DHS COVID-19 PROVIDER RESOURCES // OMAP
Provider Quick Tips #246: Rescinding Prior Guidance on Elective Services
Issued: May 7, 2020
On March 26, 2020, the Office of Medical Assistance Programs (OMAP) issued a provider quick tip that
elective services should not be provided during the COVID-19 emergency disaster and described the
manner in which requests for authorization of elective services would be reviewed. This guidance was
based on Governor Wolf’s and Secretary of Health Dr. Rachel Levine’s executive orders which prohibit
elective medical and surgical procedures from being performed in Pennsylvania during the duration of
the COVID-19 emergency.
On April 27, 2020, the Department of Health (DOH) issued updated guidance for hospitals and ambulatory surgical facilities regarding elective procedures. Based on the updated guidance from DOH, the Office of
Medical Assistance Programs (OMAP) rescinds the guidance on elective services issued on March 26,
As of April 27, 2020, Medical Assistance (MA) Fee-for-Service authorization requests for inpatient and
outpatient elective procedures, elective interventional radiology and dental procedures will be reviewed and
authorizations issued if the service is medically necessary. Prior authorization changes outlined in Quick Tip #241 remain in effect.
All procedures reviewed from March 26-April 27, 2020 that were determined to be elective and were
approved other than as requested with a start date of July 1, 2020, will be changed to reflect an effective
date of April 27, 2020. Updated notices will be sent to the provider, recipient and prescriber indicating the
new effective begin date of the elective procedure.
Additional guidance will be issued for CHIP and the MA managed care programs.
Providers should continue to check the Department of Human Service’s COVID-19 website and the
Department of Health’s website for updates.
For elective inpatient, outpatient and radiology authorization questions, please contact 1-800-537-
8862, option 2, option 3, option 1.
For dental questions regarding this information please contact 1-800-537-8862, option 2, option 6,