On June 28th, 2024 the Maryland Department of Health Issued a  Six-Month Pause on New Enrollments of Select Provider Types to Address Potential Fraud, Waste, and Abuse.

The Maryland Department of Health is imposing a six-month pause on new enrollments into the Maryland Medicaid Program of the following behavioral health program types, which are licensed under Maryland Code of Maryland Regulations 10.63 and 10.09:
  • Psychiatric Rehabilitation Programs 
  • Psychiatric Rehabilitation Programs, Health Home
  • Level 2.5 Partial Hospital Programs, and
  • Level 2.1 Intensive Outpatient Treatment Programs 

MDH has stated the reason for the pause is "...to assess and evaluate the provider landscape, the quality of care rendered, compliance with state and federal regulations, and identify, and mitigate potential fraud, waste, and abuse”

Providers of the above services should expect aggressive auditing of service and personnel records over the next 6 months. 

Retrospect Consulting Group can help to prepare for the impending state audits by conducting forensic internal audits and providing corporate compliance training. 
Forensic Audits 
Many small and medium sized providers do not have an effective in-house compliance  program because of the cost or lack of expertise. ​​​​We assist agencies wishing to protect its interests by:
  • Conducting external audits to determine adequacy and effectiveness of internal controls in the prevention and detection of fraud and embezzlement
  • Assisting to maintain compliance with federal and state regulations
  • Preparing you for Provider Monitoring
  • Developing  Plans of Correction ​
  • Superintending plans of correction and settlement agreements

Case Consultation
We will  provide case consultation to your attorney and expert witness services to your attorney  regarding: 
  • RAC Notice of Over Payments
  • MCO Re-considerations
  • Program Integrity Hearing
  • Other Adverse Actions

Corporate Compliance 
  • Develop compliance plans 
  • Provide compliance and documentation training 
  • Train quality assurance staff ​
 RCG requires a Business Associate Agreement with our customers to be in compliance with 45 CFR 164.522.  Please complete this online BAA. A copy will be e-mailed to you.