DIVISION OF ACUTE CARE SERVICES
Stanley H. Freedman, Chief
225-1722

Established July 1, 1987, the Division of Acute
Care Services reviews and monitors the use of acute
care services provided by general and special hospi-
tals, physicians, and clinics reimbursed by the
Maryland Medical Assistance Program.

DIVISION OF LONG-TERM CARE
Samuel Colgain, Chief
225-1712

The Division ofLongTerm Care was organized
July 1,1987. The Division reviews and controls the
use of long-term care services provided by special
chronic, psychiatric and rehabilitation hospitals;
skilled and intermediate nursing facilities; and the
alternatives to such services provided by home
health and personal care programs, medical day
care, and community placements for the develop-
mentally disabled.

DIVISION OF MEDICAL ASSISTANCE
RECOVERIES
Nancy Dieter, Chief
225-1760

The Division of Medical Assistance Recoveries
was created in 1969. The Division operates third-
party liability programs. Through these, other
responsible parties are pursued for payment of
health care received under the Maryland Medical
Assistance Program, and money spent on behalf of
recipients is recovered from sources allowed by
federal or State law.

DIVISION OF UTILIZATION &
ELIGIBILITY REVIEW
Glenn W. Kendall, Chief
225-1694

Formed in 1979, the Division of Utilization and
Eligibility Review is responsible for a broad array of
programs. These include corrective managed care,
diabetes care, and hospice care; and quality as-
surance for these programs, health maintenance
organizations (HMOs) and the Make-A-Choice
Program. The Division investigates and refers for
prosecution and money recoveries fraud cases in-
volving recipients ofMedicaid and Pharmacy Assis-
tance; identifies and refers recipients who have
misused benefits; and oversees the recipient com-
ponent of the surveillance and utilization review
subsystem of Medicaid Management Information
System (MMIS). The Division also is responsible
for the child abuse pilot project; utilization review
of the program for human immunodeficiency virus
(HIV) targeted case management; and special
projects relating to the use ofMedicaid services.

Department of Health & Mental Hygiene/309

DIVISION OF ADJUNCT SERVICES
Richard N. Seaborg, Chief
225-1739

The Division of Adjunct Services was organized
July 1, 1987. The Division controls and monitors
services provided to recipients of the Maryland
Medical Assistance Program in the following areas:
Ambulance and Wheelchair Van, Dental, Durable
Medical Equipment and Disposable Supplies,
General Transportation, Hearing Aid, Laboratory,
Oxygen, Pharmacy Physical Therapy Podiatry and
Vision Care. The Division also administers the
Physicians Referral Service and contracts with the
Maryland Pharmacists Association to perform drug
utilization review.

MEDICAL CARE OPERATIONS
ADMINISTRATION

Joseph E. Davis, Director

201 W Preston St.
Baltimore, MD 21201 225-5400

The Medical Care Operations Administration
develops and maintains systems for prompt and
accurate reimbursement of claims submitted by
providers of health care services. It maintains files
of approved providers of services and of Maryland
residents certified as eligible to receive services
through the Medical Assistance Program. The Ad-
ministration also manages the Maryland Pharmacy
Assistance Program. This State-funded program
helps pay for prescriptions, insulin, and certain
medical supplies for low-income families and in-
dividuals who are not eligible for Medicaid.
The Administration consists of five divisions:
Provider Services, Claims Processing, Eligibility
Services, Medicaid Information Systems, and Spe-
cial Programs.

DIVISION OF PROVIDER SERVICES
Joseph L. Fine, Assistant Director
225-5795

The Division of Provider Services was organized
in Fiscal Year 1990. It enrolls providers of services
under the Medical Assistance Program, assists them
with prompt and accurate reimbursement of claims,
addresses provider problems, and answers their in-
quiries.