Robert Besser
06 Mar 2025, 15:09 GMT+10
ANNAPOLIS, Maryland: Maryland's largest managed care organization for Medicaid recipients has had its accreditation suspended, prompting state officials to pause new enrollments and allow existing members to switch plans.
Priority Partners, which covers approximately 350,000 Medicaid enrollees—about 24% of Maryland's 1.5 million Medicaid recipients—was suspended due to concerns related to provider credentialing and quality reviews, according to the Maryland Department of Health.
The suspension does not impact existing coverage or access to care for current members, but the state will not allow new enrollments into Priority Partners starting March 17, said Ryan Moran, the state's Deputy Secretary of Health Care Financing and Medicaid Director.
"We will be following up with communication to those members," Moran told The Associated Press, adding that the state will also post information online to keep enrollees informed of their options.
Current members will have a 60-day window to switch to another managed care organization if they choose.
The National Committee for Quality Assurance (NCQA), an independent nonprofit that evaluates and reports on health plan performance, took action against Priority Partners MCO due to concerns about compliance with quality standards.
"NCQA has suspended Health Plan Accreditation for Priority Partners MCO until they implement corrective action and undergo a resurvey," the nonprofit said in a statement. "Details of the suspension cannot be disclosed."
According to the Maryland Department of Health, Priority Partners is the only Medicaid managed care organization in the country to have its accreditation suspended.
Moran emphasized that maintaining high-quality healthcare standards is a priority for the state.
"The sanctions on Priority Partners ensure that Marylanders across the state receive top-quality care," he said, adding that the suspension will remain in effect until the NCQA deems that corrective actions have been successfully implemented.
Priority Partners has not yet responded to requests for comment regarding the accreditation suspension.
Get a daily dose of Philadelphia Herald news through our daily email, its complimentary and keeps you fully up to date with world and business news as well.
Publish news of your business, community or sports group, personnel appointments, major event and more by submitting a news release to Philadelphia Herald.
More InformationHANOI, Vietnam: Amid shifting global trade dynamics and growing concerns over U.S. tariffs, France and Vietnam have signed more than...
NEW YORK, New York - U.S. stocks were weaker Wednesday, following Tuesday's heady gains when the Dow Jones jumped 741 points. Bond...
SAO PAULO, Brazil: Amid a surge in electric vehicle (EV) adoption and growing competition in Brazil, Chinese automaker GAC has officially...
CHICAGO, Illinois: McDonald's is closing its experimental beverage spinoff, CosMc's, less than two years after launching the standalone...
BEIJING, China: China's Lenovo reported a steep 64 percent drop in fourth-quarter profit, falling significantly short of analyst expectations...
NEW YORK, New York - Strong economic data jump-started U.S. stocks and the dollar Tuesday, a welcome reprieve after weeks of pressure...
HONOLULU, Hawaii: A man from Oregon, Oliver Widger, has arrived in Hawaii after sailing across the ocean with his cat, Phoenix. He...
BUENOS AIRES, Argentina: The Archbishop of Buenos Aires, Jorge García Cuerva, used a major religious event over the weekend to criticize...
CIUDAD JUAREZ, Mexico: In a first-of-its-kind judicial election in Mexico, more than 5,000 candidates are vying for over 840 federal...
ZERMATT, Switzerland: Five skiers were found dead on a mountain in Switzerland near the popular ski resort of Zermatt, officials said...
TORONTO, Canada - Tens of thousands of people from across Canada have marched in support of Israel in a massive turnout in Toronto....
BOSTON, Massachusetts: U.S. President Donald Trump's administration has taken away Harvard University's right to enroll international...