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Health Care
Financing is responsible for the activities and missions of
the five Medical Care Programs, which includes: Medical
Assistance (Medicaid and HealthChoice), Pharmacy Assistance,
Kidney Disease, Family Planning Programs and Maryland
Children’s Health Program. In addition, the Health Services
Cost Review Commission and the Maryland Health Care
Commission (Healthcare Access and Cost Commission and
Maryland Health Resources Planning Commission) are under the
Deputy Secretariat for Health Care Financing.
The
responsibilities of the Medical Care Programs are covered by
three administrations:
The
Office of Planning
Development and Finance provides support in the
areas of budget, administration, and program and policy
development and evaluation. It advises the Deputy Secretary
on major policy matters, including programmatic changes,
budget and fiscal issues, rate-setting, and federal and
State legislative issues and proposals.
The
Office of Health Services
manages the areas of Acute and Primary Care and Long-term
Care. Primary responsibilities include development and
implementation of regulations, coordination of State Plan
amendments, federal waiver agreements, and provider
agreements. In addition, it develops legislative proposals
and handles compliance activities including
pre-authorization, fraud and abuse activities, quality
assurance, complaint resolution, and other ongoing program
management activities.
The
Office of Operations and
Eligibility oversees eligibility policy and
training, handles claims processing for enrolled health care
providers, and assures that eligible recipients receive
their entitled health benefits under the five Medical Care
Programs (Medical Assistance, Pharmacy Assistance, Kidney
Disease, Family Planning Programs and Maryland Children’s
Health Program). |