FAQs

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Extended Implementation of Electronic Visit Verification Memorandum
October 26, 2023

The Office of Long Term Services and Supports (OLTSS) will extend the implementation timeframe of Electronic Visit Verification (EVV) for the Home Health and Nursing Services programs until November 30, 2023. The extended implementation will allow sufficient time for providers to access participant information, train staff on using EVV, and set up their staff profiles in LTSSMaryland to ensure a successful implementation.

Deputy Secretary Ryan Moran and I invite you to meet with us on October 31, 2023 from 11:30am to 12:00pm to discuss next steps and address any questions. Meeting credentials and EVV implementation information are forthcoming.

Questions regarding this matter may be directed to Ms. Dawnn Williams, Chief, Division of Nursing Dervices at (410) 767-1596 or dawnn.williams@maryland.gov.

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District of Columbia Nurse Licensure Compact Proposed Legislation
July 19, 2023

Please be advised that on July 13, 2023, with endorsements from the Coalition on Long Term Care, among others, Councilmember Matt Frumin introduced "The District of Columbia Nurse Licensure Compact Authorization Act of 2023."  This legislation authorizes DC to enter the nurse Licensure Compact which enables nurses from other Compact states to practice in DC with no additional licensure.

The Coalition worked with Councilmember Frumin's office on the Bill language and to secure support from key stakeholders. A link to the legislation, along with the Councilmember’s introductory letter reflecting MNCHA’s support, can be found here. A copy of the Coalition's detailed letter of support is attached (PDF). The next step will be a hearing, likely in the Fall, so please stay tuned for additional information.

While this Bill does not address reciprocity for Home Health Aides or Certified Nursing Assistants - a top priority for the Coalition and MNCHA - we anticipate that this Fall, there will be legislation to amend the Health Regulations Occupations Act (HORA). We will have an opportunity to regroup and rally for additional needed changes involving the direct care workforce. It will be helpful to our ongoing advocacy efforts to capture the access to care implications of the workforce shortage.

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The Beacon Institute, in collaboration with Innovation Horizons, is offering Alzheimer’s Disease and Related Dementias (ADRD): Courses for Healthcare Providers. This free, four-part series will equip you with tools and knowledge about ADRD care. You will find tools for early ADRD diagnosis, identify prevention strategies and evidence-based therapeutic management strategies, and recognize the importance of cultural awareness and relationship-centered care. Virtual and in-person options are available.

The four accredited continuing education courses include:
- ADRD Clinical Management: Part I
- ADRD Clinical Management: Part II
- Medication Management in Alzheimer’s Disease & Related Dementias
- Promoting Equity through Institutional & Community-Based Approaches for ADRD Populations

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August 30, 2023 Deadline for In-Person I-9 Verification of All Remote Verified Employees
July 11, 2023

The U.S. government declared that the federal COVID-19 public health emergency ended on May 11, 2023. As such, ICE announced that the temporary COVID-19 flexibilities for remote I-9 verification will end on July 31, 2023. Employers must complete in-person physical document inspections by August 30, 2023, for all employees whose documents were inspected remotely during the temporary flexibilities period. Even if a company began operating remotely during COVID-19 and/or is not requiring employees to return to the workplace, the employer is required to conduct the in-person document inspection for each remote-verified employee.

Click here to read the full PDF

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Updated Orders from MDH; Executive Order on LTC & Caregiving
April 20, 2023

Two important announcements were released yesterday, one from the Maryland Department of Health and one from the White House. The MDH Secretary’s Directives and Orders, effective April 18, 2023 include Nursing Home Matters, Vaccination Matters, and Healthcare Matters. Please review these new orders carefully to ensure you are in compliance with the most up-to-date state requirements.

Yesterday, President Biden signed an Executive Order summarizing his Administration’s caregiver actions and proposals. A co-released Fact Sheet outlines the key measures included in the Executive Order. Central to this order are the improvement of jobs and supports for caregivers; increased access to affordable care for families; and the provision of more care options for families.

Click here to access the orders - MDH Order - Amended Various Health Care Matters Order 01     MDH Order - Amended Nursing Home Matters Order 02  
MDH Order - Amended Vaccination Matters Order 03

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The Home Care Workforce Crisis: An Industry Report and Call to Action
March 28, 2023

The National Association for Home Care & Hospice (NAHC) and the Home Care Association of America (HCAOA) have brought together some of the smartest and most experienced industry leaders to create The Home Care Workforce Crisis: An Industry Report and Call to Action. This groundbreaking initiative not only addresses the needs of the nursing and home care aide workforce, but also the supply and demand issues for home based care. This report, told from the perspective of the people on the front lines of this crisis, offers policy recommendations and operational best practices to address the workforce shortage in home-based care.

Click here to access the full digital version of the The Home Care Workforce Crisis report.

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Board of Nursing Guidance - Nursing Diploma Fraud 
February 27, 2023

On January 25, 2023, the FBI announced a fraudulent nursing diploma scheme to sell fraudulent nursing degree diplomas and transcripts obtained from accredited Florida-based nursing schools to individuals seeking licenses and jobs as RNs and LPNs/LVNs. The overall scheme involved the distribution of more than 7,600 fake nursing diplomas issued by three South Florida-based nursing schools: Siena College and Sacred Heart International Institute in Broward County, and Palm Beach School of Nursing in Palm Beach County.
MedPage Today featured a follow-up special report that highlighted the response by several individual state boards of nursing.

For current guidance from our local nursing boards:

Maryland Board of Nursing: In a February 9, 2023 update, the Maryland Board of Nursing requests that all employers who identify licensees who attended a nursing education program named above should submit the licensee’s name, license number, and employing agency/organization to sara.tongue1@maryland.gov. You can find new updates on the Maryland BON website.

District of Columbia Board of Nursing: The District of Columbia Board of Nursing, to date, has not released any specific instructions to employers regarding this matter. Until further direction is made available, MNCHA encourages you to flag these licensees and refer them, along with their name and license number, to DC Health via education.bon@dc.gov. Please check the DC BON website for future updates.