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DHS COVID-19 PROVIDER RESOURCES // OMAP

Provider Quick Tips: Waiver of Prudent Pay during COVID-19 emergency 

Issued: March 20, 2020

On March 6, 2020, Governor Wolf issued an emergency disaster declaration in response to the presence of the COVID-19 (coronavirus) in Pennsylvania. 

The Department of Human Services (Department) recognizes many providers in the Medical Assistance (MA) Program provide vital services to their recipients/patients. The Department understands organizations and agencies will need to adapt to the changing public health emergency situation and resulting economic downturn. 

Effective for claims with a Remittance Advice (RA) date of March 23, 2020 and a payment date of April 1, 2020, in the MA fee-for-service program, the Department will waive the Prudent Payment of claims process outlined in Medical Assistance Bulletin99-06-04 to ease the financial burden of MA providers. 

This will allow providers to submit claims and be paid in the next financial cycle after the claim is approved for payment. Please note all claims must still meet all other billing requirements before payment. This waiver will remain in effect while a valid disaster declaration by the Governor related to the COVID19 virus remains in effect. OMAP may re-issue these guidelines as appropriate. 

Providers should continue to check the Department’s COVID-19 website for updates. 

For questions regarding this information, please contact 1-800-537-8862, option 2, option 6, option 1.