Provider News & Notices

At Jai Medical Systems, keeping our providers informed is our top priority.

Dear Provider,
I hope you are enjoying the start of spring and the brighter days ahead. On an annual basis, Jai Medical Systems conducts a Provider Satisfaction Survey to assess overall provider satisfaction within our network and improve the services and benefits we offer.

Our Satisfaction Survey requests provider feedback on various aspects of our performance, including Customer Service, Provider Relations, Credentialing, Claims processing, Case Management, Authorizations, and Pharmacy services. Our goal is to ensure provider satisfaction and gain valuable insights from our network providers.

According to the results of the 2025 Provider Satisfaction Survey, we achieved a 100% overall provider satisfaction rate based on responses to key statements, including:

“I am satisfied with Jai Medical Systems. ”
“I would recommend other providers to join the Jai Medical Systems network. ”

Additionally, we achieved satisfaction scores above 80% across all other survey questions, highlighting our continued commitment to delivering excellence in provider support and network performance. We sincerely appreciate the valuable feedback you have shared with us through our internal survey.

Now, we kindly ask for your support in sharing your satisfaction through the State of Maryland’s Annual Provider Survey. In the coming weeks, primary care providers participating in the HealthChoice program may receive an invitation by mail, email, or fax, to complete a satisfaction survey regarding our health plan. We would appreciate your participation in the survey and your continued willingness to share the positive feedback you have provided to us internally.

RARE & EXPENSIVE CASE MANAGEMENT PROGRAM

The Rare and Expensive Case Management (REM) Program is a voluntary Maryland Medicaid program that provides medical case management and specialized services for members with certain qualifying rare and expensive medical conditions. When a member enrolls in REM, they receive all benefits directly through Maryland Medicaid.

ELIGIBILITY REQUIREMENTS

• Be eligible for the HealthChoice program
• Have at least one qualifying rare and expensive medical condition
• Choose to enroll in the REM Program

Primary Care Providers are encouraged to discuss qualifying conditions with members. Providers and members may call our Customer Service team or our Special Needs Coordinator at 1‑888‑JAI‑1999 for more information.

REM BENEFITS INCLUDE:

• Case management services
• CNA and CNA‑CMT services
• Chiropractic care
• Home Health Aide (HHA) and HHA‑CMT services
• Nutrition counseling and supplements
• Occupational therapy
• Private duty and shift nursing
• Speech‑language pathology

Members must apply, and Maryland Medicaid must approve enrollment. Approved members are assigned a REM case manager who helps transition coverage and develop an individualized care plan. For more information or to apply, contact the REM Program at 1-800‑565‐8190.

STATIN MEDICATION SUPPORT PROGRAM

Jai Medical Systems has launched a Population Health Management program to help manage emerging cardiovascular risk among members who have experienced recent cardiovascular events. This initiative supports consistent statin use as part of secondary prevention and includes incentives to encourage medication compliance, while complementing provider‑led clinical care. Providers who believe their patient may benefit from this program are encouraged to contact Jai Medical Systems.

Colorectal Cancer Screening

The U.S. Preventive Services Task Force recommends colorectal cancer screenings for all patients beginning at age 45. There are many ways that this requirement can be satisfied beyond the traditional colonoscopy, such as Cologuard, ColoFIT, and FOBT. Jai Medical Systems is also offering members a $25 Healthy Rewards gift card when they complete a screening during 2026. Members can claim their gift card on the Jai Medical Systems’ website at www.jaimedicalsystems.com or by calling our Customer Service Department at 1-888-JAI-1999.

PROVIDER ENROLLMENT PORTAL TRANSITION

Maryland Medicaid is transitioning from the ePREP enrollment system to a new platform called MPRIME, scheduled to launch in October 2026. In preparation for this transition, an application hold will take place for Maryland Medicaid. Providers with revalidations originally scheduled between July and October 2026 will receive early revalidation notices beginning in February, ensuring they have 90 days to complete the process before the hold begins. Maryland Medicaid has released an FAQ to address provider questions. In addition, they have created a dedicated email, mdh.mprimegolive@maryland.gov, for all MPRIME-related inquiries, and providers are encouraged to check the FAQ before submitting questions. Additional training and guidance will be shared as the October go‑live date approaches. If you have any questions, please contact our Provider Relations Department at 1-888-JAI-1999.

PRENATAL & POSTPARTUM CARE

We would like to encourage our providers to notify us as soon as they become aware that a patient is pregnant. Early notification allows us to promptly enroll the member in our comprehensive case management program, ensuring timely support, education, and care coordination throughout the pregnancy. Please note that pregnant members are not required to pay a pharmacy co‑pay. Additionally, Jai Medical Systems can assist your patients in accessing home visiting services or doula support, if desired. We also offer an enhanced case management program for pregnant members with a co‑occurring substance use disorder (SUD) to ensure they receive specialized, coordinated care. Providers may contact our Customer Service team at 1-888-JAI-1999 to report a member’s pregnancy or request assistance for a pregnant member.

COVERAGE UPDATES: CONTINUOUS GLUCOSE MONITORING SYSTEMS

Maryland Medicaid has updated and expanded its coverage of medically necessary continuous glucose monitoring (CGM) systems effective January 1, 2026. Coverage now includes member with Type 1 or Type 2 diabetes who use insulin, those with gestational diabetes, and individuals experiencing problematic hypoglycemia. To qualify, members must have a diabetes diagnosis, proper training from their practitioner, an FDA‑indicated prescription, and either be insulin‑treated or have documented severe hypoglycemic events. Providers must evaluate diabetes control within six months prior to ordering a CGM. Telligen, the Department’s utilization control agent will continue to preauthorize durable medical equipment, including CGMs. For a list of the Medicaid DME/DMS/Oxygen Approved Items, please visit the Division of Community Support Services website at https://health.maryland.gov/mmcp/communitysupport/pages/Home.aspx. If you have any questions, please contact our Provider Relations Department at 1-888-JAI-1999