DHS Reorganizes

The Pennsylvania Department of Human Services (DHS), which administers the state’s Medicaid program, has reorganized both the department as a whole and its Office of Medical Assistance Programs.
Pennsylvania_Bulletin_logoNew tables of organizations for both entities have been published in the Pennsylvania Bulletin. Find them here.

2015-09-01T06:00:43+00:00September 1st, 2015|Pennsylvania Bulletin|Comments Off on DHS Reorganizes

PA Seeks to Modernize, Improve Medicaid Program Integrity

The Pennsylvania Department of Human Services (DHS) has announced new steps to enhance its program integrity efforts and reduce improper and fraudulent payments, including Medicaid payments.
The proposed new approach will rely heavily on automation, analytics, and technology. Major changes include:

  • pa dhsConsolidation of the Office of Program Integrity and Bureau of Program Integrity
  • Issuing a request for information for program integrity data analysis of provider payments
  • Implementation of a customer portal for third-party liability
  • Implementation of “identity proofing” of program recipients
  • Automating provider enrollment
  • Eliminating manual updating of milestone changes

In the state’s 2015 fiscal year it prevented nearly $600 million in improper payments, 74 percent of which were potential provider payments.
For a closer look at the state’s plans, see this DHS news release.

2015-08-07T06:00:01+00:00August 7th, 2015|Pennsylvania Medicaid policy|Comments Off on PA Seeks to Modernize, Improve Medicaid Program Integrity

PA Moves to Streamline Medicaid Provider Enrollment

In response to the challenges the state has encountered processing Medicaid provider enrollment applications, the Pennsylvania Department of Human Services (DHS) has unveiled what it believes will be an improved approach to tackling this problem.
The improvements include electronic enrollment, standardization of policies and procedures, and additional provider enrollment staffing.
At the heart of the backlog are Affordable Care Act requirements.
Go here to see a message from DHS acting secretary Theodore Dallas on this subject.

2015-04-23T06:00:08+00:00April 23rd, 2015|Affordable Care Act, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Moves to Streamline Medicaid Provider Enrollment

Introducing…The Pennsylvania Department of Human Services

The Pennsylvania Department of Public Welfare is no more.
The state executive branch agency whose Office of Medical Assistance Programs has overseen Pennsylvania’s Medicaid program since its inception has officially been renamed the Department of Human Services.
The legislation requiring the name change takes effect in November and the department will phase-in its new name over time.
Read the press release from the governor’s office announcing the name change here.

2014-09-25T06:00:40+00:00September 25th, 2014|Uncategorized|Comments Off on Introducing…The Pennsylvania Department of Human Services
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