PA Reform EnactedTransparency Requirements
Maryland Prior Authorization Requirements
A guide to prior authorization rules, turnaround times, and laws for medical practices operating in Maryland (MD).
PA Turnaround Times
Standard Requests
14 calendar days
Urgent / Expedited
24 hours
PA Reform Legislation
Maryland has enacted legislation limiting step therapy and requiring faster PA turnaround times.
Key Regulations
- Standard PA turnaround of 14 calendar days
- Urgent requests must be resolved within 24 hours
- Step therapy override protections
- PA criteria must be accessible to providers
Maryland Medicaid PA
Maryland Medicaid uses managed care organizations (HealthChoice). PA is administered by MCOs under state regulations.
Recent Changes (2025-2026)
- Step therapy reform legislation enacted
- Increased oversight of PA turnaround compliance
Top Payers in Maryland
CareFirst Blue Cross Blue ShieldUnitedHealthcareAetnaCignaKaiser Permanente
State Regulatory Body: Maryland Insurance Administration
File PA complaints or appeals through your state insurance department.
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