Priority Partners is owned by Johns Hopkins Health Plans and the Maryland Community Health System. The NCQA suspended Priority Partners’ accreditation on Feb. 19 over “quality-related concerns,” leading the Maryland Department of Health to sanction the MCO on Feb 28.
The sanctions do not change coverage, benefits, or access to care for the more than 300,000 individuals who receive Medicaid benefits from Priority Partners, but enrollees can switch to another Medicaid plan starting March 17.
The sanctions will remain in place until the health plan accreditation suspension is lifted by NCQA. Priority Partners is working with the organization on a corrective action plan to address the issues.
“We are working closely with our regulators to address a self-reported issue at Priority Partners, which has resulted in suspension of our accreditation pending resurvey. We take this matter very seriously,” a spokesperson for the MCO told Becker’s. “The issue in question does not reflect our commitment to ensure our members have access to the highest quality providers. Our priority remains the health and well-being of our members, and we are dedicated to upholding the standards of excellence that they expect from us.”
In 2024, the Maryland Department of Health told local media that it would drop Kaiser Permanente as a Medicaid MCO in 2025 after “lengthy contract negotiations,” though the state quickly reversed course.
