What's New
08/14/2020
Added Remittance Advice Dates - September 2020 Remittance Advice Dates
Added Provider Quick Tip - The following Quick Tip has been added to the website.
08/12/2020
Added Remittance Advice Alerts - The following Remittance Advice Alert/PROMISe™ Banner pages have been added to the website.
07/29/2020
Added Provider Quick Tip - The following Quick Tip has been added to the website.
07/24/2020
Added Managed Care Enrollment Information.
07/17/2020
Added Remittance Advice Dates - August 2020 Remittance Advice Dates
Added Medical Assistance Advisory Committee Meeting minutes, agenda, and attachments - The June 2020 MAAC Webinar Audience Questions have been posted and can be accessed from the Meeting Minutes archives page.
07/08/2020
Added Webinar Registration Links for Medical Assistance Advisory Committee Meeting - The MAAC meeting will be held on July 23, 2020 10:00AM EDT - Register here.
Added Webinar Registration Links for Consumer Subcommittee Meeting agenda and attachment - The Consumer Subcommittee meeting will be held on July 22, 2020 1:00PM EDT - Register here.
07/02/2020
Added MA Bulletin numbered:
07/01/2020
Added the Third Quarter 2020 edition of the MMIS 2020 Platform Newsletter
06/26/2020
Added Remittance Advice Alerts - The following Remittance Advice Alert/PROMISe™ Banner pages have been added to the website.
06/24/2020
Added Provider Quick Tip - The following Quick Tip has been added to the website.
Added MA Bulletin numbered:
06/18/2020
Added MA Bulletin numbered:
06/16/2020
Provider's ordering MA Provider Forms Electronically
06/15/2020
Added the updated Pennsylvania Medicaid Managed Care Organization Directory.
06/12/2020
Added MA Bulletin numbered:
06/11/2020
Added MA Bulletin numbered:
05/27/2020
Added MA Bulletin numbered:
05/26/2020
Updated Provider Quick Tip - The following Quick Tip has been added to the website.
Added MA Bulletin numbered:
05/20/2020
Added MA Bulletin numbered:
05/19/2020
Added Provider Quick Tip - The following Quick Tip has been added to the website.
05/08/2020
Added Provider Quick Tip - The following Quick Tip has been added to the website.
05/07/2020
Added Provider Quick Tip - The following Quick Tip has been added to the website.
05/01/2020
Added MA Bulletin numbered:
04/30/2020
Added Provider Quick Tip - The following Quick Tip has been added to the website.
04/17/2020
Added Provider Quick Tip - The following Quick Tip has been added to the website.
04/16/2020
Added Provider Quick Tip - The following Quick Tip has been added to the website.
04/09/2020
Added Provider Quick Tip - The following Quick Tip has been added to the website.
04/07/2020
Added Provider Quick Tip - The following Quick Tip has been added to the website.
04/03/2020
Added Provider Quick Tip - The following Quick Tip has been added to the website.
04/01/2020
Added the Second Quarter 2020 edition of the MMIS 2020 Platform Newsletter
01/28/2020
Added the First Quarter 2020 edition of the MMIS 2020 Platform Newsletter
12/31/2019
Added MA Bulletin numbered:
12/10/2019
Added MA Bulletin numbered:
12/06/2019
Added MA Bulletin numbered:
11/07/2019
Added the Four Quarter 2019 edition of the MMIS 2020 Platform Newsletter
Added MA Bulletin numbered:
- 01-19-29 A Medical Assistance Bulletin entitled Prior Authorization of Vitamin D Analogs – Pharmacy Services
- 01-19-41 A Medical Assistance Bulletin entitled Prior Authorization of Thrombopoietics – Pharmacy Services
- 01-19-31 A Medical Assistance Bulletin entitled Prior Authorization of Urinary Anti-Infectives – Pharmacy Services
- 99-19-06 A Medical Assistance Bulletin entitled Corrected - Diabetes Prevention Program Enrollment in the Medical Assistance Program
- 01-19-13 A Medical Assistance Bulletin entitled Family Planning Services Program
- 01-19-51 A Medical Assistance Bulletin entitled Prior Authorization of Antihistamines, Minimally Sedating – Pharmacy Services
- 01-19-50 A Medical Assistance Bulletin entitled Prior Authorization of Antihyperuricemics – Pharmacy Services
- 01-19-52 A Medical Assistance Bulletin entitled Prior Authorization of Antihemophilia Agents – Pharmacy Services
- 01-19-62 A Medical Assistance Bulletin entitled Prior Authorization of Intranasal Rhinitis Agents – Pharmacy Services
- 01-19-49 A Medical Assistance Bulletin entitled Prior Authorization of Bronchodilators, Beta Agonists – Pharmacy Services
- 01-19-53 A Medical Assistance Bulletin entitled Prior Authorization of Anticoagulants – Pharmacy Services
- 01-19-58 A Medical Assistance Bulletin entitled Prior Authorization of GI Motility, Chronic Agents – Pharmacy Services
- 01-19-54 A Medical Assistance Bulletin entitled Prior Authorization of Estrogens – Pharmacy Services
- 01-19-59 A Medical Assistance Bulletin entitled Prior Authorization of Oncology Agents, Breast Cancer – Pharmacy Services
- 01-19-61 A Medical Assistance Bulletin entitled Prior Authorization of Iron Chelating Agents – Pharmacy Services
- 01-19-60 A Medical Assistance Bulletin entitled Prior Authorization of Multiple Sclerosis Agents – Pharmacy Services
- 01-19-55 A Medical Assistance Bulletin entitled Prior Authorization of Sedative Hypnotics – Pharmacy Services
- 01-19-57 A Medical Assistance Bulletin entitled Prior Authorization of Urea Cycle Disorder Agents – Pharmacy Services
- 01-19-48 A Medical Assistance Bulletin entitled Prior Authorization of Ulcerative Colitis Agents – Pharmacy Services
- 01-19-56 A Medical Assistance Bulletin entitled Prior Authorization of Ophthalmics, Anti-Inflammatories – Pharmacy Services
- 01-19-64 A Medical Assistance Bulletin entitled Prior Authorization of Stimulants and Related Agents – Pharmacy Services
- 01-19-47 A Medical Assistance Bulletin entitled Prior Authorization of Potassium Removing Agents – Pharmacy Services
- 01-19-63 A Medical Assistance Bulletin entitled Prior Authorization of Hypoglycemics, Meglitinides – Pharmacy Services
- 35-19-01 A Medical Assistance Bulletin entitled School-Based ACCESS Program Provider Handbook
- 01-19-21 A Medical Assistance Bulletin entitled Updates to Sterilization Consent Form (MA 31)
- 01-19-65 A Medical Assistance Bulletin entitled Statewide Preferred Drug List (PDL) Implementation – Pharmacy Services
- 01-19-79 A Medical Assistance Bulletin entitled Prior Authorization of Glucocorticoids, Inhaled – Pharmacy Services
- 01-19-94 A Medical Assistance Bulletin entitled Prior Authorization of Antimigraine Agents, Triptans – Pharmacy Services
- 01-19-84 A Medical Assistance Bulletin entitled Prior Authorization of Blood Glucose Meters and Test Strips (Formerly Diabetic Meters and Diabetic Strips) – Pharmacy Services
- 01-19-86 A Medical Assistance Bulletin entitled Prior Authorization of Anticonvulsants – Pharmacy Services
- 01-19-83 A Medical Assistance Bulletin entitled Prior Authorization of Fluoroquinolones, Oral – Pharmacy Services
- 01-19-97 A Medical Assistance Bulletin entitled Prior Authorization of BPH Treatments – Pharmacy Services
- 01-19-82 A Medical Assistance Bulletin entitled Prior Authorization of Antifungals, Oral – Pharmacy Services
- 01-19-85 A Medical Assistance Bulletin entitled Prior Authorization of Antidepressants, SSRIs – Pharmacy Services
- 01-19-87 A Medical Assistance Bulletin entitled Prior Authorization of Acne Agents, Topical – Pharmacy Services
- 01-19-88 A Medical Assistance Bulletin entitled Prior Authorization of Antiemetic/Antivertigo Agents – Pharmacy Services
- 01-19-96 A Medical Assistance Bulletin entitled Prior Authorization of Histamine 2 (H2) Receptor Blockers – Pharmacy Services
- 01-19-78 A Medical Assistance Bulletin entitled Prior Authorization of Growth Factors – Pharmacy Services
- 01-19-76 A Medical Assistance Bulletin entitled Prior Authorization of Immunosuppressives, Oral – Pharmacy Services
- 01-19-81 A Medical Assistance Bulletin entitled Prior Authorization of Intra-Articular Hyaluronates – Pharmacy Services
- 01-19-77 A Medical Assistance Bulletin entitled Prior Authorization of Idiopathic Pulmonary Fibrosis (IPF) Agents – Pharmacy Services
- 01-19-72 A Medical Assistance Bulletin entitled Prior Authorization of Ophthalmics, Allergic Conjunctivitis (Formerly Ophthalmic Agents for Allergic Conjunctivitis) – Pharmacy Services
- 01-19-68 A Medical Assistance Bulletin entitled Prior Authorization of Ophthalmics, Immunomodulators (Formerly Ophthalmic Immunomodulators) – Pharmacy Services
- 01-19-74 A Medical Assistance Bulletin entitled Prior Authorization of Macrolides (Formerly Macrolides/Ketolides) – Pharmacy Services
- 01-19-75 A Medical Assistance Bulletin entitled Prior Authorization of Ophthalmics, Glaucoma (Formerly Ophthalmic Agents for Glaucoma) – Pharmacy Services
- 01-19-67 A Medical Assistance Bulletin entitled Prior Authorization of Opioid Overdose Agents (Formerly Opiate Overdose Agents) – Pharmacy Services
- 01-19-71 A Medical Assistance Bulletin entitled Prior Authorization of Ophthalmics, Antibiotics (Formerly Ophthalmic Antibiotics) – Pharmacy Services
- 01-19-95 A Medical Assistance Bulletin entitled Prior Authorization of Iron, Oral - Pharmacy Services
- 01-19-80 A Medical Assistance Bulletin entitled Prior Authorization of Iron, Parenteral – Pharmacy Services
- 01-19-70 A Medical Assistance Bulletin entitled Prior Authorization of Ophthalmics, Antibiotic-Steroid Combinations (Formerly Ophthalmic Antibiotic-Steroid Combinations) – Pharmacy Services
- 01-19-73 A Medical Assistance Bulletin entitled Prior Authorization of Neuropathic Pain Agents – Pharmacy Services
- 01-19-66 A Medical Assistance Bulletin entitled Prior Authorization of Otic Antibiotics (Formerly Otic Antibiotic Preparations) – Pharmacy Services
- 01-19-93 A Medical Assistance Bulletin entitled Prior Authorization of Proton Pump Inhibitors (PPIs) - Pharmacy Services
- 01-19-92 A Medical Assistance Bulletin entitled Prior Authorization of Prenatal Vitamins – Pharmacy Services
- 27-19-17 A Medical Assistance Bulletin entitled Medical Assistance Program Dental Fee Schedule and Dental Provider Handbook Update
- 01-19-90 A Medical Assistance Bulletin entitled Prior Authorization of Steroids, Topical (Formerly Steroids, Topical Low; Steroids, Topical Medium;Steroids, Topical High; and Steroids, Topical Very High) – Pharmacy Services
- 01-19-91 A Medical Assistance Bulletin entitled Prior Authorization of Tetracyclines – Pharmacy Services
- 01-19-89 A Medical Assistance Bulletin entitled Prior Authorization of Skeletal Muscle Relaxants – Pharmacy Services
- 01-19-69 A Medical Assistance Bulletin entitled Prior Authorization of Pancreatic Enzymes – Pharmacy Services
- OMHSAS-19-03 A Medical Assistance Bulletin entitled Guidelines for Implementing Assisted Outpatient Treatment
Added Remittance Advice Alerts - The following Remittance Advice Alert/PROMISe™ Banner pages have been added to the website.
Added Remittance Advice Dates
Added Provider Quick Tip - The following Quick Tip has been added to the website.
Added Managed Care Delivery System Subcommittee agenda, draft file note and attachment - The September 2019 Managed Care Delivery System Subcommittee agenda and July 2019 draft file note and attachment have been posted and can be accessed from the Meeting Minutes archives page
Added Managed Care Delivery System Subcommittee agenda, draft file note and attachment - The October 2019 Managed Care Delivery System Subcommittee agenda and September 2019 draft file note and attachment have been posted and can be accessed from the Meeting Minutes archives page
Added the Fee-for-Service Subcommittee Meeting minutes - The August 2019 Fee-for-Service Subcommittee minutes have been posted and can be accessed from the Meeting Minutes archives page.
Added the updated Pennsylvania Medicaid Managed Care Organization Directory
11/01/19
Added the Second Quarter 2019 edition of the MMIS 2020 Platform Newsletter
Added the Third Quarter 2019 edition of the MMIS 2020 Platform Newsletter
Added the Fourth Quarter 2019 edition of the MMIS 2020 Platform Newsletter
Added MA Bulletin numbered:
- 00-19-03 A Medical Assistance Bulletin entitled Prioritization of Urgency of Need for Services (PUNS) Manual
- OMHSAS-19-02 A Medical Assistance Bulletin entitled Service Location Enrollment for Behavioral Health Providers
- 01-19-37 A Medical Assistance Bulletin entitled Prior Authorization of Antimigraine Agents, Other - Pharmacy Services
- 01-19-34 A Medical Assistance Bulletin entitled Prior Authorization of Acne Agents, Oral - Pharmacy Services
- 01-19-39 A Medical Assistance Bulletin entitled Prior Authorization of Antianginal Agents - Pharmacy Services
- 01-19-38 A Medical Assistance Bulletin entitled Prior Authorization of Antimalarials - Pharmacy Services
- 01-19-40 A Medical Assistance Bulletin entitled Prior Authorization of Angiotensin Modulators - Pharmacy Services
- 00-19-12 A Medical Assistance Bulletin entitled Notification Protocol for Formal Licensing Actions and Incidents
- OMHSAS-19-03 A Medical Assistance Bulletin entitled Serious Mental Illness: Adult Priority Group
- 01-19-27 A Medical Assistance Bulletin entitled Prior Authorization of Colony Stimulating Factors - Pharmacy Services
- 01-19-22 A Medical Assistance Bulletin entitled Prior Authorization of Thalidomide and Derivatives - Pharmacy Services
- 01-19-26 A Medical Assistance Bulletin entitled Prior Authorization of HIV/AIDS Antiretrovirals - Pharmacy Services
- 01-19-24 A Medical Assistance Bulletin entitled Prior Authorization of Monoclonal Antibodies - Anti-IL, Anti-lgE (MABs - Anti-IL, anti-IgE) - Pharmacy Services
- 01-19-28 A Medical Assistance Bulletin entitled Prior Authorization of Cephalosporins - Pharmacy Services
- 01-19-25 A Medical Assistance Bulletin entitled Prior Authorization of Local Anesthetics, Topical - Pharmacy Services
- 01-19-23 A Medical Assistance Bulletin entitled Prior Authorization of Penicillins - Pharmacy Services
- 99-19-02 A Medical Assistance Bulletin entitled Pennsylvania's Early and Periodic screening, Diagnosis and Treatment (EPSDT) Program Periodicity Schedule
- 99-19-04 A Medical Assistance Bulletin entitled 2019 Healthcare Common Procedure Coding System(HCPCS) Updates, Fee Adjustments and Other Procedure Code Changes
- 01-19-32 A Medical Assistance Bulletin entitled Prior Authorization of Bone Density Regulators - Pharmacy Services
- 01-19-35 A Medical Assistance Bulletin entitled Prior Authorization of Antivirals, Herpes - Pharmacy Services
- 01-19-44 A Medical Assistance Bulletin entitled Prior Authorization of H. Pylori Treatments - Pharmacy Services
- 01-19-36 A Medical Assistance Bulletin entitled Prior Authorization of Antivirals, CMV - Pharmacy Services
- 01-19-33 A Medical Assistance Bulletin entitled Prior Authorization of Antivirals, influenza - Pharmacy Services
- 01-19-42 A Medical Assistance Bulletin entitled Prior Authorization of COPD Agents - Pharmacy Services
- 01-19-43 A Medical Assistance Bulletin entitled Prior Authorization of Antipsychotics - Pharmacy Services
- 01-19-30 A Medical Assistance Bulletin entitled Prior Authorization of Vaginal Anti-infectives - Pharmacy
7/18/19
Added MA Bulletin numbered:
Added Remittance Advice Alerts - The following Remittance Advice Alert/PROMISe™ Banner pages have been added to the website.
Added Remittance Advice Dates
Added Managed Care Delivery System Subcommittee Meeting Agenda and Draft File Note - the July 2019 Managed Care Delivery System Subcommittee Agenda and Draft File Note have been posted and can be accessed from the Meeting Minutes archives page
6/20/19
Added Provider Quick Tip - The following Quick Tip has been added to the website.
Added Medical Assistance Advisory Committee Meeting minutes - The May 2019 Medical Assistance Advisory Committee minutes have been posted and can be accessed from the Meeting Minutes archives page.
Added Managed Care Delivery System Subcommittee agenda and draft file note - The June 2019 Managed Care Delivery System Subcommittee agenda and May 2019 draft file note have been posted and can be accessed from the Meeting Minutes archives page.
Added the updated Pennsylvania Medicaid Managed Care Organization Directory.
5/23/19
Added Provider Quick Tip - The following Quick Tip has been added to the website.
Added Medical Assistance Advisory Committee Meeting agenda, minutes and attachments - The May 2019 Medical Assistance Advisory Committee agenda and April 2019 minutes and attachments have been posted and can be accessed from the Meeting Minutes archives page.
Added Managed Care Delivery System Subcommittee agenda and draft file note - The May 2019 Managed Care Delivery System Subcommittee agenda and April 2019 draft file note have been posted and can be accessed from the Meeting Minutes archives page.
Added the Fee-for-Service Subcommittee Meeting minutes - The May 2019 Fee-for-Service Subcommittee minutes have been posted and can be accessed from the Meeting Minutes archives page.
Added Pharmacy and Therapeutics Committee Meeting minutes - The November 2018 Pharmacy and Therapeutic Committee Meeting minutes have been posted and can be accessed from the Meeting Minutes archives page.
4/25/19
Added MA Bulletin numbered:
Added Remittance Advice Alerts - The following Remittance Advice Alert/PROMISe™ Banner pages have been added to the website.
Added Medical Assistance Advisory Committee Meeting agenda, minutes and attachments - The April 2019 Medical Assistance Advisory Committee agenda and March 2019 minutes and attachments have been posted and can be accessed from the Meeting Minutes archives page.
4/11/19
Added MA Bulletin numbered:
Added Remittance Advice Alert - The following Remittance Advice Alert/PROMISe™ Banner page has been added to the website.
Added Provider Quick Tip - The following Quick Tip has been added to the website.
Added Managed Care Delivery System Subcommittee agenda and draft file note - The April 2019 Managed Care Delivery System Subcommittee agenda and March 2019 draft file note have been posted and can be accessed from the Meeting Minutes archives page.
Added the updated Pennsylvania Medicaid Managed Care Organization Directory.
3/28/19
Added Remittance Advice Alert - The following Remittance Advice Alert/PROMISe™ Banner page has been added to the website.
Added Medical Assistance Advisory Committee Meeting minutes, agenda, and attachments - The December 2018 and January and February 2019 Medical Assistance Advisory Committee minutes and March 2019 agenda and attachments have been posted and can be accessed from the Meeting Minutes archives page.
Added Consumer Subcommittee Meeting agenda and attachment - The March 2019 Consumer Subcommittee agenda and attachment have been posted and can be accessed from the Meeting Minutes archives page.
Added Drug Utilization Review Board minutes - The September 2018 Drug Utilization Review Board minutes have been posted and can be accessed from the Meeting Minutes archives page.
3/14/19
Added MA Bulletin numbered:
Added Provider Quick Tip - The following Quick Tip has been added to the website.
Added the updated Pennsylvania Medicaid Managed Care Organization Directory.
Added Managed Care Delivery System Subcommittee agenda, draft file note and attachment - The March 2019 Managed Care Delivery System Subcommittee agenda and February 2019 draft file note and attachment have been posted and can be accessed from the Meeting Minutes archives page.
2/28/19
Added Remittance Advice Alert - The following Remittance Advice Alert/PROMISe™ Banner page has been added to the website.
Added Provider Quick Tips - The following Quick Tips have been added to the website.
Added Medical Assistance Advisory Committee Meeting agenda - The February 2019 Medical Assistance Advisory Committee agenda has been posted and can be accessed from the Meeting Minutes archives page.
Added the Fee-for-Service Subcommittee Meeting minutes - The February 2019 Fee-for-Service Subcommittee minutes have been posted and can be accessed from the Meeting Minutes archives page.
Added Managed Care Delivery System Subcommittee agenda and draft file note - The February 2019 Managed Care Delivery System Subcommittee agenda and January 2019 draft file note have been posted and can be accessed from the Meeting Minutes archives page.
1/31/19
Added Remittance Advice Alert - The following Remittance Advice Alert/PROMISe™ Banner page has been added to the website.
Added Provider Quick Tips - The following Quick Tips have been added to the website.
Added Medical Assistance Advisory Committee Meeting agenda and attachments - The January 2019 Medical Assistance Advisory Committee agenda and attachments have been posted and can be accessed from the Meeting Minutes archives page.
Added the updated Pennsylvania Medicaid Managed Care Organization Directory.
1/22/19
Added MA Bulletins numbered:
Added Managed Care Delivery System Subcommittee agenda and draft file note - The January 2019 Managed Care Delivery System Subcommittee agenda and December 2018 draft file note have been posted and can be accessed from the Meeting Minutes archives page.
Added the first quarter 2019 edition of the MMIS 2020 Platform Newsletter.
1/3/19
Added MA Bulletins numbered:
Added Remittance Advice Alert - The following Remittance Advice Alert/PROMISe™ Banner page has been added to the website.