MedStar Family Choice-Maryland Providers

Federal rules

Federal rules require that MCO providers enroll with the MCO’s state Medicaid agency. To continue to render Medicaid reimbursable services, you must enroll with the Maryland Medical Assistance Program (Medicaid), even if your practice will be providing services only to HealthChoice participants. As an existing MedStar Family Choice provider, you are required to enroll through ePREP. As of April 1, 2019, MedStar Family Choice does not accept any new provider credentialing applications without a Maryland Medicaid provider number. To make this process easier for your practice, the Maryland Department of Health has implemented a new self-service electronic Provider Revalidation and Enrollment Portal (ePREP). ePREP is now the one-stop shop for provider enrollment and demographic changes. Please visit Eprep.Health.Maryland.gov to submit your enrollment application or create an account linked to your existing enrollment. Click here for more information.

Clinical Practice Guidelines

A listing of guidelines for a variety of conditions.

Pharmacy and Formulary Information

Learn about MFC’s formulary and authorizations.

Preauthorization and Utilization Management

Reviewers and physician advisors are available to discuss any and all utilization management decisions, questions or issues. Temporary Relaxation of UM Requirements - December 2021

Additional information

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Learn about how to become a MedStar Family Choice provider.

MedStar Family Choice logo
Learn about the HealthChoice program and requirements of providers participating in MedStar Family Choice.
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Primary care providers must use the Uniform Consultation Referral Form when referring MedStar Family Choice enrollees to Specialists. 
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MedStar Family Choice strives to ensure that its enrollees receive high quality health care services. To achieve its quality improvement goals, MedStar Family Choice participates in a variety of Quality Monitoring programs.

Information current as of: