Baltimore council committee probes rapid growth, fraud concerns in psychiatric rehabilitation programs

Baltimore City Council's Public Health and Environment Committee held an oversight hearing on psychiatric rehabilitation programs (PRPs), during which Maryland Department of Health officials described rapid growth in PRPs concentrated in parts of Baltimore and said the state has paused new Medicaid enrollments for certain behavioral service providers while it investigates licensing, billing and quality concerns.

The pause on new Medicaid provider enrollment, which began in July and covers PRPs and several substance-use outpatient program types, followed departmental reviews that flagged clustering of provider sites in Baltimore, potential multiple-site billing by the same staff and a subset of Medicaid payments the department identified as retractable. Deputy Secretary Alyssa Lord told the committee the state is convening data and regulatory workgroups to refine licensure and oversight.

PRPs are community-based programs that provide rehabilitation and recovery supports, often billed monthly through Maryland's behavioral health administrative services organization (ASO). Officials said PRP growth has been especially heavy in Baltimore City: the department's geospatial analysis identified roughly 241 PRP sites in the city, about 35% of the statewide total, and indicated multiple PRP locations sometimes clustered on the same block.

"PRP or psychiatric rehabilitation programs are accreditation based ... programs that provide community based comprehensive rehabilitation and recovery services and supports and promote successful community integration and the use of community resources," Deputy…