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DHS COVID-19 PROVIDER RESOURCES // OMAP

CHIP Policy Clarification 2020-06: 
Temporary Suspension of the PRV720
Provider Revalidation Files

Issued: April 9, 2020

Purpose

To inform CHIP Managed Care Organizations (MCOs), that effective immediately, the PRV720 Provider Revalidation File will be suspended and providers who have not completed their revalidation will not be terminated.

Background

On March 6, 2020, Governor Wolf issued an emergency disaster declaration in response to the presence of the COVID-19 (coronavirus) in Pennsylvania. COVID-19 was declared a national emergency under the Stafford Act on March 13, 2020, and a nationwide public health emergency on January 31, 2020 (retroactive to January 27, 2020). 

Discussion

Pursuant to this disaster declaration, the Department of Human Services (DHS) is issuing guidance to advise MCOs to accept and process claims from providers who have not completed their revalidation in the PA Medicaid or CHIP program. 

The PRV720 Provider Revalidation file (PRV720M.XX.zip) is sent the 1st of each month to all MCOs and provides the upcoming revalidation dates for all providers/service locations. Because of the COVID-19 pandemic emergency, DHS is no longer terminating providers who haven’t completed their revalidation. Many MCOs systematically load this file into their upfront validations and claims processing systems as well as use the information to assist DHS in informing providers of the revalidation process. DHS does not want to create additional confusion by providing these revalidation dates since the Department is suspending the termination of providers based on the lack of revalidation. 

Until further notice, this file will not be provided. 

Information on CHIP coverage related to COVID-19, including an FAQ document can be found on the CHIP website. 

Additional information is also available on the CDC website and through CMS

The Pennsylvania Department of Health has a dedicated page for COVID-19 that provides regular updates. Click here for the most up to date information regarding COVID-19. 

Next Steps

    1. Review the information in this policy clarification with appropriate staff. 
    2. Implement this policy clarification immediately. 
    3. This policy clarification will remain in effect while a valid disaster declaration authorized by the Governor related to the COVID-19 virus remains in effect. The OOC may re-issue this policy clarification as appropriate.
    4. Questions concerning the PRV720 Monthly Provider Revalidation file should be directed to provider@pa.gov.
    5. Questions concerning this transmittal should be directed to Virginia Perry at (717) 772- 1110 or via email at virperry@pa.gov