Baltimore 410-987-1048

Washington 301-621-7830

 

The REM Program

The REM Program is for individuals participating in Maryland Medical Assistance.The purpose of the program is to provide the integrated coordination of services for people with specialized health care needs. For purposes of the program, these needs have been defined as rare in occurrence and expensive to treat.

Population Served

Individuals who may be eligible have:

  • Specialized health care needs that meet the designated criteria for the program
  • Health care needs that exceed the scope of services provided by Medicaid managed care organizations
  • Medicaid eligibility

There is no age limitation. However, some diagnoses may include projected age limitations that are reflected in the definitions for program eligibility.  Thus, some individuals may age out of the program and others may not, depending on the diagnostic criteria.

Covered Services

In addition to receiving care coordination, which is provided by The Coordinating Center and other companies, participating individuals have eligibility for all Medicaid plan covered services as well as an array of optional services, all of which must be preauthorized.

Basic services under the state plan include medically necessary:

  • Physician visits
  • Inpatient hospital services
  • Pharmacy
  • Home health services
  • Radiology and lab services
  • Durable medical equipment
  • Disposable medical supplies
  • Therapies, including PT/OT/SL/Assistive Technology

Possible optional services may include medically necessary:

  • Private duty nursing and nursing assistance
  • Nutritional supplements
  • Dental care

Referral, Eligibility and Planning

  • Anyone can refer an individual for the program. Many individuals are referred by Medicaid managed care organizations when they identify individuals whose needs are outside the scope of service and therefore meet the REM diagnostic criteria.
  • Referrals are accepted by the REM Intake Unit at DHMH.