MCO Frequently Asked Questions

How do I obtain a copy of the Providers Certification?
Providers are required to have on site a valid copy of their program’s certification certificate. They can provide you with a copy of their certificate.

Does ADAA issue the Program Certification? 
Program certification process and certificates are handled by the DHMH Office of Health Care Quality (OHCQ).

Office of Health Care Quality, Department of Health and Mental Hygiene
Spring Grove Hospital Center, Bland Bryant Building
’ Catonsville, Maryland 21228
Phone Number:     Toll-free:
Email:    Web:  http://dhmh.maryland.gov/ohcq 

What if the program has an expired certificate?
Programs are required, by Code of Maryland Regulations (COMAR),  to notify OHCQ of the pending expiration at least two - weeks before their certificate expires. OHCQ will schedule a site inspection for renewal or issue an extension of the certification pending renewal by way of a “letter of good standing”. Programs that do not have an active certificate or a “letter of good standing” issued by the OHCQ are not in compliance with COMAR.

How do I contact ADAA if I have additional questions regarding MCO/Provider relations?
You can submit questions to . 

Will the MCOs allow providers to submit authorization requests for services for PAC recipients in advance of the January 1 start date?  (Posted 5/60)
 Four of the five PAC MCOs have agreed to accept early requests for substance abuse services for PAC enrollees.  These MCOs are: UnitedHealthcare, Maryland Physicians Care, Jai Medical System and Amerigroup Community Care.

 Will MCOs allow substance abuse providers to order urinalysis tests for PAC recipients?  Do any of the MCOs have preauthorization requirements for urinalysis tests for PAC recipients?  (Posted 5/60)
 None of the MCOs have preauthorization requirements for urinalysis tests.  Currently 3 of the MCOs (Jai, Maryland Physicians Care and UnitedHealthcare) allow substance abuse providers to order the tests.  The other 2 MCOs (Amerigroup and Priority Partners) only allow the recipient's primary care physician to order the test but they are planning on changing their systems to accommodate orders from substance abuse providers.

In terms of those MCO’s who don’t require pre-authorizations and allow the SA providers to order urinalysis, isn’t it true that the UA tests must be performed at the labs with whom the various MCO’s have contracts?  (Posted 5/60)

Yes.  They all have a contract with Lab Corp.  For ease of administration, we recommend that you work with them.