DHS Eliminates MA Provider Enrollment Backlog

DHS Eliminates MA Provider Enrollment Backlog

Message From the Department of Human Services
June 8, 2023

Harrisburg, PA — The Shapiro Administration today announced it has completely eliminated a backlog of Medicaid provider enrollment and revalidation applications, paving the way for more health care providers to become part of the Medicaid program, and giving Medicaid recipients more options for care. This announcement follows news in late April that the Department of Human Services (DHS) had already reduced the provider backlog by 75 percent within Governor Shapiro’s first 100 days in office.

As of January 2023, there was a backlog of more than 35,000 provider applications and revalidation applications that were more than 30 days old. Within the first 100 days of the Administration, the number of waiting applicants was reduced by 75 percent to under 8,500 applications, and that backlog has now been entirely eliminated.

“Pennsylvania is fortunate to have so many caring, high-quality health care providers and professionals who want to be part of the Medicaid program and care for some of our most vulnerable friends, neighbors, and loved ones,” said DHS Acting Secretary Dr. Val Arkoosh. “I want to thank them and DHS staff who worked so diligently on this issue. They have helped to ensure that Medicaid recipients in the Commonwealth can continue to get the care they need and deserve.”

By federal law, organizations are not able to offer care to patients under the Medicaid program unless they are enrolled providers. In addition, DHS must revalidate Medicaid service providers every five years. Any backlogs in processing applications means that providers who want to offer services to Medicaid recipients cannot do so until their applications are approved.

The Medicaid program in Pennsylvania serves more than 3.7 million people, including children, seniors, and people with disabilities. Recognizing the scope of the backlog and its impact on Pennsylvanians, the Shapiro Administration and DHS staff and leadership acted quickly to address it, removing roadblocks to processing applications quickly and cutting red tape.

Read the full announcement here. If a member has not been notified of the status of a pending enrollment or revalidation, please contact your RCPA Policy Director.