The Maryland Department of Health and Mental Hygiene (DHMH), through the Office of Health Services (OHS), strives to ensure that Medicaid recipients receive health services that are medically necessary, provided in the appropriate clinical setting, and rendered in accordance with published national standards. At the same time, DHMH must be constantly vigilant about the fiscal impact of Medicaid expenditures on the State of Maryland’s budget.
At Delmarva Foundation, we understand the daily challenges and pressures faced by DHMH to meet recipients’ and providers’ ever-increasing expectations in a difficult economic environment. We have experience as Medicare’s federally-designated QIO and expertise in quality improvement, UR, and the identification of fraud, waste, and abuse. We have also worked with more than 13 state Medicaid agencies.